House of Representatives passes clean extension of ACA tax credits
On Jan. 8, the House of Representatives took advantage of a seldom-used parliamentary maneuver to pass a three-year clean extension of the enhanced premium tax credits (EPTCs) used by beneficiaries to purchase health insurance via the Affordable Care Act (ACA) insurance marketplaces.
Prior to the winter holiday district work period, four congressional Republicans joined all House Democrats as co-signers of “a discharge petition” that required the chamber to take a vote on H.R. 1834, despite opposition from House Republican leadership. Once a majority of the House co-signs a discharge petition, a vote must be scheduled on the measure so long as the bill has been introduced for 30 days.
While disagreements over this issue contributed to a more than 40-day federal government shutdown in October and November 2025, the three-year extension of the ACA EPTCs was ultimately passed by a vote of 230 to 196. A total of 17 Republicans joined all House Democrats present for the vote in support of this legislation (5 members did not vote).
Although it passed the House, the bill is unlikely to advance in the Senate in its current form. However, the House-passed bill could provide a legislative vehicle for the Senate to insert new, compromise language on the ACA EPTCs. A collection of bipartisan senators led by Senator Bernie Moreno (R-OH) are close to striking an agreement on legislation that will extend the ACA EPTCs for two years while also requiring new policy concepts like income limits, minimum premiums, and other insurance reforms. As of publication, no actual legislation reflecting the compromise has been introduced by this bipartisan collection of senators.
AMA wrote (PDF) to bipartisan, bicameral leaders of the House and Senate in support of continuation of the ACA EPTCs in Sept. 2025. AMA will continue to monitor congressional efforts related to this key policy issue.
FDA releases new guidance for digital health technologies
On Jan. 6, the Food and Drug Administration (FDA) released two final guidance documents outlining the agency’s new approach toward regulation of wearable technologies and clinical decision support software (CDS). The guidance documents represent a significant departure from FDA’s previous approach towards regulation of both types of technologies and signal a shift in FDA’s general approach towards AI regulation broadly.
Wearable Technologies: Under its new guidance, FDA outlines its plans to exercise enforcement discretion for non-invasive, low risk technologies that are marketed to promote healthy lifestyle behaviors, such as exercise, better sleep, and stress management. The new enforcement discretion policy will apply only to products that make general wellness claims only, and do not diagnose, treat or prevent disease. FDA review will continue to be required for devices that inform medical or clinical decisions or care.
Clinical Decision Support Software: In an update to its previous final guidance outlining its approach towards regulation of CDS software, FDA acknowledges that it plans to exercise enforcement discretion for a large number of CDS software technologies. While the guidance is nuanced, generally speaking, CDS software will fall under enforcement discretion policies so long as the output from the CDS software is intended to support clinicians with recommendations, rather than provide a specific diagnostic or directive for care. Importantly, the guidance requires any CDS software subject to enforcement discretion to provide clinicians with the ability to independently review the basis for the recommendation and notes that physicians should not rely solely on the CDS recommendation.
Additional statements made by FDA Commissioner Marty Makary, MD, signaled that the agency plans to make additional updates to its regulatory approach towards AI-enabled and other digital health technologies and is working on a new regulatory framework for AI-regulation broadly.
Register now: AMA National Advocacy Conference
The AMA National Advocacy Conference is coming up next month—Feb. 23-25 at the Grand Hyatt in Washington, D.C. The hotel room block closes on Jan. 24, so make sure to reserve your room and register now.
Featured speakers
Mark Cuban, co-founder, Cost Plus Drugs, entrepreneur
Sanjay Gupta, MD, chief medical correspondent, CNN
Agenda
Join hundreds of physician advocates in bringing the power of organized medicine to our nation’s capital, advocating on crucial health care issues affecting physicians and patients.
See the preliminary agenda (PDF) for this year’s meeting.
Please contact [email protected] with any questions.
