Congress is mulling numerous plans this week to extend the Affordable Care Act tax credits that are set to expire at the end of the year, including compromise measures introduced by members of Maine’s congressional delegation.

However, so many proposals are floating around Washington, D.C., that it can be difficult to tell which have a chance of passing.

“I’ve heard of at least eight different plans,” Cynthia Cox, vice president and director of the Program on the ACA for KFF, a national health policy think tank, said in an interview Tuesday. “What this actually reveals is how fragmented the Republican Party is on this issue. I think it’s less likely that will result in a compromise between the two parties.”

In interviews with the Press Herald on Tuesday, both Sen. Angus King, I-Maine, and Rep. Chellie Pingree, D-1st District, signaled a willingness to compromise with Republicans.

“We have to come up with a solution that should be bipartisan,” King said. “Not solving this problem would be a disaster.”

Sen. Susan Collins, R-Maine, said in an interview on Wednesday that she hopes a compromise bill she put forward will gain traction if measures advanced by Democrats and Republicans fail in key votes on Thursday. This week, Collins introduced a middle-of-the-road proposal with Sen. Bernie Moreno, R-Ohio.

Rep. Jared Golden, D-2nd District, co-sponsored a bipartisan bill being advanced this week by moderate House Republicans and Democrats.

But whether there’s any real chance of Democrats and Republicans finding middle ground is uncertain.

The Biden-era tax credits — first approved in 2021 and extended through 2025, subsidize premiums for plans on the ACA marketplace. They’re sometimes referred to as Enhanced Premium Tax Credits. If the tax credits were to expire, some lower-income and higher-income enrollees would get swamped with large premium increases, in some cases thousands of dollars more per month.

Many small-business owners and self-employed workers would be among the hardest hit by premium spikes.

Time is running short. Open enrollment at coverme.gov is ongoing, with plans needing to be selected by Dec. 15 for coverage that starts Jan. 1. For coverage that begins Feb. 1, plans must be selected by Jan. 15.

Collins’ bill would extend the tax credits for two years, and create a new cap for when the subsidies would be cut off — $100,000 in income for an individual enrollee, and $200,000 for couples and families.

Collins’ proposal also eliminates zero-premium plans for lower-income enrollees, requiring that people must pay at least $25 per month. She said her aim is to prevent “enormous spikes in health insurance premiums” which would make health insurance unaffordable for some enrollees.

The bill Golden co-sponsored, introduced by Rep. Brian Fitzpatrick, R-Pennsylvania, would phase out the tax credits for those earning more than 700% of the federal poverty level, or $148,000 for a two-person household. It would also eliminate zero-cost premiums, replacing them with $5 per month premiums. (Collins said she’s considering amending her bill to include a similar $5 monthly premium measure.)

Mario Moretto, a Golden spokesperson, said Golden is “actively engaged in multiple, bipartisan conversations about how to ensure we avoid the health care cliff and protect Mainers from massive coverage price spikes.” 

National media reported on Tuesday that a bill by Republican Sens. Bill Cassidy of Louisiana and Mike Crapo of Idaho would likely be voted on on Thursday, alongside a Democratic proposal. The Cassidy-Crapo measure would fund health savings accounts — which can’t be used to lower premium costs — by $1,000 to $1,500 annually per household.

The Cassidy-Crapo bill is further to the right of Collins’ bill, and wouldn’t do much to alleviate costs for many millions of Americans with ACA plans, said Cox, the KFF vice president.

Pingree said the Cassidy-Crapo bill is “dead on arrival” in the Senate, and she doesn’t believe it’s a serious attempt at a solution.

“I’m very willing to look at compromise plans that Republicans and Democrats are moving forward,” said Pingree, who referred to the bill Golden was touting as “reasonable.”

If the tax credits are allowed to expire, Maine enrollees — about 65,000 Maine residents have ACA insurance — would face a 77% premium spike on average. Those earning more than 400% of the federal poverty level — $85,600 for a two-person household — would see even greater increases, in some cases thousands more per month, depending on age and income level.

The current enhanced tax credits do not have an income cap, but they mandate that premiums cost no more than 8.5% of annual income. So the credits become gradually less generous — or zero out — the more money a household earns.

The credits were at the heart of a dispute that resulted in this fall’s government shutdown that ended on Nov. 12. Another tax credit, the Advanced Premium Tax Credits, were part of the original ACA law, which went into effect in 2013. Those have no expiration date.

King said Republicans are so far insisting on including Hyde amendment language in bills to extend tax credits, which is a nonstarter for Democrats. Bills that include the Hyde amendment forbid using funds to pay for abortions.

“The Hyde amendment is a barrier to getting anything done, stymying any sort of a deal,” King said. Collins’ bill does not include Hyde amendment language, but the Cassidy-Crapo bill does include the abortion funding restrictions.

Democrats are in the minority in the Senate and House, but could use the filibuster in the Senate to nix a bill that includes the Hyde amendment.

King was at the center of negotiations to reopen the government, securing a vote on an extension of the tax credits, and Democratic leadership’s proposal is a three-year extension without changing the credits.

“This straight-up extension that’s coming to the floor, that’s a reasonable option,” King said.

Collins said she’s not committed to voting for or against the three-year extension by Democratic leadership or the Republican bill crafted by Cassidy and Crapo.