Some House Republicans pushed for a short-term extension of Obamacare’s enhanced premium tax credits in addition to the market reforms included in the bill.

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WASHINGTON—The House of Representatives on Dec. 17 passed a health care reform bill amid an intra-party debate on whether to extend the expiring enhanced premium tax credits offered in the Affordable Care Act exchanges.

The Lower Health Care Premiums for All Americans Act aims to lower health insurance premiums in both the Affordable Care Act exchanges and the general market. The Affordable Care Act is former President Barack Obama’s health care law, known as Obamacare.

The bill passed in a 216–211 vote. One Republican, Rep. Thomas Massie (R-Ky.), joined all Democrats in voting against the bill.

Following the vote, Speaker Mike Johnson (R-La.) touted the bill’s passage as a more significant achievement than extending the temporary subsidies would have been.

“What we just passed off the floor will reduce everybody’s premiums by 11 percent,” Johnson said, comparing it with the 5.7 percent reduction a subsidy extension would yield. “We did a better and more important thing for 100 percent of Americans, not just 7 percent of Americans.”
Disagreement Over Enhanced Subsidies

Rep. Brian Fitzpatrick (R-Pa.) and three other Republicans had earlier joined a discharge petition circulated by Minority Leader Hakeem Jeffries (D-N.Y.) to force a vote on a three-year extension of the subsidies.
That move came after an amendment sponsored by Fitzpatrick and another advanced by Rep. Jen Kiggans (R-Va.) were rejected by the House Rules Committee.

The amendments mirrored bipartisan bills each had sponsored that would have extended the enhanced subsidies for two years and one year, respectively, with accompanying changes to reduce the cost and combat fraud.

Fitzpatrick, joined by Reps. Mike Lawler (R-N.Y.), Robert Bresnahan (R-Pa.), and Ryan Mackenzie (R-Pa.), provided the final signatures needed to reach 218, forcing a vote on the Democrats’ proposal.

Under House rules, seven legislative days must pass before a signer of the petition can call for a vote. The speaker then has two legislative days to schedule it.

Democrats have called on Johnson to waive the waiting period and schedule the vote immediately.

Johnson, when asked whether Republicans’ siding with the opposition was a signal that he had lost control of the House, said that that was not the case.

“These are not normal times,” Johnson said, noting that the party’s slim majority in the House allows members to exert leverage that they otherwise could not.
Bill Aims to Lower Premiums

The Lower Health Care Premiums for All Americans Act includes five provisions to reduce the cost of health insurance and broaden access to it.

Those include requiring greater transparency in prescription drug pricing, providing federal funding to reduce the copayments and deductibles paid by some Obamacare customers, and making it easier for businesses that self-insure their employees to buy stop-loss insurance.

The bill would also make it easier for small employers and the self-employed to leverage the buying power of a larger organization by joining association health plans. And the bill would make it more attractive for employers to contribute pretax funds for employees to purchase their own coverage.

Republicans said the changes are needed because Obamacare has failed to live up to its promise of lowering the cost of health insurance.

“Obamacare premiums are up 80 percent since the program’s inception, with patients paying on average $5,000 out of their own pocket to hit their deductible,“ Rep. Brett Guthrie (R-Ky.) said during debate on the bill. ”The average out-of-pocket spending maximum for one year is over $20,000.”

“Obamacare has proven to be unaffordable and unsustainable,” Guthrie said.

Guthrie said the Republican bill would lower premiums by 11 percent compared with the 5 percent reduction realized by extending the enhanced subsidies.

Democrats countered that the expiration of the enhanced subsidies would make health insurance unaffordable for many Americans.

“Health insurance premiums are going to skyrocket for more than 20 million Americans across the country,” Rep. Frank Pallone (D-N.J.) said in arguing against the bill.

“Republicans are bringing a bill to the floor that does absolutely nothing to lower prices,” he said.

He said that in his view, the bill promotes “junk insurance plans.”
Senate Options

The Lower Health Care Premiums for All Americans Act now moves to the Senate, where a Republican bill to replace the enhanced subsidies with Health Savings Accounts failed to advance on Dec. 11.
A three-year extension of the enhanced subsidies also failed to advance, although four Republican senators joined Democrats in support.

Sen. Susan Collins (R-Maine), who voted for the three-year extension, told reporters on Dec. 17 that the discharge petition helps her cause.

Sen. Bill Cassidy (R-La.) told reporters on Dec. 17 that he is “not personally opposed to subsidies.”

“It’s just not the end-all deal, because if somebody does need a subsidy but they have a $6,000 deductible, they’re effectively not insured,” he said.

Sen. Lisa Murkowski (R-Alaska), who also voted for the three-year extension, was asked on Dec. 17 whether the measure might yet pass in the Senate if forwarded by the House.

“I hope so,” she said.

Good

The ACAcwas designed to fail and it did. It was designed to expire so it should.

Change you can believe in!

Its a start. I pray congress ramps up first thing 2026.

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Originally posted by 6guns:
“What we just passed off the floor will reduce everybody’s premiums by 11 percent,” Johnson said,

quote:

Originally posted by SIG4EVA:
Its a start.

It's a start. And that's good, because I learned last week that my health insurance premiums are going up 71% for the coming year.

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It's a start. And that's good, because I learned last week that my health insurance premiums are going up 71% for the coming year.

I've decided to opt out. It's not worth it.

The so-called Affordable Care Act is the biggest driver of inflation. Many companies are facing such large health insurance costs that the choices are: reduce or eliminate coverage or reduce wages. Health "insurance" has become a bigger and bigger portion of total compensation. It's completely out of control.

It doesn't matter whether you are part of the 11% of the population buying insurance on an ACA "exchange" plan or not. That terrible 2009 act has destroyed the entire market for and even the very meaning of the word insurance.

When I studied insurance the simple definition was a small certain loss (the premium) given in exchange for a large but uncertain loss (the peril).

Insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. It is a form of risk management, primarily used to protect against the risk of a contingent or uncertain loss.

That's not what "health insurance" is anymore. Furthermore, they have made simple insurance either illegal or unobtainable. By mandating coverages and doing away with underwriting (pre-existing conditions) it's not insurance. It's pre-paid medical spending and subsidizing it only further drives inflation.

The extension that the Democrats proposed, and a few Republicans support, is three years
I suspect some sort of short term extension will pass to prevent chaos and give time to create an alternative, but it needs to be 6 months or less. Otherwise they'll wait until the bitter end and then once again we'll be right back at this same point.

I am so confused by all of this. I'm basically losing my health insurance at the end of March. I was laid off in May after 29 years.

My options seem to be

1: I can keep my current employer plan at loss of most subsidizing by the company as a "retirement benefit". The cost would literally be $4000/month. Can't afford that.

2: ACA marketplace is what I see. About $2100/month for me and my wife without tax credits. High deductibles about 10K

3: ACA with subsidies: Anywhere from $50-$500/month if we can keep our income below $84,600. This may be possible. So this seems the best option if we can keep the income that low based on living expenses (using retirement IRA)

I have no idea how the Republican plan would help. 11% reduction in the non-subsidized plan isn't anywhere as low as the plans with tax credits. This stuff is so complicated. We can take the lower priced ACA plan and pay it back if our income exceeds the max.

Government funded healthcare is another step toward socialism. Who's next to have their livelihood regulated by the government, plumbers,dentists;stonemasons??

quote:

Originally posted by 220-9er:
The extension that the Democrats proposed, and a few Republicans support, is three years
I suspect some sort of short term extension will pass to prevent chaos and give time to create an alternative, but it needs to be 6 months or less. Otherwise they'll wait until the bitter end and then once again we'll be right back at this same point.

Is there even a question in your scenario as to whether there would be a solution forthcoming? They'd wait 5 1/2 months, and then punt anyway! The ACA is a festering wound that destroyed so called 'health insurance' in this country. It did exactly what it was designed to do! The only solution is to rip the band-aid off...The sooner the better!

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The ACA is a festering wound that destroyed so called 'health insurance' in this country. It did exactly what it was designed to do! The only solution is to rip the band-aid off...The sooner the better!

Yes. Exactly.

Insurance is a pass through. The root cause is out of control medical provider costs. Some say this is because medicare/medicaid reimbursement is too low and they have to make it up elsewhere. A big part of it is the fact that hospitals cannot turn anyone away who needs urgent care, even those who can't/won't pay, so all of that cost is made up by those who do pay.

The system is socialized by proxy. People in the health insurance business told me this 20 years ago, long before the ACA.

Medical providers still don't really comply with cost disclosure laws because how much they bill depends on what insurance company/plan you have, or if you are paying cash.

ACA needs to change eliminate coverage mandates for things some customers may want to opt out of. It needs to stop forcing men to pay the same as women, and allow the different risk levels between men and women to return. There has to be a requirement for coverage history so you can't sit out and only sign up only when you need care.

The whole problem is insurance cost is based on risk and the ACA does a lot to PREVENT risk from being considered.

quote:

ACA needs to change eliminate coverage mandates for things some customers may want to opt out of. It needs to stop forcing men to pay the same as women, and allow the different risk levels between men and women to return. There has to be a requirement for coverage history so you can't sit out and only sign up only when you need care.

The whole problem is insurance cost is based on risk and the ACA does a lot to PREVENT risk from being considered.

I want to opt out of most of it... I want a high deductible, low cost plan for catastrophic injury or illness.
That type of plan was eliminated by Obamacare.

I want to be able to pay cash for any ongoing or routine care. I want up front pricing.

Now, because what I want is no longer available, my best option is to opt out and hope I don't get sick.

quote:

Originally posted by Lefty Sig:
Insurance is a pass through. The root cause is out of control medical provider costs. Some say this is because medicare/medicaid reimbursement is too low and they have to make it up elsewhere. A big part of it is the fact that hospitals cannot turn anyone away who needs urgent care, even those who can't/won't pay, so all of that cost is made up by those who do pay.

The system is socialized by proxy. People in the health insurance business told me this 20 years ago, long before ACA.

Consider the source; they’re not going to admit they’re that cause of high healthcare prices.

The root cause isn’t out of control medical provider costs because the medical providers don’t control how much they get “reimbursed.” You know who controls how much medical providers get reimbursed? That’s right, the medical insurance companies determine reimbursement rates. Medical providers don’t even know how much they’ll get for a certain procedure at the beginning of the year. Their billing office just needs to invoice a high enough amount so that the insurance payment they get is lower than the invoice amount. If ever the insurance payment is equal or near the invoice amount, the provider’s office has to raise the amount for future billings to make sure they’re not leaving money on the table.

It’s the insurance companies who are running the racket. By law, they’re supposed to pay out a certain percentage of premiums received and keep the rest for admin and profits, something like 85/15%. 15% is hefty but how do they raise their profits for next year? By paying out 86 or 87% this year so they can say costs have increased which means they can increase premiums to keep the 85/15 ratio. Their 1 or 2% less in profits this year gives them a healthy ROI into perpetuity.

Look at the gross profits of medical insurance companies compared to the healthcare care industry such as hospitals or pharmaceuticals; the insurance companies’ profits far outpace the medical providers.

When you take your car to a mechanic for an oils change, is your car insurance involved? No. But every time you see your medical doctor, your health insurance is involved because they want a piece of every action just like any mob-run racket.

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The extension that the Democrats proposed...is three years

The remainder of Trumps term. Seems like they're banking on a political turn-around, getting a DemocRat president and either the Senate or the House. Then they can get exactly what they want.