Lawmakers have another huge, politically charged deadline looming at the end of the year. That’s when the Affordable Care Act’s enhanced premium tax credits are set to expire.
If Congress doesn’t renew the credits, 4.2 million Americans could lose health insurance coverage, per CBO.
The politics are incredibly complex here for the GOP.
Republicans just slashed hundreds of billions of dollars in Medicaid funding, which is already a focus of Democrats’ midterm messaging. The Obamacare subsidies are mainly a priority for Democrats. But some Republicans are now starting to back an extension, wary of allowing more Americans to wind up uninsured in what may be a tough election landscape for the party.
“This is a perfect opportunity for us to move past the reconciliation process, which is clearly a partisan exercise,” Sen. Thom Tillis (R-N.C.) said. “It may even be an opportunity for us to address some of the defects, as I see them, in the reconciliation bill.”
Tillis voted against the GOP’s “One Big Beautiful Bill” after railing against Medicaid cuts.
Sen. Josh Hawley (R-Mo.) said the GOP has to act, whether that’s extending the ACA credits or something similar.
“We have to do something to allow people to afford health care,” Hawley said. “The cost of insurance on the exchanges is just astronomical. That’s why so many people are on Medicaid.”
Both of Alaska’s Republican senators want to see congressional action too.
“There’s a lot of interest in this, and I’m certainly part of that interest,” Sen. Dan Sullivan (R-Alaska) said.
Sen. Lisa Murkowski (R-Alaska) said she’s planning to start bipartisan talks for an extension of the credits soon.
The outlook. Republicans who want to extend the credits face significant headwinds.
Plenty of GOP lawmakers aren’t interested in extending the subsidies. Democrats would likely have to make a big push in any year-end negotiations to get something done.
Those talks will be complicated by the messy efforts to address government funding over the next few months, which is especially charged for Democrats.
Sen. Ron Wyden (Ore.), the Finance Committee’s top Democrat, is already blaming the GOP for the subsidies expiring. When asked about bipartisan talks, Wyden insisted Republicans are choosing partisanship.
“I’ll work with anybody, but I don’t see anything resembling that, and what I do see is all over the political rags is they’re already planning the second reconciliation partisan bill,” Wyden said.
GOP leader view. Top tax writers are pushing for other priorities in a potential year-end health deal. Senate Finance Committee Chair Mike Crapo (R-Idaho) floated pharmacy benefit manager reforms and other health extenders as possibilities, but told us he isn’t focused on the Obamacare credits yet.
When we asked House Ways and Means Committee Chair Jason Smith (R-Mo.) about the ACA credits, Smith said his focus is on access to rural health care.
Senate Majority Leader John Thune said the ACA expiration is under discussion now.
“We’re having conversations about how we might deal with that issue,” Thune said.
Both Speaker Mike Johnson and House Majority Leader Steve Scalise said they haven’t yet thought about the issue.
“We haven’t really gotten into that,” Scalise said Tuesday. “Obviously, One Big Beautiful Bill was all the focus. Now we’re looking at some of these other items.”
