Manchin signaled he could get onboard extending Obamacare aid past the end of this year.
But he appears to want to renew it with some strings attached.
"We should be helping the people who really need it the most and are really having the hardest time."
Sen. Joe Manchin of West Virginia signaled he's open to extending enhanced subsidies under the Affordable Care Act, a move that would help Democrats avert a huge political threat in the November midterms from millions of people learning about spiking monthly premiums only weeks before casting ballots.
The conservative Democrat reiterated his concern about Americans enduring a difficult stretch of inflation, which reached its highest level in four decades. But he suggested that an extension of the program should be directed towards aiding lower-earning families.
"The main thing here is the means-testing," he said in a brief interview on Wednesday evening. "We should be helping the people who really need it the most and are really having the hardest time."
"With healthcare, people need help. They really do," Manchin said.
Under last year's stimulus law, Democrats increased federal subsidies to shrink monthly premiums for Americans purchasing health insurance plans under the ACA. The move caused many lower-income enrollees to pay little or nothing for private coverage. Many middle-class families also qualified for major federal assistance for the first time.
The program is already means-tested, meaning financial assistance is conditional based on earnings. The premiums that enrollees pay is tied to income and increases the more they earn. But payments are capped at no more than 8.5% of their annual income under the temporary stimulus program.
Manchin's statements are a fresh sign that the conservative Democrat hasn't closed the door on continuing an initiative that has wide approval in his party. House Democrats led by the centrist New Democrat Coalition in particular are raising the pressure on Democratic leaders to secure an extension of the program before it's set to expire at the end of the year.
House Speaker Nancy Pelosi said at a news conference last week that extending Obamacare aid was a top Democratic priority. Manchin and Senate Majority Leader Chuck Schumer have been holding private negotiations on a smaller tax and climate spending bill to replace the House-approved Build Back Better plan.
If Democrats don't succeed at reviving a reconciliation bill extending the enhanced subsidies past year's end, roughly 13 million Americans would learn in the fall they're up for steep premium hikes in 2023. In addition, three million people would lose their health insurance because it would become too expensive, per the Department of Health and Human Services.
Manchin had expressed strong support for extending subsidies in February, but was noncommittal when Insider asked about his position in early May.
But Manchin's new remarks open the possibility of an income limit to restrict the number of higher-earners who qualify for the financial assistance, according to healthcare expert Larry Levitt.
"An upper income limit for the ACA subsidies at a level at or above four times the poverty level would preserve assistance for the vast majority of enrollees, but a small number would face big premium hikes," Levitt, executive vice president for health policy at the nonpartisan Kaiser Family Foundation, told Insider.
The federal poverty level governs eligibility for safety net programs based on household size and income. That level currently sits at $27,750 for a family of four. So, a hypothetical Obamacare subsidy cutoff at four times the federal poverty line would exclude a similarly sized family making at least $111,000 from receiving aid.
Democrats insist the initiative remains a big priority. "I'm focused on holding down premiums, which is hugely important to me," Sen. Ron Wyden, chair of the tax-writing Senate Finance Committee with jurisdiction over the Obamacare program, told Insider.
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