House Passes Health Reform Measure that Excludes PTC Extension

On December 17, the House of Representatives passed a bill, H.R.6703, that would make it easier and/or less expensive for individuals to buy health insurance and/or for employers to offer health insurance to their workers. However, the bill did not include an extension of the now-expired enhanced Affordable Care Act (ACA) health insurance premium tax credits (PTCs). The vote was 216 to 211.

The Lower Health Care Premiums for All Americans Act would:

• Codify the Association Health Plan (AHP) regulation released by the first Trump Administration and rescinded by the Biden Administration. The measure would allow self-employed and small businesses to buy group health insurance through an AHP with loosened nexus requirements.
• Fund cost-sharing reduction (CSR) payments (thus, bill supporters say, allowing insurance companies to lower premiums). The bill did not change current law which sends CSR payments to insurance companies, despite many calls (including by President Trump) to instead channel those payments to individuals.
• Provide that self-funded health plans’ stop loss coverage will not be considered health insurance for purposes of ACA minimum essential benefit (and other) rules
• Create CHOICE accounts (including enhanced tax benefits for new accounts built on the structure of current law individual choice health reimbursement arrangements)
• Reform pharmacy benefit manager (PBM) rules

The House-passed bill reflects GOP conviction that bolstering more affordable private sector health insurance is a key way to resolve the health care cost crisis. However, it does not address current individual cost issues, like the huge increases in the cost of health insurance currently faced by many individuals who had been benefitting from the now-expired ACA enhanced PTCs.

Prospects: The partisan HR 6703 has virtually no chance for consideration, much less enactment, in the Senate where it would take 60 votes (and thus Democratic support) to pass. However, its provisions could come into play if and when Congress combines GOP and Democratic priorities in a compromise health reform package that can address the enhanced PTC expiration issue.

NAIFA Staff Contacts: Jayne Fitzgerald – Director – Government Relations, at jfitzgerald@naifa.org or Mike Hedge – Senior Director – Government Relations, at mhedge@naifa.org.