In Addition to Slashing Medicaid, Republicans Are Using Reconciliation to Repeal Key Parts of the ACA
Republicans aren’t satisfied with just slashing Medicaid, so they are now looking at using reconciliation to repeal large swaths of the Affordable Care Act (ACA). New reporting confirms that they want to rip care away from hardworking Americans who buy coverage on their own all to pay for tax breaks for billionaires and big corporations.
We’ve been down this road before. Taken together, the renewed Republican effort to repeal key parts of the ACA will threaten coverage for upwards of 25 million people. And that doesn’t include coverage losses resulting from their attacks on Medicaid. These policies are highly unpopular – even among Republican voters. But if Republicans get their way, costs will go up, hardworking families will lose their coverage, and the entire health care system will be thrown into chaos.
Codify Trump’s 2025 Marketplace Sabotage Rule: Republicans are planning to codify into law the 2025 Marketplace Sabotage rule proposed by CMS in March that will kick 2 million people off their Marketplace coverage, increase premiums for millions of people, and make enrolling in a plan more difficult. These changes will make it harder for families to enroll in ACA plans by shortening the enrollment period and taking away low-income families’ ability to sign up for coverage outside of the six-week enrollment period. The rule establishes more paperwork burdens for enrolling and proving eligibility for tax credits, and targets vulnerable communities that have historically faced barriers to accessing health care by barring immigrants with ‘Dreamer’ status from enrolling in ACA Marketplace plans and banning gender-affirming care from being covered as an essential health benefit.
Increase Premiums and Cost Sharing For Middle Class Families: By ending the current practice of “silver loading” and instead reinstating cost-sharing reduction (CSR) payments, the value of premium tax credits will drop, which will lead consumers to pay more out-of-pocket for premiums or deductibles and copays. Under the Affordable Care Act, CSRs are the reduced cost sharing levels Marketplace insurers are required to provide enrollees with incomes below 250% of the federal poverty level (about $39,000 for an individual and about $80,000 for a family of 4) who enroll in silver plans.
Ending The ACA’s Medicaid Expansion As We Know It: Whether by reducing the federal match rate or applying a per-capita cap to federal funding for people with Medicaid expansion, Republicans are planning to gut the ACA’s Medicaid expansion, threatening coverage for over 20 million Americans.
Continuing Their Plan to Take Away Enhanced Premium Tax Credits: Republicans want to end enhanced premium tax credits for working families, which will raise average premium costs by 93% and lead 5 million people to lose their health care altogether.