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Scoop: New coalition pushes for ACA subsidies

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Jun 4, 2024
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Illustration: Natalie Peeples/Axios

An unusual coalition of insurers and patient advocacy groups is in the early stages of forming a lobbying group to push for renewing the enhanced Affordable Care Act subsidies next year.

Why it matters: The move shows there are a lot of players who rely on the subsidies passed under the Inflation Reduction Act — and will put up a fight to keep them.

Driving the news: Sources say the new coalition is called Americans to Keep Health Care Accessible, and includes major health insurers as well as patient groups, some of whom have been traditional rivals.

  • While the effort is in the early stages, groups like America's Health Insurance Plans, as well as patient groups like American Cancer Society Cancer Action Network are involved in the talks around the subsidy push.
  • "If the enhanced tax credits are not made permanent, affordability could become a barrier to lifesaving cancer care for millions of people in the U.S.," Lisa Lacasse, president of ACS CAN, said in a statement to Axios.
  • It is unclear whether providers will join the effort, but it is possible. Many are also pushing for the subsidies to be extended — a sign of the wide health care industry backing.

The big picture: The enhanced subsidies that help ACA enrollees cover their premiums will expire at the end of next year unless Congress acts.

  • If Republicans sweep the elections, they will likely allow the subsidies to expire. Prospects are better if there's divided government since the 2017 Trump tax cuts are also expiring next year, creating the potential for a deal.
  • "We want people to know that the cost of their health care is riding on the outcome of the election," former Speaker Nancy Pelosi said on a press call last week when asked about the enhanced subsidies.
  • Asked about a possible deal in a divided Congress, she replied: "As with every aspect of what we do, this is a priority for us, something we will fight for and negotiate for."

The other side: While Republican messaging against the ACA itself is far less strident than it used to be, congressional Republicans still attack the enhanced subsidies as a giveaway to health plans.

  • House Ways and Means Chairman Jason Smith and Budget Chairman Jodey Arrington wrote in a letter last month that an extension would mean "writing even bigger checks to insurance companies instead of addressing the true cost of care."

By the numbers: CBO estimates extending the enhanced subsidies would cost $335 billion over 10 years, but would also lead to 3.8 million more people with health insurance.

  • A single person making $30,000 a year would see the monthly premium rise from $55 to $168, if the subsidies are not extended, according to the Center on Budget and Policy Priorities.
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