The White House is weighing a proposal to extend the COVID-enhanced Obamacare subsidies that Democrats have urgently pushed to preserve before they expire at year's end.
President Donald Trump is considering a two-year extension of the subsidies, but with limits.
Under the draft plan currently under debate in the White House, eligibility would be capped at households earning up to 700% of the federal poverty level, a significant shift from the current open-ended income structure that pumped taxpayer dollars into Obamacare under COVID.
Today, households can access subsidies as long as their premium costs exceed 8.5% of income.
The proposal would also end the popular zero-premium insurance option. Lower-tier plans could carry a minimum monthly charge of $5.
The White House has not committed to the plan, and internal debate continues, but no plan is final until Trump announces it.
"Until President Trump makes an announcement himself, any reporting about the administration's healthcare positions is mere speculation," White House spokesman Kush Desai said Monday.
White House press secretary Karoline Leavitt told reporters Monday afternoon that Trump "is very much involved in these talks" and he is "focused on unveiling a healthcare proposal that will fix the system and will bring down costs for consumers."
The subsidies were at the heart of the Democrats' demands in the government shutdown fight that ended earlier this month.
Most Democrat lawmakers had insisted on a straight extension of the tax credits they had planned to expire, with the COVID pandemic long being behind the world now.
The baseline tax credits that were originally part of the Affordable Care Act were capped at 400% of the federal poverty level, but that cutoff was suspended because of the temporary COVID-era credits that allowed middle- and higher-income people to benefit from subsidies too.
There are signs that parts of the nascent White House plan could get buy-in from Democrats. Sen. Maggie Hassan, D-N.H., one of eight members of the Senate Democrat caucus who voted to reopen the government earlier this month, said it "represents a starting point for serious negotiations."
"The fact that President Trump is putting forward any offer at all to extend the Affordable Care Act's tax credits shows that there is a broad understanding that inaction in this regard will cause serious harm to the American people," Hassan said.
Sen. Jeanne Shaheen, D-N.H., who led bipartisan efforts to end the government shutdown, said, "I'm glad the president is reportedly considering a serious proposal."
"I've had constructive conversations with many of my Republican colleagues who I believe want to get this done," Shaheen said. "They understand that the vast majority of people who benefit from these tax credits live in states the president won, and that the president's own pollsters have underscored the enormous political urgency of Republicans acting."
In 2017, Trump fell short in a push to dismantle the Affordable Care Act.
The GOP has failed to coalesce around a unified healthcare proposal since, and the expiration of the pandemic-era subsidies gives Trump and his party an opportunity to put their own stamp on the issue.
As the White House worked quietly on its plan, led by the Domestic Policy Council, key lawmakers on Capitol Hill have drafted their own proposals.
Sen. Rick Scott, R-Fla., Sen. Bill Cassidy, R-La., and others have proposed various ideas for redirecting the program's spending on federal subsidies into health savings accounts that enrollees could use to shop for plans or defray out-of-pocket costs.
Scott's plan has been discussed with the White House multiple times since it was released Thursday, according to a person familiar, who was not authorized to discuss the private conversations.
The draft of the White House plan would allow those in lower-tier plans, such as the bronze-level or catastrophic plans, to put money into health savings accounts.
It would also codify the "program integrity rule" to further help root out fraud, waste, and abuse.
Costs are set to rise significantly as the subsidies run out, and Trump has repeatedly reminded Americans that he believes the 10-plus-year experiment on Obamacare has proved it is a fraud and a failure.
Recent national polls have shown Americans are concerned about healthcare costs, along with broader affordability issues. Trump has endeavored to fix the ills of those policies, he says.
Newsmax writer Eric Mack and The Associated Press contributed to this report.
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