WASHINGTON — The U.S. House passed a three-year extension of the Affordable Care Act enhanced subsidies Thursday, in a rebuke of Republican leadership. Alabama’s congressional delegation split on party lines.
Seventeen Republicans joined House Democrats to support a straight extension of the subsidies that hundreds of thousands of Alabamians relied on to help pay for their health insurance. Democrats forced a vote on the extension by gaining support from four Republicans on their discharge petition late last year. Moderates feared that the risk of doing nothing to address high health care costs was riskier than supporting an extension without modifications.
The bill now moves to the Senate, where bipartisan lawmakers are already working on a deal to address the now-expired enhanced ACA tax credits. But a straight three-year extension isn’t expected to be the final fix, as that measure already failed in the Senate last month.
U.S. Rep. Terri Sewell, D-Birmingham, said she was excited to see some bipartisan progress on addressing the tax credits for Alabamians who receive insurance through the marketplace.
She added that she’s heard from constituents who have opted to go without coverage now in the hope that Congress takes action on the subsides and extend the enrollment period.
“I can’t tell you how many people have asked me that,” Sewell told Alabama Daily News. “And my response has always been, you can’t rely on that because we don’t know what’s going to happen. But they just could not afford those skyrocketed premiums without help.”
Jan. 15 is the deadline to enroll for a marketplace plan this year unless a major life change, life job loss or divorce, qualifies someone for a special enrollment period.
Alabama Republicans have repeatedly spoken out against the ACA marketplace and have pushed for other options to help Americans deal with high premiums, such as expanding health savings accounts.
The nonpartisan Congressional Budget Office estimated the three-year extension would add $80.6 billion to the nation’s deficit over the decade.
Earlier this week, Senate Majority Leader John Thune, R-S.D., said any health care plan in the Senate would need income limits, the elimination of $0 premiums, and an expansion of health savings accounts.
“…some sort of a bridge to HSAs, an expansion of HSAs so that you’re getting more money into the pockets of the American people, the patients, if you will, the consumers as opposed to the insurance companies,” Thune told reporters Tuesday.
Another sticking point in the negotiations for a bipartisan health care deal is abortion restrictions.
President Donald Trump urged Republicans Tuesday to be “flexible” on the Hyde Amendment, a 50-year statute that bars federal dollars from being used on abortion, in ongoing talks.
But Republicans, including Alabama’s lawmakers, aren’t flexible on the issue.
“I think most of the people who support the president would support the Hyde Amendment,” Rep. Robert Aderholt, R-Haleyville, chair of the Values Actions Team, told ADN. “Right now, I believe it’s the right thing to do.
After Trump’s comments Tuesday, Aderholt posted on social media that his commitment to abortion restrictions is “unchanging.”
Sen. Katie Britt, R-Ala., said she believes in “protecting the unborn” and wants to continue to do that.
“There would need to be something in there that I felt like gave us a greater opportunity to protect life,” Britt told ADN, referring to a potential health care deal.
When asked if he would be flexible on the Hyde Amendment, Rep. Barry Moore, R-Enterprise, said, “I don’t think tax dollars should ever go for abortions, so I would be a no in most cases.”
Thune also reiterated this week that the Hyde Amendment must remain in place to ensure “those dollars aren’t being used to go against the practice that’s been in place for the last 50 years.”
States have a patchwork of laws on abortion coverage for insurance through the marketplace. Alabama and 24 other states prohibit abortion coverage in ACA marketplace plans, 12 states require coverage, and 13 states and D.C. don’t have any requirements or limitations for abortion care, according to health policy research group KFF.