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Picture yourself in a boat on a river, with tangerine trees, and a Republican party that grounds genuine fiscal conservatism (the kind that eschews multi-trillion-dollar tax cuts) in fact rather than in lies and fantasy. What might a compromise on extension of the enhanced premium subsidies in the ACA marketplace look like?
Stop presses: It might look like the bill put out by the Problem Solvers’ caucus today. (I mean ‘‘stop presses” literally, as I was sketching out my own compromise here when I came across the bill in question.)
The Healthcare Optimization Protection Extension (HOPE) Act (summary here, bill text here) was introduced today by Problem Solvers members Tom Suozzi (D-NY), Don Bacon (R-NE), Josh Gottheimer (D-NJ), and Jeff Hurd (R-CO). It addresses two legitimate concerns about the enhanced premiums subsidies (eAPTC) created by the American Rescue Plan Act and currently funded only through 2025: that they spend too much money subsidizing high-income enrollees (questionable, but not absurd), and that they opened an easy pathway to fraud (true, but only in concert with other factors that can be addressed to shut the fraud down).
The HOPE bill only lightly increases the premium burden at incomes over 600% of the Federal Poverty Level ($93,900 annually for an individual, $126,900 for a couple, $192,900 for a family of four). The subsidy “cliff” — the cap on eligibility — goes back in place, but rises from the pre-ARPA (and now pending) 400% FPL to 935% FPL. The new cliff will take a substantial bite from some pretty affluent individuals and families, as explored below, but the ranks of those affected are small.
