WASHINGTON — A leading Senate Republican on healthcare policy has been courting Democrats to back his alternative proposal to an extension of the COVID-era Obamacare subsidies set to expire next month.
Sen. Bill Cassidy (R-La.), who chairs the Senate Health, Education, Labor and Pensions Committee, is seeking to take the extra funding, which has been going to insurance companies, and give it to consumers directly through their healthcare savings accounts.
“I am speaking to Democrats, and there’s things you have to work through,” Cassidy told reporters Monday when asked about negotiations. “At least one person has been, ‘Wow, this sounds pretty good.’ Another person [said, ‘It] ‘sounds good, but let me learn more.’
“As a conservative, I love it, but I think it’s got a lot of appeal to people who are left of center, too,” Cassidy said.
The details of Cassidy’s plan are still getting ironed out.
As a result, he is refraining from giving a price tag for the proposal, too, until he gets an assessment from the Congressional Budget Office, the Treasury Department and the Department of Health and Human Services.
The main concept is that instead of extending the Affordable Care Act’s Enhanced Premium Tax Credits — the primary issue that motivated the Democrats’ government shutdown fight — the government would instead send money to people’s HSAs.
Meanwhile, the baseline tax credits under Obamacare would be untouched.
“Who would not want to spend 100% of the dollars on the patient choosing the health care she wants, as opposed to 100% going to insurance companies and the 80% being spent on health care … and that health care is what the insurance company decides that you need,” Cassidy said.
Critics have raised concerns that similar proposals to Cassidy’s plan could undermine the Obamacare exchanges pool and push it into a death spiral, a vicious cycle in which many patients ditch their insurance, leaving mostly sick people in while premiums go up.
“For those who are concerned about a death spiral, I think they’re presuming that we’re taking the advanced premium tax credit that is baseline Obamacare, extracting that and spending it elsewhere,” Cassidy told The Post when asked about the worries.
“We’re not doing that. That baseline [Advance Premium Tax Credit] stays on an Obamacare product,” he said. “It is that incremental increase that we’re taking to fund these health savings accounts.”
The enhanced Obamacare subsidies, which are set to expire at the end of next month, cost roughly $30 billion annually and would run about $350 billion if extended over a decade, according to the CBO.
Total spending on Obamacare, including the enhanced subsidies, clocked in at roughly $138 billion in 2025, according to the Committee for a Responsible Federal Budget.
President Trump has publicly called for Congress to look at setting up a system of giving healthcare subsidies that normally go to insurance companies directly to patients.
“The insurance companies are making a fortune,” Trump told reporters Sunday. “Their stock is up over a thousand percent over a short period of time. They are taking in hundreds of billions of dollars, and they’re not really putting it back certainly like they should.”
Senate Majority Leader John Thune (R-SD) promised Democrats a vote on their preferred piece of legislation to tackle the expiring enhanced Obamacare subsidies to win over defectors during the government shutdown fight.
That vote is expected to take place in the second week of December.
