Separate Senate Republican contingents are floating competing proposals on health care, as the party struggles to unify behind a plan to stop looming premium hikes.
GOP leaders are faced with a political dilemma: Either they extend the subsidies and endorse ObamaCare, which Republicans have long opposed, or they let the subsidies expire ahead of next year’s midterms and deal with the fallout.
Some Republicans want a deal to preserve the enhanced subsidies, heading off voter ire and preventing an election-year nightmare scenario for the GOP. Others want the enhanced subsidies to expire and be replaced by direct cash to Americans, convinced they can blame Democrats for high costs.
On Monday, GOP Sens. Bernie Moreno (Ohio) and Susan Collins (Maine) introduced the Consumer Affordability and Responsibility Enhancement (CARE) Act that would create a two-year extension of expiring Affordable Care Act enhanced subsidies, along with a slate of reforms intended to appease conservatives.
Like other plans that have been floated, the bill would include an income cap — for households earning $200,000 or more — along with ending $0 premiums by requiring a $25 minimum monthly payment.
Moreno and Collins in a statement said the goal is “to shut down the fraud and abuse that zero-premium plans invite.”
A handful of bipartisan plans floated in the House offer similar ideas, as did a leaked proposal from the White House that was quickly withdrawn amid GOP pushback.
The Senate is expected to vote later this week on a Democratic plan to extend the expiring enhanced subsidies for three years. It is not expected to get the 60 votes needed to pass. But Republicans haven’t decided which plan, if any, they are going to put up as a counterproposal.
Separately, a proposal being circulated by Sens. Bill Cassidy (R-La.) and Mike Crapo (R-Idaho) doesn’t extend the subsidies at all. Instead, it would redirect that money into Health Savings Accounts paired with bronze or catastrophic plans on the ACA exchanges.
Certain ACA enrollees earning less than 700 percent of the federal poverty level would receive $1,000 in an HSA if they’re 18 to 49 years old, and $1,500 if they’re 50 to 64, according to an outline viewed by The Hill.
It explicitly states that the HSAs wouldn’t be used to buy abortion coverage, a key sticking point among Republicans opposed to the subsidies.
If Congress doesn’t act by the end of the year, the enhanced ACA subsidies will expire, returning to their original 2010 levels.
https://thehill.com/policy/healthcare/5638878-senate-republicans-health-care-proposals/
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