House Budget Committee chair says Republican fixes — not subsidy extensions — should be the focus on health care

Jody Arrington, chairman of the House Budget Committee, told Bloomberg TV that Republican proposals to change the Affordable Care Act — rather than short-term extensions of COVID-era subsidies — are the preferable route to lower premiums and reduce costs.

Arrington said he does not expect proposed extension bills to become law and argued that Democrats created the temporary COVID-era subsidy and chose not to make it permanent when they controlled Congress and the White House. "Not one that's gonna become law, Joe," he said, arguing the subsidies were designed to wind down as the pandemic receded.

He framed the central problem as affordability: "How do we make health care affordable?" Arrington said the ACA has seen rising deductibles and premiums and pointed to a Republican bill that, he said, the Congressional Budget Office estimates would reduce premiums by about 11% and save $30,000,000,000.

Arrington also said existing ACA tax subsidies already subsidize many premiums at substantial cost to taxpayers — which he estimated as roughly $60 billion to $70 billion per year — and that continuing the COVID-era add-ons doubles that outlay. He urged limiting subsidies with income caps and noted reports from the CBO and the Government Accountability Office that, he said, document tens of billions in improper payments and millions of ineligible enrollments.

On specific policy tools, Arrington voiced support for expanding health savings accounts and similar employer-provided reimbursement accounts, saying these steps help people keep more of their own money for care. He criticized insurer practices that steer consumers toward higher-cost plans and said equalizing payment rates between hospitals and physician groups could reduce costs and reverse consolidation: "If we equalize those payments ... we'd save about $150,000,000,000," he said.

Arrington framed these changes as alternatives to simply extending subsidies: "We should work together to make ACA actually affordable, the private market affordable, and bring cost down altogether," he said.

The interview included a question about the timing of open enrollment and whether a short "bridge" extension would prevent disruptions in January. Arrington reiterated his opposition to a short-term extension without accompanying reforms, saying the programs were designed to wind down as COVID receded.

Next steps: Arrington said Republicans plan to pursue legislative changes, including those they passed recently in the House, rather than rely on temporary extensions. He suggested some measures could win bipartisan support, while others could proceed through budgetary tools that require only a simple Senate majority.