Tillis. Photo: Bill Clark/CQ-Roll Call via Getty Images
Sen. Thom Tillis sees a path to working with Democrats on extending enhanced ACA marketplace subsidies once the reconciliation process is done, he told Axios this week.
Why it matters: Until now, Sen. Lisa Murkowski had been the only GOP senator to publicly express support for extending ACA subsidies that expire at the end of the year.
What they're saying: "I've talked to my Republican colleagues. They agree," said Tillis, who sits on the Senate Finance Committee. "There's a case to be made for trying to figure out how we can continue the subsidies, but then have a broader discussion.
- "We talked about child tax credit, other maybe Democrat priorities that I think could make its way into a bipartisan bill, but we've got to figure out … this [reconciliation] bill first," he said.
- "I think it can be outside reconciliation. And I believe it only makes sense after we have a greater understanding of what is in the reconciliation package.… But [the subsidy extension] is going to have to be offset. We'll just have to work on that."
By the numbers: ACA marketplace enrollment in Tillis' state of North Carolina surged 118% from 2020 through 2024, per KFF, and about 96% of enrollees got advanced premium tax credits to help them pay their premiums.
State of play: Murkowski told the Northern Journal in January that she thought Congress needs to extend the ACA premium tax credits.
- "I think [expiration of the credits] has the potential to move us backwards, in terms of the progress that we have made in improving access to health care and affordability," Murkowski said in the interview.
The other side: Senate Finance Ranking Member Ron Wyden told Axios that although his immediate priority is reviving the health package that was dropped from the year-end funding deal, he could be open to working with Republicans later on extending the ACA subsidies.
- "I say work with anybody who wants to get things done that are good," Wyden said.
Between the lines: Tillis is up for reelection next year and could face a tough race in a purple state. Former Democratic Gov. Roy Cooper is reportedly weighing a challenge.
- Tillis already has at least one primary challenger: Andy Nilsson, a businessman and former candidate for North Carolina lieutenant governor.
- Nilsson's campaign appears to be running to the right of Tillis, saying that the senator couldn't be relied on "to fully support Trump's America-first agenda."
The big picture: KFF recently estimated that 8% to 12% of each congressional district in the state is enrolled in the ACA marketplace.
- If the enhanced subsidies expire, the premium for a benchmark silver plan for a 60-year-old couple making $82,000 would at least double in the vast majority of those districts, KFF found.
Yes, but: The cost of renewing the subsidies could be prohibitively expensive. The CBO has estimated that permanent subsidies would cost $335 billion over 10 years.
