Maine's two senators both support extending premium subsidies under the Affordable Care Act but are publicly backing two different proposals just days before a likely Senate vote.
King, an independent who caucuses with the Democrats, has indicated that he plans to vote for a Democratic proposal that would extend for three years the subsidies used by more than 20 million Americans. The Senate is expected to vote on that Democratic proposal this Thursday as part of a controversial agreement that King and seven Democrats struck last month to end the six-week-long federal government shutdown.
Most Republicans are unlikely to support the Democratic measure, with both sides referring to Thursday's floor action as a "messaging vote." But Republicans are under intense pressure to come up with alternatives or else risk being blamed for allowing premiums to rise sharply for millions of Americans — including more than 50,000 Mainers — starting on Jan. 1.
On Monday, Collins joined Republican Sen. Bernie Moreno of Ohio in proposing a two-year extension, which they described as a "glidepath off the COVID-era subsidies."
Their bill would also eliminate subsidies for households earning more than $200,000 a year, reflecting the Republican desire for restoring income caps in the program. The Moreno-Collins bill would also require everyone who purchases insurance through an ACA marketplace to pay at least $25 a month, eliminating the possibility of $0 premiums.
“Families in Maine and across the country are struggling with the high cost of health care, and we need to pursue practical solutions that increase affordability without creating sudden disruptions in coverage,” Collins, who chairs the Senate Appropriations Committee, said in a statement. "This bill would help prevent unaffordable increases in health insurance premium costs for many families by extending the Affordable Care Act enhanced premium tax credits for two years and putting a reasonable income cap on these subsidies to ensure they are going to the individuals who need them.”
The Moreno-Collins proposal is one of several apparently being discussed by Republican senators. Another GOP proposal that has received more attention would instead put money into health savings accounts for people to use. House Speaker Mike Johnson, R-Louisiana, has also said he planned to release a health care bill as early as this week.
But it was unclear Monday whether Senate Republicans would put forward their own alternative proposal during Thursday's vote on the Democratic bill.
Either way, political pressure is on Congress to act quickly.
While the existing ACA subsidies will expire on Dec. 31, individuals who purchase their health insurance through the ACA must do so by Dec. 15. Without congressional action, the average premium nationwide for an ACA policy is expected to more than double starting on Jan. 1 and will quadruple for some higher-income families. As a result, many consumers who currently purchase health coverage through the ACA are having to decide whether they can afford to re-enroll.
Roughly 85% of the 61,000 Maine residents who purchase insurance through the state's ACA Marketplace at CoverME.gov receive the enhanced premium tax credits that subsidize their premiums. According to the administration of Gov. Janet Mills, those households will see an 88% increase in premiums, on average, if the subsidies expire.
Democrats would need at least 13 Republicans to pass their 3-year extension out of the Senate, a scenario that appears highly unlikely. Collins declined to say during a Punchbowl News event last week whether she would support the Democratic bill but instead talked about the need for income caps and elimination of plans where consumers pay $0 in premiums — two issues that are addressed in the bill she is co-sponsoring with Moreno.
King's office said Monday that the independent will take a closer look at any alternative proposals offered by Republicans.
