WASHINGTON - Fifty-seven House Democrats are pressuring party leaders to act quickly to avert a sharp hike in health insurance premiums that threaten to hit many Americans in October, just ahead of the midterm elections.
A letter written by leaders of the moderate New Democrat Coalition and signed by numerous lawmakers in competitive races this fall aims to push Senate Majority Leader Chuck Schumer, D-N.Y., to unify his 50-member caucus around a filibuster-proof bill that extends a set of enhanced Affordable Care Act subsidies, which passed in the 2021 American Rescue Plan and expire after this year.
"Without Congressional action this fall to extend the advanced premium tax credits, millions of Americans face the prospect of losing health care coverage or seeing their premiums spike," the lawmakers wrote, which is signed by Reps. Cindy Axne of Iowa; Kim Schrier of Washington; Tom Malinowski of New Jersey; and Chris Pappas of New Hampshire, and others in some of the toughest contests this year.
"With prices rising broadly, our constituents cannot afford these increased health insurance costs. This cannot happen on our watch," the Democrats said in the letter, first reported by NBC News and sent Monday evening to the offices of Schumer and House Speaker Nancy Pelosi, D-Calif.
According to the Department of Health and Human Services, 3 million people are projected to lose their coverage if the subsidies aren't extended. An additional 9.4 million would see their premiums go up due to an automatic reduction in funding set to take effect next year, which consumers are poised to be notified of this fall.
With inflation already causing hardships, failure to prevent those hikes would be a "double-whammy" for middle-class Americans in the health care marketplaces, said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.
"This would be a big hit to family budgets for ACA enrollees, and a big hit politically to Democrats, who count the ACA as one of their biggest domestic achievements in decades," Levitt said in an email. "Notices of premium increases would come right before the midterm elections, so the timing couldn't be worse for Democrats if they fail to pass a subsidy extension."
The political perils of failure are significant for Democrats, who enjoyed huge advantages against Republicans among voters in 2018 and 2020 who prioritized health care as their top issue. The GOP lost ground on the issue by pushing to eliminate the ACA, and the party unanimously opposed the subsidy boost last year.
The House passed the Build Back Better Act in November, extending a provision through 2025 that caps premiums on a "benchmark" plan to no more than 8.5 percent of income. But it has languished in the Senate after centrist Sen. Joe Manchin, D-W.Va., torpedoed it over other concerns. Democrats' only hope of extending the funding is to use the budget reconciliation process to bypass unanimous GOP opposition, which requires all 50 of their members.
In recent weeks, Schumer and Manchin have held a number of private meetings in recent weeks about a new bill, although neither has divulged details. It remains unclear whether Democrats can unify their caucus around a new party-line bill.
"Senator Manchin has supported extending the ACA subsidies in the past," Rep. Suzan DelBene, D-Wash., the chair of the New Democrat Coalition, said in an interview. "This is, clearly, critically important to families across the country. And so he voted for this provision in the American Rescue Plan. And I hope it has broad support and it is part of that discussion."
Manchin has told NBC News he's open to extending ACA funding. "Anything that helps working people be able to buy insurance that's affordable, I've always been supportive of," he said in February.
DelBene said there is "a great sense of urgency about moving legislation" before health insurers send out notices of new premiums next year. She said it's important that Congress extend the funding before the monthlong August recess.
"Ideally we get legislation passed long before letters go out, so people aren't confused," she said.
Senate Finance Chair Ron Wyden, D-Ore., said he has talked to Manchin and other Democrats "repeatedly" about "the meaning and the urgency of holding premiums down" by preserving ACA money.
"Too many people are still walking on an economic tightrope," he said. "So I see that as part of my job."