Negotiations over any extension of the enhanced Affordable Care Act premium subsidies are seemingly dead.
Tensions between lawmakers escalated amid finger-pointing over an impasse in negotiations for a deal that had seemed to be a long shot ever since the subsidies expired at the end of December.
A draft from one of the key GOP negotiators, Sen. Bernie Moreno, was leaked Wednesday, outlining a final offer to Senate Democrats containing the “maximum” of what Republicans could support, according to a report from Semafor.
But while Democratic senators offered little reaction publicly to the proposal in the hours after it was released—a number of lawmakers said they still needed to review the proposal—some Democratic offices were privately caught off-guard by its contents. The draft language went beyond conversations senators had, according to two Senate Democratic sources familiar with the talks.
“This isn’t what you would do if you were trying to get an agreement,” one Democratic source told National Journal, on condition of anonymity to speak freely about the state of negotiations.
Moreno’s proposal would offer a one-year straight extension of the enhanced premium tax credits, which expired at the end of last year. Under the draft, the subsidies would be phased out after 2026, with the option of redirecting funds directly into health savings accounts for those in bronze plans under the ACA marketplace during plan years 2027 and 2028.
The proposal would require a minimum premium payment of $5, extend open enrollment until the end of March, enact income limits at up to 700 percent of the federal poverty level, and enact penalties for fraudulent enrollment by insurance agents and brokers. It also would fund cost-sharing reduction payments, and require regular audits to ensure that funds being spent do not conflict with the Hyde amendment barring taxpayer funding of abortions.
In an interview with Semafor, Moreno noted that the proposal did not represent the larger GOP conference’s views, but was rather “the maximum” of what he thought his party could support.
“We haven’t sold this to our conference yet,” he said. “What I am presenting to them today is the best-case scenario of what they would accept.”
It’s also unclear whether or not the proposal has the backing of the other Republican senators involved in the negotiations—Sens. Susan Collins and Bill Cassidy.
The contours of the Moreno proposal caught some Democratic offices off-guard. Sen. Tim Kaine—one of the Democrats involved in negotiations who said he still needed to review bill text—had mentioned that his Democratic colleagues had a “general agreement” about what would be included in any measure. He said he still needed to compare notes on whether Moreno’s proposal aligned with that agreement.
However, a number of items in the proposal went beyond what was initially agreed to, the two Democratic sources said. According to one Democratic source, the language limiting an extension of the subsidies to one year and language that would prevent them from going to undocumented migrants was not a part of those initial conversations.
Moreno's office declined to comment.
“There are a lot of issues that need to be resolved,” Sen. Dick Durbin said Thursday, noting that he had spoken to Moreno and the other senators involved in negotiations. “But we can do it, because millions of people have seen their premiums go through the roof.”
Senators may have run out of time to reach a deal. Lawmakers had been hoping that momentum from a discharge petition that passed the House at the beginning of the month would drive negotiations in the Senate. But conversations have bounced back and forth, with disagreements on the key tenets of any deal.
Democrats had disagreements over the language requiring minimum premiums, with certain states such as Georgia being disproportionately impacted by such policies. Republicans had drawn a red line that any extension would need to include language prohibiting tax dollars from flowing to abortions.
All throughout January, Moreno told reporters that a deal was within reach and bill text was forthcoming soon. However, bill text for any supposed bipartisan agreement has not yet been released.
In an interview with NOTUS Thursday, Moreno said he had not heard from negotiators and claimed that Minority Leader Chuck Schumer had squashed Democratic support of the deal.
The friction over the deal suggests it’s doubtful Democrats will give a counteroffer to Moreno’s draft, or that there are further meetings planned on the issue. One Democratic source took issue with the statement provided by Moreno’s chief of staff to Semafor, which signaled that the senator’s final offer didn’t leave a lot of room for further negotiation.
When asked if time has run out for further negotiations, one Democratic source put it plainly: “It sure looks like it.”
