Moving heaven & earth to get the tax credits extended

The other person, I follow on healthcare and the ACA. He lives in Michigan like I did before we moved to the desert. Kind of miss the Green.

“Dear Democrats: I’m the guy who’s moving heaven & earth to get the tax credits extended, and I’m telling you not to cave for a short-term fix.”

Charles Gaba ACA Signups

This is gonna be one of the stranger references I’ve made on this site, but bear with me.

Back in 1996 there was an HBO movie called “The Late Shift” which told the story of the Late Night TV show battle between David Letterman and Jay Leno over who would succeed Johnny Carson as host of The Tonight Show. As stupid as this may sound today, this was actually a Really Big Deal in the ’90’s…one of those absurd pop culture stories which dominated the headlines and the tabloids for several years.

The movie itself was decent, with some interesting casting including Kathy Bates and Treat Williams, but nothing special. The main problem is that the audience is expected to root and feel sympathy for a couple of dudes who were already rich & famous and who would both continue to be rich & famous no matter how the story played out. The stakes weren’t exactly the fate of the world, is what I’m saying.

However, there was a scene near the end of the film which seems relevant to me today. After months of all sorts of legal & PR shenanigans, Letterman’s producer manages to finally get NBC to give Letterman an offer to take over the Tonight Show…maybe. Sort of. The wording of the offer has a lot of loopholes and vague language.

Letterman, who has spent his entire life dreaming of hosting The Tonight Show, is anguishing over whether to take the offer or not, and has this discussion with his producer:

I thought of this scene, and Pete’s final words, as I read stories about the upcoming federal government funding battle in the U.S. Congress. As Josh Marshall puts it over at Talking Points Memo:

I don’t think it’s an exaggeration for me to say that there’s literally been no bigger champion of extending the ACA’s enhanced Advance Premium Tax Credits (eAPTC) which have been in place since 2021 than me.

I’ve spent years pushing for the formula to be made dramatically more generous, and I’ve spent the better part of the past year obsessing over exactly how many enrollees will be damaged and by just how much in every state across the country if the current APTC structure reverts back to where it was prior to 2021. Tracking this sort of data is the very DNA of ACA Signups, after all.

This is also true on a personal level: Both my wife and I are self-employed and have relied on ACA exchange coverage off and on over the years (we switched to her university plan when she went back to school to get her counseling degree a few years back, but moved back onto an exchange plan after she graduated a year or so ago).

I’m not going to go into the specifics of our income beyond stating that it varies widely from year to year, generally ranging between 300 – 500% of the Federal Poverty Level.

Furthermore, one of us has a fairly expensive chronic medical condition which requires ongoing treatment.

While we’re definitely better off overall than millions of other ACA enrollees, this means that the elimination of the much-hated “Subsidy Cliff” at 400% FPL was always a constant fear of ours, as moving even $1 over that cap used to mean the difference between paying less than 10% of our income in premiums, or having to pay full price, which (given our requirements) can still top 25% of our gross income as it stands…and assuming eAPTCs do expire, our provider network requirements mean that our current plan would likely end up costing us at least $11,000 more next year.

Since there’s no way we can afford that type of hit (especially on top of the other Trump tariff inflation swirling around every other purchase in our lives), we’d have to downgrade to a worse plan with far higher deductibles & co-pays.

My point here is that while there are certainly many families in an even worse situation than ours, this is not a case of us living in a golden tower while dictating the sacrifices that the masses should make either: If the eAPTCs expire, we’re seriously screwed right along with millions of other families.

EVEN SO . . .

One minor quibble: The “agreement” is supposedly for a 1-year extension of the eAPTC (thru 12/31/26), not 6 months, but the point is made.

As he says, ideally Democrats shouldn’t raise a finger to avoid a government shutdown this time around without ironclad guarantees that the Trump Administration’s worst abuses of power and lawlessness will be reined in.

This includes things like:

• ICE gestapo running out of control;
• His military invasions of U.S. cities;
• Deporting civilians and non-civilians alike to torture prisons both locally and abroad;
• Imposing tariffs left & right without  Congressional approval;
• Being required to actually spend Congressionally-allocated funding on the projects and programs that Congress, you know, allocated them for.

HOWEVER, if you’re going to focus on “kitchen table economic issues” and the like, for God’s sake at least don’t go small bore on those.

You know I’m a pretty mainstream Democrat. I’m not demanding Medicare for All here. What I am urging on the healthcare front is for three clear demands:

• Restore the massive funding cuts to the NIH & other critical medical/scientific departments of the federal government;

• Repeal the draconian cuts to Medicaid (especially the disaster-as-a-feature-waiting-to-happen “work reporting requirements;” and . . .

• Make the enhanced ACA premium tax credits (eAPTC) permanent so we can avoid this Sword-of-Damocles worry which is paralyzing carriers, providers and enrollees every few years.

At a bare, bare minimum, do not settle for a one- or two-year extension of the eAPTCs.

You can catch the rest of his discussion here: Dear Democrats: I’m the guy who’s moving heaven & earth to get the tax credits extended, and I’m telling you not to cave for a short-term fix., ACA Signups.