Democratic Lawmakers Will Launch Bid To Save Extra Obamacare Subsidies

One of the bigger and more underappreciated policy debates coming to Congress this year will be over whether to extend a Biden-era initiative that’s helping millions of Americans to pay for their health insurance.

Some Democrats want to make sure that debate starts now.

Sen. Jeanne Shaheen (D-N.H.) and two other Democratic lawmakers are planning to introduce legislation that would keep the Biden-era program going, aides to lawmakers told HuffPost. Most likely, the lawmakers will introduce their bill formally on Thursday.

Getting the proposal through Congress won’t be easy now that both houses are under the control of Republicans, who have traditionally opposed government-financed health care programs and have said cutting federal spending is a priority.

But there are reasons to think the Democratic proposal, or at least some version of it, could become law. And at the top of the list is the fact that doing nothing ― in other words, allowing the Biden-era program to lapse completely ― would mean higher insurance costs for millions.

The program these Democrats want to extend is a temporary supplement to the Affordable Care Act. It provides extra financial assistance to people who are buying coverage on their own, whether through the federal insurance marketplace (HealthCare.gov) or one of its state-run analogues (Covered California, Minnesota’s MNsure, and so on).

The extra assistance can bring down premiums by hundreds, or in some cases thousands, of dollars. That’s enough to allow people to buy better coverage or save meaningfully on premiums ― and, in some cases, to buy insurance when they would otherwise remain uninsured.

The effects have been dramatic. Since the extra money first became available in 2021, as part of the Democratic pandemic relief package that President Joe Biden signed into law, the number of people getting coverage on the marketplaces has risen to record highs, contributing almost certainly to a record decline in the number of uninsured Americans.

And signups this year are about to hit 24 million, the Biden administration announced Wednesday morning. That’s the highest number yet, with a week still to go before open enrollment ends.

But the authorization and funding for the extra assistance will run out at the end of 2025 — unless Congress acts.

That’s where the Democratic lawmakers hope to make something happen.

Shaheen and her Wisconsin colleague, fellow Democratic Sen. Tammy Baldwin, plan to introduce legislation on Thursday that would make the extra assistance permanent. Rep. Lauren Underwood (D-Ill.) is planning to introduce a companion version in the House.

The proposal itself isn’t really new, and neither is the idea. Shaheen and Underwood also championed the original push to make the financial assistance more generous. In early 2023, not long after the temporary assistance was rolled out, they introduced legislation to make that funding permanent.

Their bill didn’t go anywhere, with Republicans newly in charge of the House following the 2022 midterm elections, and with so much else on the agenda. But now the expiration date is less than a year away — which means that in less than a year, millions could see higher insurance premiums.

That increase could be enough to make coverage downright unaffordable, pushing the number of uninsured Americans up by a few million, according to separate, independent analyses from the Congressional Budget Office, the Commonwealth Fund, KFF and the Urban Institute.

“The numbers speak for themselves — the Affordable Care Act has record enrollment, benefitting millions of working-class families,” Shaheen said in a statement provided to HuffPost. “But if the ACA’s enhanced premium tax credits expire, costs will increase across the country and millions of Americans would be at risk of losing coverage altogether.”

Baldwin, in a separate statement to HuffPost, said the proposal is in line with longtime efforts by her and some of her colleagues to make health care more affordable through government-financed programs. “I’m looking at every way we can further lower costs and expand access to good health care for families — and that starts with not jacking up costs on Wisconsinites,” Baldwin said.

On the surface, Democrats’ prospects for extending the extra health insurance relief seem slim.

For one thing, extending the subsidies would require roughly $33 billion in new federal spending per year, based on the latest Congressional Budget Office estimates. That’s going to be a tough sell at a time when Republicans are desperately seeking ways to offset the cost of the big tax cuts they are intent on passing.

And then there’s the fact that the money is connected to the Affordable Care Act, aka Obamacare, the law Donald Trump and Republicans spent so much time trying to repeal last time he was president.

It remains to be seen whether another frontal attack on the law is in store. But it’s hard to imagine much enthusiasm for anything that looks like bolstering the ACA, which is a fair interpretation of what the extra financial assistance does.

Back in September, when the three Democratic lawmakers were trying to push last year’s legislation, Trump spokesperson Karoline Leavitt told the Washington Post that the extra assistance “benefit[s] big insurance companies and brokers more than American patients.”

In her response, the Post reported, Leavitt linked to a paper from the right-leaning Paragon Institute that was critical of the extra assistance. The new money, it argued, created new incentives for enrollees, agents and brokers to misrepresent incomes on insurance applications, since doing so could in some cases mean (for enrollees) even more financial assistance with their insurance and (for the agents and brokers) even higher sales commissions.

“The Biden administration has made ObamaCare even more wasteful than it already was,” Paragon President Brian Blase argued in an opinion column for the Wall Street Journal last year. Blase, who served in Trump’s first administration, has urged Congress to let the extra assistance lapse.

But Trump campaign statements have never been a reliable indicator of his intentions. And in general, Republicans haven’t had a lot to say on the matter, which may have something to do with the fact that the millions who currently benefit from the extra financial assistance include millions of their own supporters and constituents.

Explaining to these people why their premiums suddenly jumped could be especially difficult following an election in which inflation was a top, potentially decisive issue, and in which Republicans up and down the ticket pledged they would bring down the cost of living for average Americans.

Shaheen alluded to that prospect in her statement to HuffPost: “At a time when hardworking Americans are facing higher costs due to inflation, we should make every effort to lower prices where we can,” she said.

Probably the most intriguing statement about the matter so far has come from Sen. Lisa Murkowski, the Alaska Republican, who over the holidays told the Northern Journal, an Alaska political publication, that some kind of extension would be necessary.

And while the relatively moderate Murkowski is frequently a lone dissenter from her caucus, Bill Cassidy, a GOP senator from Louisiana who is frequently influential on health care matters, has hinted some kind of compromise version could get broader Republican support, Axios has reported.

“Republicans have the power to end these tax credits, but they are recognizing that means they are also on the hook for the major premium spikes and coverage losses that will result,” Anthony Wright, executive director of the left-leaning advocacy group Families USA, told HuffPost over email.

One reason Shaheen, Baldwin and Underwood are anxious to start the conversation now is that timing matters. When insurance companies decide what insurance policies to offer ― and how much to charge for them ― they take the level of federal assistance into account. And they’ll be finalizing their plans for 2026 by summer.

Saving the extra health insurance assistance will require more than finding Republican support. It’ll mean finding that support soon.