| |  | The Lead Brief | Delaware Gov. Matt Meyer is leading a coalition of 17 other governors in calling on congressional leadership to extend the Affordable Care Act enhanced premium tax credits before they expire at the end of the year — a timeline that underestimates the actual policy urgency. In a letter sent to House and Senate leadership on Monday, the governors warned that insurers are already setting 2026 rates, meaning that failure to act this fall could translate into irreversible premium hikes and reduced enrollment stability across the marketplaces. “This isn’t a partisan issue. It’s about protecting working people who are doing everything right but [are] still struggling to get by. Extending these tax credits is one of the simplest, most effective steps Congress can take to keep healthcare affordable and provide real stability for millions of families,” reads the letter, first obtained by Health Brief. It was also signed by the governors of California, Colorado, Connecticut, Illinois, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Washington and Wisconsin. Although all the signers are Democrats, Meyer told me he’s also reached out to Republican governors in an effort to get them to join in. → KFF found that almost half of people who purchase health care through the Obamacare marketplaces identify as Republican. “Republicans have centered their politics on making life more affordable for working Americans — like, that's the centerpiece — and right now they're screwing them through this policy,” Meyer told me in a phone call Monday morning. Role in Government Funding Talks → House Republicans are racing to put a funding bill on the floor this week to kick off the process and ultimately avert a government shutdown. They’re reportedly looking at a short-term fix to allow conversations to continue. Democrats have issued an ultimatum that they’ll need the package to contain their health policy goals — including an extension of the subsidies — to gain their votes, which are most needed in the Senate. → Though some in GOP leadership have recognized that allowing the tax credits to expire could hurt Republicans in the 2026 midterm elections due to a spike in health costs, they’ve also criticized how proposals to extend them don’t include stricter limits on who can receive them. More conservative members oppose extending them at all. Means Testing The enhanced subsidies — originally passed as part of a coronavirus pandemic relief bill in 2020 and renewed in the Democrats’ signature Inflation Reduction Act in 2022 — removed the cap on eligibility for subsidies for people with incomes at 400 percent of the federal poverty level. (For a single person in 2025, that’s $62,600 and $128,600 for a family of four.) It also limited premiums to a maximum of 8.5 percent of household income. “You can couch it in whatever technical jargon you want. These are working American families whose health care costs are about to spike,” Meyer said. While some Republicans in Congress in tough reelection fights have supported a one-year extension of the subsidies, Meyer is pushing for a permanent extension. “You can't say to people, ‘Oh, we're saving your health care,’ — and then the day, the week, the month after the election, take it away or have it dramatically increase in cost,” said Meyer, whose wife is an emergency room physician. “That's not right.” Action on Health * Tues., Sept. 16, 2 p.m.: The House Ways & Means Oversight Subcommittee is holding a hearing entitled “Virtue Signaling vs. Vital Services: Where Tax-Exempt Hospitals are Spending Your Tax Dollars.” * Wed., Sept. 17, 10 a.m.: The Senate Health, Education, Labor, and Pensions Committee is holding a hearing entitled “Restoring Trust Through Radical Transparency: Reviewing Recent Events at the CDC and Implications for Children’s Health.” * Wed., Sept. 17, 3:30 p.m.: The Senate Special Committee on Aging is holding a hearing entitled “Prescription for Trouble: Drug Safety, Supply Chains, and the Risk to Aging Americans.” * Thurs., Sept. 18, 9:30 a.m.: The House Energy & Commerce Health Subcommittee is holding a hearing entitled “Examining Policies to Enhance Seniors’ Access to Breakthrough Medical Technologies.” * Thu.‑Fri., Sept. 18‑19: The Advisory Committee on Immunization Practices is meeting to discuss and potentially vote on new recommendations for covid‑19, hepatitis B, MMRV and RSV vaccines. The House is set to vote on a number of measures impacting veterans’ health tonight, including the Protecting Veteran Access to Telemedicine Services Act — legislation that would enable veterans to use telehealth to receive controlled medicines. Votes are expected at 6:30 p.m. | 
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