By Ahmed Aboulenein and Richard Cowan
WASHINGTON, Dec 12 (Reuters) – Republican leaders in the U.S. House of Representatives on Friday presented a healthcare proposal that leaves unresolved steep health insurance premium increases set to impact millions of Americans as early as January.
The bill does not extend the Affordable Care Act, also known as Obamacare, enhanced subsidies enacted during the COVID-19 pandemic, which are scheduled to expire on December 31 unless Congress acts, leaving some 24 million Americans vulnerable to significantly higher insurance premiums beginning on January 1.
The bill includes cost-sharing reductions, a measure aimed at lowering premiums for some individuals while reducing overall subsidies and raising premiums for others, which would kick in starting January 2027.
House members could offer amendments to the bill to extend the subsidies and address the 2026 gap if the House Rules Committee votes to allow them to be offered during floor debate next week. The House Rules Committee is set to meet on Tuesday to decide that.
Even if it were to pass the House, the bill’s prospects in the Senate are dim as it is unlikely to draw the support of at least 60 of the 100 senators needed to advance most legislation.
Republicans in Congress are divided on extending the subsidies. Moderate House Republicans are pushing for a two-year extension of the enhanced tax credits, seeking to attach a vote on the matter as an amendment to the broader package.
The issue has further complicated discussions; some GOP lawmakers say any potential extension should address abortion coverage, a non-starter for Democrats.
Other measures in the bill include expanding access to association health plans, which allow small businesses, freelancers, and self-employed individuals to pool resources and purchase group health insurance at potentially lower costs.
It also introduces new transparency rules for pharmacy benefit managers, and expands the use of Health Reimbursement Arrangements, which allow employers to reimburse workers tax-free for healthcare expenses and premiums.
(Reporting by Ahmed Aboulenein and Richard Cowan; Editing by Lisa Shumaker)
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