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At least two House Republicans, Rep. Brian Fitzpatrick of New York and Rep. Jen Kiggans of Virginia, are still hoping to get Affordable Care Act subsidy bills to the House floor before the end of the year, according to Politico.
Fitzpatrick has filed a discharge petition seeking quick floor action on the "Bipartisan Health Insurance Affordability Act" bill, which has 11 Republican cosponsors and four Democratic cosponsors. It would extend high subsidy levels for ACA individual and family health insurance bills for two years and also includes a provision that would require pharmacy benefits managers that work with employer-sponsored health plans to offer the employers detailed tracking reports.
Kiggans has filed a discharge petition for the CommonGround for Affordable Health Care Act bill, which would extend high premium subsidy levels for one year and includes a PBM regulation provision that would apply only to Medicare and Medicaid plans, not to employer plans.
Many members of Congress are looking for ways to keep exchange plan users from falling off an "Affordable Care Act subsidy cliff" Jan. 1, 2026. The cliff is coming because of the looming expiration of a temporary increase in ACA exchange plan subsidies adopted in response to the COVID pandemic. For some families, the expiration could increase annual coverage costs to more than $50,000 per year, from less than $10,000 per year now.
The Senate considered a Republican ACA subsidy cliff response bill and a Democratic bill Thursday and failed to get either to the Senate floor.
Politico says House Republicans could also try to move a package bill that would not affect subsidy levels for ACA public exchange plan users.
Rep. Jake Auchincloss, D-Mass., may have tried to contribute to the package Thursday by introducing two PBM regulation bills: one bill which would affect only PBMs that work with Medicare and Medicaid plans, and a second that would affect only federal employee health benefit plans.
What it means: Congress could still pass an ACA subsidy bill of some kind.
Even if Congress does not end up passing a subsidy bill, it could pass a package that would include employee benefits provisions, such as PBM provisions, health savings account and individual health coverage arrangement provisions.
Nuts and bolts: Some Republicans want to help people affected by the subsidy cliff by putting cash directly in those people's health savings accounts or other personal health accounts.
Josh Schultz, an executive at Softheon — a company that provides services for ACA public exchange programs and health insurers' off-exchange ICHRA programs — said in an email that one obstacle is that connecting ACA exchanges with health account custodians and oversight machinery could take more time than supporters of that approach think.
"Private financial and payment-processing vendors already operate HSAs and HRAs at scale and could support the effort, but launching a new nationwide subsidy program on a short timeline still poses operational and data-integration challenges," Schultz said.
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