Many Americans can take a slight sigh of relief as the U.S. House of Represenatives agreed on Jan 8 to extend the Affordable Care Act (ACA) tax credits for another three years, as they expired this year. While the Senate still has to pass the bill, lawmakers are working to reach a compromise deal to address rising premiums.
The ACA was the biggest reason for the government shutdown last year as Democrats pushed for the repeal of the bill, with Republicans wanting to revise the bill to only benefit American citizens, among other revisions. “Am I going to guarantee a vote on ACA unreformed COVID-era subsidies that are just a boondoggle to insurance companies and rob the taxpayer? We got a lot of work to do on that,” Speaker of the House Mike Johnson said during the shutdown. “We, the Republicans, would demand a lot of reforms before anything like that was ever possible. And we have to go through that deliberative process.”
Democrats and health experts argued that the Republicans are thinking backwards, as losing the subsidies will result in fewer people having health insurance and further increase health insurance costs. “If you’ve got some condition, even if you lose the subsidies, you’re going to really do everything you can — scrimp and save — to try to come up with the extra money because you need insurance coverage,” Michael Sparer, chair of the department of health policy and management at the Mailman School of Public Health at Columbia University, told ABC News.
“That’s part of the reason the premiums have been going up, because the insurance companies realize that healthy people are more likely in this situation to drop their coverage with the subsidies, and sicker people are more likely to stay on,” he continued.
Justin Markowski, an assistant professor in health policy and administration at the University of Illinois Chicago’s School of Public Health, added that uninsured individuals will still need care, and hospitals or other clinics may have to negotiate directly with patients or seek government funding. This may result in hospitals eating some of the care costs, which could be harmful.
The bill passed by the House is similar to the bill the Senate shut down in December, so lawmakers aren’t that opposed to the potential of this new bill. “What the House is going to pass tomorrow will not pass in the United States Senate,” Sen. Bernie Moreno, R-Ohio, part of the Senate group, told reporters. “It probably wouldn’t be put on the floor, because why waste floor time on something we’ve already considered?” Seventeen Republicans joined all Democrats voting in favor of the legislation, which passed 230-196.