On the Hill: Clock Running out to Extend ACA Enhanced Premium Tax Credits; Protecting 340B

Late last week, the Senate rejected proposals from both Democrats and Republicans aimed at addressing the impending expiration of the Affordable Care Act's (ACA) enhanced premium tax credits.

In the House, lawmakers are expected to vote this week on a narrow health care package that does not directly extend the expiring subsidies. Instead, the legislation includes provisions related to pharmacy benefit managers, expands access to association health plans, and supports ACA cost-sharing reductions. Many moderate Republicans are advocating for an amendment that would extend the enhanced tax credits for an additional two years.

America's Essential Hospitals continues to engage with lawmakers and their staff to underscore the devastating year the health care sector has endured-particularly the impact on essential hospitals and the patients they serve-and to push back against policies that would further strain the system. As part of this effort, the association has strongly opposed harmful Medicare payment reductions, including so-called "site-neutral" cuts, which were being considered as potential pay-fors in these proposals.

340B

On Dec. 11, America's Essential Hospitals, in coordination with a coalition of health care associations, sent a letter to House Speaker Mike Johnson (R-La.), House Minority Leader Hakeem Jeffries (D-N.Y.), Senate Majority Leader John Thune (R-S.D.), and Senate Minority Leader Chuck Schumer (D-N.Y.) expressing concerns about the Health Resources and Services Administration's (HRSA) 340B Rebate Program; it urged congress to call on the Trump Administration to cancel the rebate program.

Also on Dec. 11, America's Essential Hospitals and two other hospital associations filed an amicus brief with the U.S. District Court for the District of Maine in a lawsuit to stop the implementation of unlawful rebate models for the 340B Drug Pricing Program. Absent legal intervention, the HRSA pilot program will begin Jan. 1, 2026.

The association sent a separate letter to HRSA on Dec. 1 describing outstanding questions about the pilot program implementation and requested a meeting to discuss these questions.

Committee Activity This Week

The Senate and House are in session Monday through Friday this week.

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