Congressional negotiations to extend enhanced Affordable Care Act subsidies have veered off course.
Subsidies were expanded during the coronavirus pandemic to blunt rapidly rising premiums. Those subsidies are set to lapse in less than a month. The shutdown-ending deal struck between Republicans and defectors in the Democratic Party in early November was pitched as a way to give both parties breathing room in negotiations for a bipartisan extension. Instead, lawmakers have spent the weeks since retrenching around familiar fights while millions of Americans face steep health insurance hikes come January.
Democrats entered December signaling they were prepared to negotiate limits on the subsidies, but talks sputtered almost immediately. Republicans have insisted that any extension must revisit abortion-related restrictions in ACA marketplace plans, a demand Democrats argue is both unnecessary under existing law and clearly designed to fracture their caucus. Sen. Angus King, I-Maine, said that GOP negotiators drew “a red line that is also a red line for the Democrats.” The independent senator caucuses with the Democrats and was a key vote in the deal to reopen the government. He said the GOP was trying to freeze the room before substantive talks even began, according to the Associated Press.
Republicans have struggled to unify around an alternative deal, citing a lack of clear direction from President Donald Trump. Some are circulating ideas centered on new health savings accounts. Others want income caps layered onto the existing subsidy structure. And conservatives continue to press for more sweeping rewrites of the ACA. Many have urged leadership to let the subsidies collapse, a move they say would force a reckoning with what they consider a broken law, even if it means higher premiums for millions in the interim.
“The base of the Republican Party still thinks Obamacare is a swear word, so supporting it in that manner is just a bridge too far for most Republican members,” one GOP strategist told Politico. “Who wants to risk that in any kind of deep red district, or even a swing district? No one wants a primary challenge where the accusation is, ‘You supported Obamacare.’”
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In brief comments, Trump has oscillated between disinterest, saying he’d “rather not extend them at all” and acknowledgment that a short-term extension might be unavoidable. A plan recently floated by the White House was never released.
Democrats are preparing to bring a vote on the Senate floor next week, even though it’s likely to fail.
“That vote will happen. And whether it will pass is in the hands of Donald Trump and the Republicans,” Sen. Amy Klobuchar, D-Minn., said during a television appearance on Sunday.
