Nebraska senators explain health care votes as ACA credit expiration looms

The U.S. Senate rejected two plans to address health care costs Thursday as federal subsidies to lower Affordable Care Act premiums are set to expire at the end of the year.

Both of Nebraska’s Republican senators voted for the GOP-backed measure, known as the Health Care Freedom for Patients Act.

Instead of extending ACA tax credits, the bill would provide between $1,000 and $1,500 in payments to health savings accounts held by Americans earning less than 700% of the federal poverty level – around $225,000 for a family of four.

The bill would also prohibit the coverage of gender transition procedures as an essential health benefit.

Democrats proposed a three-year extension of the existing enhanced premium tax credits, which were introduced through the American Rescue Plan Act in 2021. The provision allowed additional households to become eligible for the credit, lowering payments toward premiums for some plans offered through health insurance exchanges.

In a statement following the vote, Sen. Pete Ricketts said the Democrats’ plan would only make the problems worse.

“The Republican plan gives money to people, not insurance companies,” Ricketts said. “It includes common-sense reforms to lower health care costs and combat waste, fraud and abuse. It builds on the successes of the ‘Working Families Tax Cuts Act’, which expanded access to health savings accounts. These solutions allow people choice and will improve health care access and affordability for Nebraskans.”

Sen. Deb Fischer said extending the credits would have helped insurance companies instead of addressing the root cause of rising costs.

“It's ridiculous that we would continue a program with tremendous fraud in it when we should be addressing the real issue, and that's the high cost, high, high cost, to health insurance due to Obamacare,” she said.

According to the Kaiser Family Foundation, health care premium payments could increase by an average of 114% if the subsidies aren’t extended. Nearly 25 million people are enrolled in the Affordable Car Act Marketplace, more than double the number of enrollees prior to the enhanced premium tax credits’ introduction.

The Senate is unlikely to take another vote on the topic before it goes into recess Dec. 22.