House Democrats are proposing a permanent extension of enhanced Affordable Care Act tax credits to middle-income earners that would mark the largest expansion of the healthcare law's benefits since its passage in 2010.
Under the House Ways and Means Committee's portion of a $3.5 trillion domestic policy bill Democrats are advancing, people with incomes at or above 400% of the federal poverty level—about $52,000 for an individual—would be eligible for subsidies to buy insurance on the ACA marketplaces. The bill would also make ACA subsidies more generous for people making between 100% and 400% of the federal poverty level.
The COVID-19 relief legislation Congress passed earlier this year created larger health insurance exchange subsidies on a temporary basis, but hospitals, insurers and patient advocates have called for a permanent expansion
More than 2.5 million new enrollees signed up for marketplace plans under a pandemic-related special enrollment period as of Aug. 10. President Joe Biden's administration had warned that the end of those enhanced subsidies would drive up costs and lead people to drop their coverage. Open enrollment for 2022 health plans on the exchanges begins Nov. 1.
The Ways and Means Committee proposal would also authorize $10 billion a year for state reinsurance programs to reduce premiums and other out-of-pocket costs and to close the Medicaid expansion gap, similar to a bill released last week by the House Energy and Commerce Committee.
The bills are expected to be part of the $3.5 trillion domestic policy package congressional Democrats hope to pass by the end of the year. Because Democrats are using a legislative procedure called budget reconciliation to move the package, Senate Republicans can't filibuster the bill and the Senate's Democratic majority can pass it with a simple majority.