REGIONAL — U.S. Rep. Pete Stauber joined fellow House Republicans this week in approving a health care bill that would expand access to employer insurance options but leave millions of Affordable Care Act enrollees exposed to steep premium hikes when enhanced subsidies expire Dec. 31.
The bill, titled the Lower Health Care Premiums for All Americans Act, passed the House on Wednesday on a 216-211 vote. It aims to lower costs for small businesses and self-employed workers by expanding association health plans and limiting how states can regulate stop-loss insurance for self-funded employer plans. The House bill also includes funding for cost-sharing reductions for low-income ACA enrollees, projected to reduce gross benchmark premiums by about 11 percent.
Association plans are a key feature of the legislation. These plans allow small employers and self-employed people to join together to buy health insurance as a larger group. Pooling workers from different industries lets them negotiate rates more like a big employer. Unlike ACA marketplace plans, association plans face fewer federal regulations. Supporters say that flexibility can reduce premiums. Critics warn it can mean fewer essential benefits and weaker protections for people with pre-existing conditions.
But the bill does not address the looming expiration of the enhanced ACA premium tax credits first enacted during the pandemic. Those subsidies currently cap how much eligible households must contribute toward their monthly premiums and expanded eligibility to some middle-income families for the first time. If Congress does not act before the end of the year, an estimated 22 million ACA enrollees would see average monthly premiums double, according to health policy organization KFF.
There are about 20,500 ACA marketplace enrollees in Minnesota’s Eighth Congressional District, representing approximately 2.8 percent of the population.
As reported by the Duluth News Tribune, in a telephone town hall shortly after Wednesday’s vote, Stauber characterized the ACA subsidy enhancement as corporate welfare.
“We’re not going to allow Big Insurance and Big Pharma to control our health insurance any longer,” Stauber said. “They’ve been ripping the American people off. We’ve paid through the nose.”
The House bill would decrease the federal deficit by an estimated $35.6 billion through 2035, according to projections from the Congressional Budget Office. Roughly 100,000 Americans per year would lose their health insurance, driven by changes in subsidy calculations, association plan enrollment shifts, and cost-sharing reduction impacts.
Republican leaders declined to allow a vote on an amendment to extend the enhanced ACA subsidies as part of the bill. That refusal prompted four GOP moderates to sign a Democratic discharge petition intended to force a vote early next year, though none of them were from Minnesota.
Minnesota DFL officials criticized Stauber and the state’s Republican delegation for supporting the legislation.
“Instead of stepping up to make health care affordable for working people, Minnesota’s Republican delegation is selling out families and refusing to lift a finger as premiums skyrocket,” DFL Chair Richard Carlbom said in a statement. “Families are facing higher costs, fewer protections, and impossible choices if they get sick.”
The DFL press release gave examples of how the loss of subsidies for health insurance premiums would affect two Minnesota families.
A 59-year-old Minnesota widow and caregiver described the stakes of rising premiums for her disabled son in the DFL release.
“I often find myself skipping meals to better afford his needs and keep our home. At 59, I never thought I would be in this position,” she said. “Congress has the power to stop this insanity and they are choosing not to.”
Another Minnesota family warned their daughter’s MNsure premium would increase 80 percent on Jan. 1 and said higher Medicare Part B costs will strain their own household budget.
“If my daughter had not been on my insurance, hospital costs would have bankrupted her. These credits expiring will surely close hospitals and clinics or reduce the services they provide,” said the parent.
The Senate is expected to consider its own health care legislation in the coming weeks, which could include funding for health savings accounts and debate over subsidy extensions.