When Congress reconvenes in January, health care policy will be a major focus. Rising insurance premiums are impacting millions of Americans, and lawmakers are aware of this urgent issue.
However, there is significant disagreement on the way forward. Both parties, and the various factions within them, struggle to find common ground, leading to multiple proposals that haven’t yet resulted in solid legislation.
The House plans to vote on a Democrat-led bill aimed at extending enhanced Affordable Care Act (ACA) tax credits for three more years. This move follows a discharge petition, with four Republicans joining in to ensure a vote takes place.
While a similar proposal failed in the Senate, a bipartisan group of senators is crafting a compromise to extend these credits. They might include provisions favored by Republicans, such as measures to prevent fraud and income caps. Yet, divisions remain, with some Republicans insisting on including anti-abortion protections, which Democrats oppose.
Speaker Mike Johnson, R-La., recognizes the challenges, referring to health care as a “very complicated issue.” He hinted at forthcoming efforts aimed at reducing health care costs, particularly by early 2026.
Looking ahead, Congress has several key areas to consider.
Health Savings Accounts
One proposal gaining traction comes from Senators Bill Cassidy and Michael D. Crapo. They want to expand access to health savings accounts (HSAs) by offering up to $1,500 annually to those with HSAs linked to bronze ACA plans, especially if the credits expire. Former President Trump has expressed support for funding consumers directly rather than subsidizing insurance companies.
Senate Majority Leader John Thune agrees, criticizing the three-year extension as a “waste of money.” House Republicans initially didn’t have time to include HSAs in their plan but plan to revisit it. Speaker Johnson believes there’s potential for broad agreement on this topic.
Democrats, however, are skeptical that HSAs can effectively replace expiring credits or deliver comprehensive coverage.
Employer Coverage
Though Congress has focused on ACA premiums, most Americans receive insurance from their employers. Cassidy, who leads the Senate Health Committee, wants to address both ACA affordability and employer-sponsored coverage, but specifics remain unclear.
Republicans have typically favored targeted fixes rather than sweeping changes, proposing ideas like expanding short-term health plans or increasing the deduction for medical expenses.
Pharmacy Benefit Managers
For years, Congress has attempted to reform pharmacy benefit managers (PBMs). While some legislation advanced, unrelated issues halted progress. Previous proposals sought to ensure PBMs pass drug rebates back to health plan sponsors and to ban “spread pricing,” a practice that overcharges certain plans for medications.
Support for reform appears strong, with influential voices like Senate Finance members Crapo and Ron Wyden advocating for a renewed PBM bill. Wyden emphasized the need to confront middlemen who increase prescription drug costs for Americans.
Other Considerations
Congress might also revisit Medicare telehealth services, which expanded significantly during the pandemic. Temporary extensions have been made, but advocates push for a long-term solution. The uncertainty has previously led to interruptions in care for many patients.
There are discussions about equalizing Medicare payments for outpatient services at hospitals versus non-hospital clinics. This has been a point of interest, especially since Congress has eyed legislation to address these discrepancies.
As these issues unfold, public interest remains high. Surveys show Americans are increasingly concerned about health care costs, placing pressure on lawmakers to find effective solutions. With discussions heating up, it’s clear that health care policy will be a central issue in the coming year.
Source link
Abortion,Bill Cassidy,Brand Safety,Budget,Congress,Democrats,Donald J. Trump,Donald Trump,Education,Elon Musk,Executive Branch,Finance,Health,Health Care,Healthcare,Holiday,House,Idaho,Insurance,John Thune,Louisiana,Medicaid,Medicare,Michael D Crapo
