Senate rejects plans to address sharp rise in health care premiums

Geoff Bennett:

Welcome to the “news Hour.”

The U.S. Senate failed to pass two dueling pieces of health care legislation today, leaving Affordable Care Act tax credits all but certain to expire at the end of the year.

Amna Nawaz:

As lawmakers prepare for year-end recess with no agreement in sight, tens of millions of Americans who rely on the ACA are being left in limbo. The expired subsidies would lead to a sharp rise in health insurance premiums starting next month.

Congressional correspondent Lisa Desjardins was at the Capitol today and joins us now.

So, Lisa, walk us through what happened today.

Lisa Desjardins:

What we had today in the Senate was Republicans and Democrats each having one shot to put up a bill to deal with these expiring enhanced tax credits.

Now, these are just — these are enhanced credits on top of what was originally in Obamacare. So we saw both parties put up bills, but, frankly, Amna, those bills, neither one of them seemed likely to pass. Let me go through what they proposed, first of all.

Now, the Republican plan is to limit the enhanced subsidies and essentially move them into health care savings accounts. Now, that plan failed. It got 51 votes, but that’s short of the 60 that was needed. Democrats, they’re planning a little bit more straightforward, a three-year extension of the enhanced subsidies as they are now.

That plan also failed, but, interestingly enough, Amna, 51 votes. So we had two plans today that both got a majority vote, but both short of the bipartisan 60 votes that’s needed in the Senate.

And we have learned a couple of things. The Senate clearly is not at a point where there are even having these bipartisan talks that are needed to come up with a compromise plan. The other thing we learned today, as the leaders said on the floor, that there is both political and policy divide.

Sen. John Thune (R-SD):

Democrats’ so-called plan is a three-year extension of the status quo, no reforms, no revisions, no rethinking of the way that Obamacare works, just a three-year extension of the status quo.

Sen. Chuck Schumer (D-NY):

Republicans will have to answer to the American people, explain to the country why they chose higher health care costs over real solutions. They must — Republicans must answer for why people will lose coverage. Republicans must answer why families see premiums double and triple over the next year.

Lisa Desjardins:

Not a great sign when you get into the finger-pointing, especially when millions of Americans waiting for a solution.

I talked to Senator Thune, especially afterward. He said there are senator-to-senator talks. He’s not given up on some possible way forward, but time is running out. And Senator Schumer seemed more in the attitude of he thinks this might be it for the year, but we will see.

Amna Nawaz:

So it’s not clear if the Senate’s going to do anything more on this. What about the House? What’s happening there?

Lisa Desjardins:

OK, the House, very interesting.

House leadership, the Republican leadership, Speaker Johnson, they are not putting forward a plan to extend these health care subsidies right now. However, other Republicans are. There is a group of bipartisan members together. There are 35 of them, one example, last week, who — there you see them — proposed a one-year extension.

There are a couple different versions of that idea. These groups are now trying to do a run-around the leadership with a discharge petition. We have talked about this on the show. That needs 218 signatures. I just checked a few minutes ago. Neither one of these extensions that these some few Republicans are proposing is anywhere close to that number yet.

And they also may not have enough time to get that done by the end of the year. But here’s the tricky part. This is very political. When I talk to Democrats, I think there clearly is a majority in the House for a one-year extension.

But the politics are such that that may not come to the House for and it certainly doesn’t look like it will come before next week. So there’s a will, but not a way potentially in the House right now.

Amna Nawaz:

So there’s a lot of competing dynamics at play here.

As you speak to your sources, give us your analysis overall of where things stand right now.

Lisa Desjardins:

Well, let’s break this down simply, because I know it is confusing. And even for members in Congress, they kept pulling me aside to say, help me understand what’s going on here.

So let’s look at this in terms of three major problems that are faced — that’s facing Congress here. First of all, Democrats, for their point, Democrats, on their end, they oppose the reforms in large form that the Republicans want. That’s a problem in the Senate especially.

Now, Republicans, they’re divided on an extension. There are a lot of moderate Republicans who, frankly, are vulnerable in the next election who want to extend this and they want to do it now. But the Republicans don’t agree.

Finally, something that hasn’t come up yet, abortion policy, Amna. This is a huge issue in the Senate. There are Republicans who want to — who are very nervous about the way forward and want to make kind of more conservative policy on abortion. Democrats don’t like that.

So that’s a big hangup as well. And all of this leads to this point now. Others say there’s a problem because none of this changes health care costs in general. It just moves money around.

Amna Nawaz:

And, finally, Lisa, I know that calendar is always a big issue here, right? Walk us through what’s ahead.

Lisa Desjardins:

You know I love doing — looking at the calendar,

Time is tight. And, in fact, it’s actually even worse than people realize. So let’s take a look really quickly. Here we are today, December 11. Now, look, at the end of the month, that’s when these enhanced tax credits expire. OK, so it seems like Congress would have time.

No, those days in that red-orange color, those are the final days that Congress plans to be here before leaving for the holiday. Now, how about January? Another problematic deadline coming up, at the end of January is when government funding runs out for most government agencies.

So they’re up against the clock on a couple of issues, not ready to deal with either one of them. Now, we know from KFF that there is a real moment here. And I talked to one of their experts today, Cynthia Cox, about where she thinks things stand.

Cynthia Cox, Program on the ACA Director, KFF: I think it’s looking more and more likely that these enhanced premium tax credits are going to expire. Even if there was some sort of last-minute deal. We’re probably looking at people’s premium payments going up significantly in January.

Lisa Desjardins:

A reminder of who that affects. So that’s not most Americans. It is a smaller portion of the American health care market, but it is 24 million Americans who are on Obamacare right now. Most of them would see premiums go up, Cynthia Cox saying double beginning in January.

And we also know from the Congressional Budget Office that around two million people would just fall off of insurance altogether. And, Amna, that’s not just hypothetical. That’s already happening. We know in Massachusetts, where open enrollment closes in just days from now, that already 10,000 people have not signed up again, won’t have insurance.

And that is going to cause real health care and financial problems ahead.

Amna Nawaz:

Lisa Desjardins, thank you, as always.

Lisa Desjardins:

You’re welcome.