
It took congressional Democrats more than a year of work — plus several years of prior policy development — to create the Affordable Care Act, also known as Obamacare. Now, Republicans are scrambling to fix it after passing President Donald Trump’s “One Big Beautiful Bill,” which stripped away the subsidies that helped make buying insurance on the exchanges affordable.
And they have just weeks to make it happen, before the new premiums go into effect on January 1.
The House is back in session after Speaker Mike Johnson kept Republicans in their home districts for almost two months during the federal government shutdown. Now, Republicans and the Trump White House are starting to decide what, if anything, they will do to keep premiums — already published — from doubling or even tripling in certain cases.
“President Donald Trump’s Domestic Policy Council and senior health officials have been meeting privately for preliminary conversations on how to address the expiration of health insurance tax credits, according to a White House official and another person familiar with the talks,” Politico reported on Thursday. “Conversations about a White House alternative to Affordable Care Act subsidies, which will expire at year’s end, are in the ‘early ideation phase,’ said a third person familiar with the talks.”
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Capitol Hill is in a similar state.
Noting that “the clock is ticking,” NBC News reported that “Republicans, under pressure from Democrats after the government shutdown revived the health care clash, have not coalesced around legislation or even an abstract idea, and are only now starting serious discussions about putting proposals together.”
“As the party scrambles to craft an alternative, multiple Republicans are vying for Trump’s endorsement of ideas that could alleviate skyrocketing costs that are just around the corner,” NBC added.
Democrats want a three-year extension of Obamacare subsidies and tax credits, Speaker Johnson has said that is a nonstarter.
Some Republicans are starting to speak out.
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U.S. Rep. Jeff Van Drew (R-NJ), a former Democrat, “warned, ‘not only is it morally bankrupt, it’s political suicide’ for Republicans to let the subsidies expire without an alternative in place.”
U.S. Senator Rick Scott (R-FL) prefers a vehicle like health care saving accounts that he claimed will lower costs by driving up competition. President Trump appeared to favor that approach, when he attacked health insurance companies in a social media post earlier this week.
Some are warning that bypassing the Obamacare exchanges could damage or destroy them.
“A tweet is not a health care plan,” Larry Levitt, executive vice president for health policy at KFF, told NBC. “If people could use these Trump health care dollars to buy insurance not regulated by the ACA, it would likely cause the ACA to collapse and upend protections for pre-existing conditions.”
Meanwhile, critics are blasting Republicans on Capitol Hill as well as the Trump administration for waiting so long before starting to try to create a plan.
Responding to the NBC News report, journalist Justin Baragona observed, “we’re still on ‘concepts of a plan’ here.”
“They’ve had 10+ years to work on this and have nothing,” wrote Laura Belin, a reporter for a progressive website. “Time to stop taking their supposed health care policy work seriously.”
“The White House is in ‘early ideation’ phase on ACA subsidies,” wrote The Bulwark’s Jonathan Cohn. “An issue already hitting millions of insurance buyers And that Democrats (not to mention analysts, journalists etc) have been saying needs attention for more than a year.”
Michigan Democratic State Senate Majority Whip Mallory McMorrow, a candidate for the U.S. Senate, wrote: “After Republicans refused to extend ACA subsidies, 4 Michigan insurers are dropping out of the ACA marketplace altogether. That’s 200,000 Michiganders who just lost their plans. Others are just going to cancel their plans. Which means more uncompensated care. Which means *everyone’s* healthcare costs will be higher.”
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