Neither bill offering solutions to the forthcoming ACA enhanced subsidy expiration survived a Dec. 11 Senate vote.
While Senate Democrats advocated for a three-year ACA tax credit extension, Republicans pitched an alternative focusing on health savings accounts. Both motions failed in separate 51-48 votes.
The subsidies are currently set to expire at the end of the year. Earlier this fall, the Senate passed a funding bill that excluded the subsidies. A Harvard CAPS-Harris Poll reported that most voters supported ending the government shutdown without them.
Hospitals and insurers share concerns over the possible post-subsidy landscape. Health system leaders said they anticipate more uncompensated care. Payer executives told Becker’s they also expect more people — particularly healthy individuals — going uninsured, along with increased emergency visits. They also voiced worries over potential cost-shifting.
Amid the uncertainty, ACA premiums have been on the rise. A recent KFF survey showed most ACA enrollees would consider picking up extra work if healthcare costs were to increase by $1,000 per year. In October, another KFF poll found over 75% of adults supported keeping the credits.
President Donald Trump has been in favor of money being sent directly to consumers, as he outlined in a recent scathing Truth Social post against insurers. Health savings accounts may have been one means of doing so, but President Trump also reportedly considered a two-year extension before delaying the announcement, according to several news outlets.
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