Bipartisan Senate panel preparing ACA subsidies bill

A bipartisan agreement among U.S. Senate members would provide federal subsidies to lower the cost of Affordable Care Act premiums if enacted after the subsidies expired at the end of 2025.

The Senate proposal would reinstate the expired tax credits for two years and extend the open enrollment period, but with more restrictions that are designed to thwart fraud.

The proposed restrictions include limits on qualifying incomes, minimum payment amounts for premiums, cost-sharing reductions and increased access to health savings accounts.

Among senators leading the bipartisan negotiations is Bernie Moreno, R-Ohio, who said the first draft of the proposed legislation might be finalized Monday.

The draft would eliminate the $0 monthly premium option for catastrophic health insurance coverage and would limit qualifying incomes to no more than 700% of the federal poverty level, which in 2025 was $109,550 for a household of one and $225,050 for a household of four, according to the Department of Health and Human Services.

Some Senate Democrats are unhappy about the proposed elimination of no-cost premiums, which might be replaced by a $5 monthly premium.

Sen. Ron Wyden, D-Ore., called the proposed $5 monthly premium minimum a "rate hike," and Sen. Jeanne Shaheen, D-N.H., said minimum premium requirements negatively affect those at the lowest income levels and cause many to forgo health insurance coverage.

Moreno disagrees and said a $5 monthly premium "is a reasonable amount that takes the fraud out" of ACA subsidies. Senate Republican leader John Thune, R-S.D., said the minimum monthly premium is needed to ensure GOP support for the bipartisan measure.

Other concerns include the Hyde Amendment, which prohibits federal funding of abortions.

Congressional Democrats have said any abortion restrictions would cause them to oppose the measure, while Republicans say it is essential to gain their support.

Whatever the final bill might say, it will require 60 votes to be approved in the Senate and a simple majority in the House of Representatives.