Forget repeal and replace. Critics of the Affordable Care Act, a.k.a. Obamacare, have a new target: key parts of the law that they say are too costly and provide incentive for fraud.<\/p>\n
Topping that list are the\u00a0ACA\u2019s enhanced subsidies<\/a>, put in place during the coronavirus pandemic as part of economic recovery legislation and set to expire next year unless Congress acts. The subsidies are credited with enabling more low-income people to qualify for zero-premium coverage and helping boost enrollment to record levels.<\/p>\n If the subsidies expire, millions of Americans will probably see premiums go up,\u00a0according to a report from KFF<\/a>. And the Congressional Budget Office (CBO) says the end of the enhanced subsidies could cause\u00a0ACA enrollment to fall<\/a>\u00a0from a projected 22.8 million in 2025 to 18.9 million in 2026.<\/p>\n But the subsidies cost a lot. The CBO recently estimated that making them permanent would add\u00a0$335 billion<\/a>\u00a0to the budget deficit over 10 years,\u00a0and some Republicans<\/a>\u00a0have said<\/a>\u00a0that\u2019s simply too much.<\/p>\n Now the subsidies are part of a larger debate about ACA fraud and enrollment schemes.<\/p>\n At issue is whether people are over- or understating their incomes to qualify for the subsidies. In addition, some lawmakers are concerned about reports that\u00a0consumers are being enrolled<\/a>\u00a0in ACA plans or their coverage is being switched \u2014 without their consent \u2014 by a subset of unscrupulous brokers eager to gain commissions.<\/p>\n House GOP leaders\u00a0have called on two watchdog agencies<\/a>\u00a0to investigate, while\u00a0Sen. Chuck Grassley\u00a0<\/strong>(R-Iowa) fired off accountability questions in\u00a0a recent letter<\/a>\u00a0to the Centers for Medicare and Medicaid Services.<\/p>\n The Republican outcry \u2014 particularly aimed at the subsidies \u2014 goes hand in hand with\u00a0a controversial recent report from a conservative think tank<\/a>\u00a0estimating that millions of people or their brokers may be misstating their incomes to qualify for ACA subsidies.<\/p>\n Still, the enhanced subsidies are unlikely to become talking points in either party\u2019s presidential campaigns.<\/p>\n \u201cIt\u2019s too complicated,\u201d said Debbie Curtis, a vice president at consultancy McDermott+. \u201cI see what\u2019s happening right now as laying the groundwork for the big fight next year.\u201d<\/p>\n Any debate about the enhanced subsidies is likely to draw in other issues \u2014 including the Trump-era tax cuts, whose extension would\u00a0add an estimated $4.6 trillion<\/a>\u00a0to the deficit over 10 years \u2014 and must be addressed next year. Other aspects of the ACA are also potentially in play, including a special year-round enrollment period for low-income consumers and whether zero-premium plans will still be available for that group.<\/p>\n \u201cThe fate of the enhanced tax credits is dependent on the Democrats holding some majority in Congress and\/or winning the presidency and is also tied inextricably to the Trump tax cut expiration,\u201d said Dean Rosen, a partner at Mehlman Consulting and a former senior Republican congressional staffer. That\u2019s because both sides have incentive to extend all or part of the tax cuts, but each will want some kind of compromise on other issues as well.<\/p>\n This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org<\/a>.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n