By Nolan D. McCaskill and Richard Cowan
WASHINGTON, Dec 11 (Reuters) - The Republican-controlled U.S. Congress is poised to allow tax credits to lapse for 24 million Americans this month, as a December
31 deadline approaches with no sign of a healthcare compromise before the Senate votes on Thursday on dueling proposals that lack enough support to pass.
The Democratic proposal on the subsidies under the Affordable Care Act, popularly known as Obamacare, would extend COVID-era subsidies for three years to keep insurance premiums from soaring for many. Those premiums could more than double in cost on average, according to KFF, a health policy organization.
A Republican bill by U.S. Senators Bill Cassidy of Louisiana and Mike Crapo of Idaho would send up to $1,500 to individuals earning less than 700% of the federal poverty level — about $110,000 for an individual or $225,000 for a family of four in 2025. Those funds could not be used for abortion or gender transition procedures and would require verification of beneficiaries' immigration or citizenship status — provisions Democrats reject.
Each party's leader in the Senate has panned the rival party's bill, with 60 votes needed to pass either measure in a Senate that Republicans control 53-47.
President Donald Trump has largely sat out the brawl over healthcare, although he ultimately embraced the Cassidy-Crapo approach.
The $1,500 payments in the Republican bill are meant to cover some of the out-of-pocket costs that people on lower-cost “Bronze” or “Catastrophic” Obamacare plans need to pay before their insurance kicks in.
However, it is far below the plans’ deductibles, meaning that even after that payment, a patient would be on the hook for up to $7,500 in out-of-pocket medical expenses before their insurance would start to pay for part of their care.
Those costs can rack up quickly for people with lower-cost plans, with a visit to a U.S. emergency room costing between $1,000 and $3,000, while an ambulance ride can cost anywhere from $500 to over $3,500.
MIDTERM ELECTIONS LOOM
With 2026 congressional elections coming into focus, many Republicans are nervous about the prospect of stiff premium increases hitting every state, including many that backed Trump's 2024 reelection. Polling indicates voters could mostly punish Republicans, who control Congress and the White House.
Republican U.S. Senator Josh Hawley of Missouri told reporters on Monday it would be unacceptable to close out the year without a healthcare fix. Even in a state Trump carried by 18 points, Hawley said constituents tell him: "We can't afford our premiums now, let alone if they would go up by 50 or 100%."
Congress' failure to send a solution to Trump would mean tens of millions of Americans being forced to make difficult spending decisions as voters cite affordability as their top worry.
"What are they going to cut back on?" top Senate Democrat Chuck Schumer of New York asked on Wednesday. "Their healthcare or their food or their ability to buy some Christmas presents for their kids?"
Insurance companies have warned customers of the rising premiums in the new year, and Democrats argue there isn't enough time to do anything but a clean extension of the tax credits. Congress aims to leave town by the end of next week until January 5.
MOST AMERICANS SUPPORT EXTENSION
A new Reuters/Ipsos poll found Americans back a healthcare subsidy continuation. Some 51% of respondents — including three-quarters of Democrats and a third of Republicans — said they support extending the subsidies. Only 21% said they were opposed.
Other healthcare bills are swirling, including four from Senate Republicans this week. Schumer said Republicans' ideas "are loaded with poison pills, unworkable restrictions and don't do anything to bring down premiums."
Meanwhile, some bipartisan House measures would temporarily extend the subsidy and add some restrictions, but House Republican leaders have rejected any extension.
Moderate Republican Representative Brian Fitzpatrick of Pennsylvania is spearheading a bipartisan bill to extend the subsidy through 2027. He is hoping to garner enough support to circumvent leadership and force votes on the measure by the full House.
It is unclear what healthcare legislation Republican House Speaker Mike Johnson will unveil in time for House votes next week. He has given no sign of consulting Democrats, whom he blames for skyrocketing premiums.
"You cannot be an arsonist and a firefighter at the same time," Johnson said of Democrats.
(Reporting by Nolan D. McCaskill and Richard Cowan; Additional reporting by David Morgan, Jason Lange and Ahmed Aboulenein; editing by Scott Malone and Bill Berkrot)
