The Senate Health Education Labor and Pensions Committee on Wednesday held a hearing on affordability, piggybacking on a similar hearing in the Finance Committee just before the Thanksgiving recess.
Committee Chair Bill Cassidy (R-La.) acknowledged that large scale reform of the Affordable Care Act is not going to happen, at least not this year.
"Now, we can push for big ideas, grandiose ideas on the right or the left, but we gotta have a solution for three weeks from now," Cassidy said. "I am speaking to my Democratic and Republican colleagues to find a bill that can get 60 votes on the floor of the Senate to take care of that problem."
But at the same time, Cassidy is pushing a plan that would end the enhanced subsidies in favor of funding health savings accounts for people who buy high-deductible plans on the exchanges.
Sen. Josh Hawley (R-Mo.) pitched a major reform to the tax code. He wants to allow taxpayers to deduct all out-of-pocket medical expenses up to $25,000 per individual or dependent. Hawley has been warning about the impact of expiring subsidies, but hasn't endorsed what Democrats want to do.
For them, the simplest and only option remains a straight extension of the enhanced subsidies.
"Saying 'let's start talking about fixing this now,' a month into open enrollment, instead of any point earlier this year when we actually had time to stop premiums from skyrocketing or look at some of these different reforms—well, this is about as serious as expressing concern about RFK Jr.'s anti-vax crusade after voting to make him the most powerful public health official in the country," Sen. Patty Murray (D-Wash.) said in the hearing.
Senate Majority Leader John Thune (R-S.D.) has promised Democrats he will hold a vote next week on a subsidy bill of their choosing. The legislation is expected to be a "clean" extension of the enhanced subsidies for three years; something that is dead on arrival for Republicans.
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