Senate to vote on dueling health care proposals as ACA premium hikes loom

With subsidies for the Affordable Care Act set to expire for millions of Americans at the end of the month, the Senate plans to vote on two health care related bills Thursday, but both are expected to fail.

In a trade-off to reopen the government following the longest shutdown in U.S. history, Senate Republicans promised Democrats a vote on a bill of their choosing to extend the subsidies. Democrats are seeking a three-year extension of the subsidies, warning that without one health care premiums are predicted to skyrocket at the start of the 2026.

While both parties agree on the need to address healthcare costs, the Democratic proposal doesn’t have enough GOP support to pass. Republicans have argued that extending the subsidies would allow what they describe as Obamacare “waste, fraud and abuse” to continue, while lining the pockets of insurance companies.

“There is nothing in their [Democrats] bill that stops billions of dollars in fraudulent spending,” Sen. Bill Cassidy, R-La., said on the Senate floor Wednesday.

Republicans are countering with a plan by Cassidy and Sen. Mike Crapo, R-Idaho, that would provide up to $1,500 a year in payments for health savings accounts for Americans earning less than 700 percent of the federal poverty level.

However the bill does not extend the ACA tax credits and the money could not be used to pay for health care premiums. Deductibles for those plans average around $7,000, according to data from the health policy organization KFF.

“It delivers the benefit directly to the patient, not to the insurance company, and it does it in a way that actually saves money to the taxpayer,” said Senate Majority Leader John Thune, R-S.D.

Democrats rejected the GOP proposal on Wednesday and called it dead on arrival. They criticized the plan for limiting coverage to plans on the ACA marketplace that provide less coverage. Funds could also not be put towards abortion services or gender reassignment.

“The Crapo-Cassidy bill would not extend the ACA tax credits for a single day. That’s what’s driving the price up, and they’re doing nothing about it,” Senate Minority Leader Chuck Schumer, D-NY, said during a press conference Tuesday.

Democrats also pushed back on the GOP timeline, as Republicans have spent weeks debating an alternative health care bill and only unveiled their proposal on Tuesday.

Sen. Jack Reed, D-R.I., criticized the GOP for waiting to unveil a health care plan. Speaking from the Senate floor on Wednesday, Reed said time was of the essence as 24 million Americans face losing their subsidies at year’s end. He argued that instead of waiting until the eleventh hour to unveil a health care plan, the GOP can approve an extension now and deal with changes to the substitutes later.

“There is no time to implement it,” Reed said of the Republican plan. “The solution is simple: extend the Affordable Healthcare tax credits.”

While Schumer said all Senate Democrats are unified behind their vote to prolong the ACA subsidies, Thune was unsure if every Republican would back the measure from Cassidy and Crapo.