The Waiting Room | The Jan. 6 Showdown: Will the House Save the ACA Tax Credit Extension?
The good news: 2025 is finally over. The bad news: There's still three more years of Trump's term to go.
Charles Gaba is a health care analyst who tracks policy and politics at ACASignups.net. Subscribe to his Substack!
Greetings, Lincoln Square readers! Welcome to the first Waiting Room of 2026!
When we left off two weeks ago, there had just been much DRAMA! amongst House Republicans, as four “moderate” members (aka “vulnerable swing district”) staged a minor mutiny against GOP Speaker Mike Johnson by signing onto the Democrats’ discharge petition to force a House vote on a clean, three-year extension of the enhanced ACA tax credits after all!
Immediately after defying Johnson, however, those same four so-called “moderates” joined the rest of the GOP caucus in passing the main bill which would do a few harmless things and two harmful things. Hopefully this bill will go nowhere in the Senate.
Meanwhile, the initial December 15th deadline for people to enroll in healthcare coverage starting January 1st in most states had come and gone.
So, where does that leave things for, y’know, all ~24 million or so actual ACA enrollees?
Well, for starters, residents of 49 states still have until at least January 15th to enroll for coverage starting February 1st.
They can also switch plans if the one they enrolled in (or were auto-renewed into) isn’t their best option. Keep in mind that switching plans for February-December has its own potential downsides—for one thing, anything you pay towards your deductible/maximum out of pocket cap in January likely won’t be credited towards the new plan, and there could be some paperwork confusion as providers have to update your plan of record twice.
However, this could be the best option for some people, especially those who were auto-renewed into a policy where the premiums shot up dramatically in January.
The exception to the above is Idaho, where the December 15th deadline was the only one for 2026 Open Enrollment.
I would once again STRONGLY urge folks to read my UPDATED ACA Enrollment Guide for a ton of important information about Open Enrollment.
As for the House vote, I believe that’s supposed to happen pretty much as soon as the House reconvenes, potentially as soon as Tuesday, January 6th (yes, January 6th).
Assuming it passes, it would then be kicked back over to the Senate, where GOP Majority Leader John Thune may or may not bother even bringing it up for another vote … and even if he does, it’s extremely unlikely to reach the 60 vote cloture threshold just a month or so after only getting 51 votes.
Of course, with the House vote coming up next week (?) and the Continuing Resolution to keep the federal government running out (again) at the end of January, most other Congressional Republicans are pulling out all the stops to try and justify not extending the enhanced tax credits, including an absurdly disingenuous CNN appearance by Oklahoma Senator James Lankford last Sunday.
MEANWHILE …
While no official enrollment report has come out since nearly a month ago, CMS Administrator Dr. Mehmet “not a snake oil salesman, really!” Oz did Tweet out a quick update about 15.6 million enrollees signing up via the federal exchange.
This may sound like an impressive number given that there’s still two weeks to go for people to sign up, but keep in mind that in spite of my repeated warnings, around half the total enrollees will likely be people who let themselves be passively auto-renewed.
This means that a significant number of people will likely have to immediately drop their coverage as soon as they recover from the sticker shock of their January invoice … while others may be able to stick it out for several months before having to do so
On a related note, don’t be surprised if the official “average premium increase” reported by the Trump Regime is “only,” say, 70% higher (or whatever) than in 2025 instead of the 114% estimated by KFF last fall. Keep in mind that their estimate was made on the assumption that 100% of current enrollees a) remain enrolled and b) renew into the same plan they had last year.
The reality is that millions of enrollees were forced into downgrading their plan to ones with much larger deductibles/out-of-pocket costs to mitigate the massive premium hikes, while others were forced into dropping out of the market altogether (which means they won’t be counted in that equation at all). Both of these will result in the “official” average premium hikes miraculously being lower than projections …even though the actual medical expenses for most enrollees still skyrockets.
In any event, let’s all pray that 2026 is a lot better than 2025.
I’ll see you again in two weeks … which will also happen to be the final 2026 Open Enrollment Period deadline in most states (unless Congress pulls a rabbit out of its hat and extends the enhanced subsidies after all … in which case they’d likely extend the final OEP deadline, as well.)
Republicans don't give one damn how many or who dies as long as billionaires thrive. That's another area where dems and non psychopathic humans fall short, they think republicans will do the right thing. They never have, they never do and they never will.
Could it be more obvious that there's no way to make health care affordable for people with little of no money unless rates are based on ability to pay. That means the rich will have to pay a premium to balance the books. There's no private sector market based solution that can do that. The only such solution that involves the private sector is a Medicare/Medicare Advantage structure funded by an income based (direct income or payroll tax that allows the finance sector to evade it). Under an Advantage plan, the wealthy can add paid perks as they wish, but at least basic care would be provided for all.
Perhaps there are other solutions, but no user funded approach can work. 'Medicare for all' can work if there are no caps and loopholes for the super rich to deny being their brother's keeper. We the people as a nation granted them the right to wealth by choosing a capitalist system for our republic, and there is a price owed back to the common good in exchange for that privilege.