WASHINGTON — Lawmakers in both the House and Senate met behind closed doors on Tuesday to discuss how to avoid a surge in health care premium costs at the end of this year when a slate of COVID-era Obamacare subsidies expire.
But there’s no plan yet. And lawmakers acknowledge they’re running out of time.
The tax subsidies in question were created in 2021 during the COVID-19 pandemic and approved in the American Rescue Plan under former President Joe Biden. The credits were given an expiration date in 2022, but that was later extended to the end of 2025 through the Inflation Reduction Act.
Conversations are ongoing in both the House and Senate, but a finalized deal has not yet been reached. But lawmakers are coalescing around specific provisions they say must be included in a final package to reform the health care system while addressing the expiring subsidies, Rep. Mike Kennedy, R-Utah, told the Deseret News.
“(Committees) have been working on it, not only all the way through the shutdown, but since the beginning of the year. People have sort of thrown around ideas,” Kennedy said in an interview on Tuesday. “I believe there’s time and will.”
Kennedy, a former family physician, said he’s engaged in bipartisan talks with both House members and senators, including a virtual meeting that occurred as recently as last week. In those talks, Kennedy said lawmakers are focused on reforming the health care system to give insurance companies less power over individual patients and their doctors.
“For me, putting the patient and the doctor back in charge of not only the delivery of the type of care, but also the cost aspects of the care, I think are a big part of policy,” Kennedy said. “Patients should be in charge of their own health care, and doctors and patients should work on these things together.”
One way to do that, Kennedy suggested, was through health savings accounts, which are usually offered by companies and allow employees to set aside pre-tax dollars to use for out-of-pocket health care expenses.
A similar idea has been proposed by Sen. Bill Cassidy, R-La., who has suggested replacing the expiring enhanced subsidies with those accounts altogether.
Cassidy pitched the full Senate Republican conference on that idea during the party’s closed-door lunch on Tuesday afternoon, alongside Sen. Mike Crapo, R-Idaho, who is co-leading the effort.
“We had a robust discussion on a subject that is of great interest,” Senate Majority Leader John Thune, R-S.D., said on Tuesday. “We want to move forward on solutions that will make health care not only more accessible but more affordable to more Americans; give them more choices, more optionality, greater competition, and therefore lower prices. And so we continue to coalesce around those solutions.”
Senators emerged from the meeting without a clear plan, characterizing the discussion as more so “soliciting feedback than about what we wanted to do.”
“I think my understanding is the leader wants to have something for Republicans to vote on” by next week, Sen. Josh Hawley, R-Mo., told reporters. “But it’s not clear what that is.”
But some Republicans threw cold water on the idea of presenting a sweeping package in the final weeks of the year, arguing it will require more time to get the majority of Congress on board.
“I think, given the time, simple is better. And I strongly believe that the simplest thing to do is to put together a bill that extends the subsidies more or less as-is,” Sen. Thom Tillis, R-N.C., said on Tuesday. “The best approach right now is to offer something simple. I mean, Bill Cassidy has great ideas, but it’s complex.”
That complex answer, Tillis argued, should come later — but for now, lawmakers could draft a temporary solution to buy more time for negotiations.
Although details of a stopgap bill are not clear, there are similar provisions being proposed from all corners of Capitol Hill dealing with new income caps, minimum premiums, and measures to cut down on waste, fraud and abuse.
One of those frameworks is being finalized in the House and could be made public before the end of this week, according to Problem Solvers Caucus Co-Chair Rep. Brian Fitzpatrick, who is leading those talks. That plan would extend the Obamacare subsidies for two years with new income restrictions and other reforms initially proposed by the White House that were later scrapped.
There’s no guarantee of a vote, but Fitzpatrick, R-Pa., told reporters that negotiators were “socializing (the plan) with members now, Democrat or Republican, to make sure that everybody’s OK with it.”
House Republican leaders have not yet committed to bringing any such bill to the floor, noting their slim majority of just three votes makes it difficult to vote on anything without overwhelming support.
“We haven’t committed to anything, but we’re getting a consensus right now,” House Majority Leader Steve Scalise, R-La., told reporters. “Because with a narrow margin … every day is going to be tight.”
Lawmakers are working against a short timeline to get everything finalized before the holiday recess. The House is scheduled to be in Washington for only 11 more working days before adjourning for the rest of the year — throwing lawmakers into a race against the clock.
“I honestly believe if we don’t come up with an outcome before Christmas, it’s not going to happen,” Tillis said on Tuesday.