In the News

Millions of people would lose health insurance if congressional Republicans let a policy expire intended to lower the out-of-pocket costs of Affordable Care Act plans, according to a Congressional Budget Office estimate released Friday.

The new findings by the nonpartisan congressional scorekeeper come as House Republicans are mulling major changes to Medicaid and other popular safety net programs as part of their major legislation to enact President Donald Trump’s domestic agenda — a pursuit that has Democrats going on political offense.

“By not extending the improvements to the Premium Tax Credits, by using reconciliation to codify cruel new rules that will make it harder for people to get care, Trump and Republicans are opening the floodgates for the biggest theft of health coverage we have ever seen,” said Reps.  Frank Pallone  and  Richard Neal  and Sen.  Ron Wyden  in a joint statement.

“Cold, hard math paints a grim picture — the Republicans’ long-pursued golden goose of dismantling and undermining the ACA means millions of Americans will see their premiums skyrocket and their care reduced or outright stolen,” they continued.

Pallone, Neal and Wyden — the top Democrats on the House Energy and Commerce, House Ways and Means, and Senate Finance Committees, respectively — requested the CBO analysis, which determined that making the so-called called enhanced premium tax credits permanent would cost more than $350 billion over a decade. The flip side, however, is that it would result in close to 4 million fewer people having health insurance.

The enhanced premium tax credits, which were created under the 2021 American Rescue Plan Act, have led to record numbers of people with insurance. Democrats are broadly in favor of continuing them, and while many in the GOP oppose extending them, a growing number of Republicans have warmed to the idea, including Sens.  Lisa Murkowski  of Alaska and  Thom Tillis  of North Carolina and Rep.  David Valadao  of California.

Republicans are now faced with a difficult choice before these tax credits expire at the end of the year: spend a significant amount of money to extend the subsidies associated with the Democrats’ 2010 health law they largely revile, or let them expire and see out-of-pocket costs rises for voters in an election year.

There’s also been a major lobbying effort from a broad coalition of health care industry groups representing doctors, insurers and hospitals to extend the subsidies.

This latest CBO report follows Democrats’ release of another set of CBO findings from earlier in the week showing that a Trump administration proposal aimed at reducing improper Medicaid enrollments would decrease the federal deficit by $210 billion over a decade — and lead to 1.9 million more uninsured people.

The scorekeeper earlier this week also projected that millions of Americans would lose health coverage under policies Democrats say Republicans would pursue to pull back on the ACA’s Medicaid expansion.