After the Senate failed to advance a pair of dueling healthcare plans yesterday, House Republican leaders on Friday rushed to release a healthcare package of their own ahead of a planned floor vote in their chamber next week — and they reportedly will allow GOP moderates an amendment vote to extend enhanced Obamacare subsidies set to expire at the end of the month.
The core House Republican plan, titled the “Lower Health Care Premiums for All Americans Act,” does not include an extension of those subsidies but instead seeks to lower costs in other ways. Those include an expansion of association health plans, which let employers unite to buy coverage, and “cost-sharing reduction” payments to help low-income enrollees afford Obamacare plans. The package reportedly also requires more transparency from pharmacy benefit managers and a provision meant to expand small business access to self-insured plans.
The House GOP plan does not include a Senate Republican proposal to redirect funding for the enhanced ACA subsidies into prefunded health savings accounts with $1,000 or $1,500. And it does not address the expiring Obamacare tax credits. The House Republican conference is deeply divided over those subsidies, with conservatives vehemently opposed to any measure in support of a health law they have long despised and moderates eager to prevent millions of Americans from seeing their premium payments spike — and to avoid the political pain that might bring for the GOP.
The path ahead remains highly uncertain. While moderate Republicans and Democrats support extending the subsidies, an amendment vote may not pass, as Democrats are still angling for a clean extension without the reforms Republicans are seeking. Democrats may prefer to pursue an extension of the subsidies via either of two discharge petitions that would force votes on bills that don’t include the GOP leadership’s provisions — or they may choose to use the issue as a cudgel against Republicans over the coming year. As of Thursday, Democratic leaders reportedly were still deciding whether to support either discharge petition push.
“Republicans leaders ultimately expect the extension vote to fail, resulting in skyrocketing premiums for millions of Americans when the subsidies expire at the end of the year,” Politico notes.
If an amendment to extend the subsidies does get adopted, it may threaten the chances for the broader GOP package to pass. Any plan that gets through the House would also have to clear the Senate, where a 60-vote threshold means Democratic support would be needed.
The bottom line: House Republicans are giving themselves the chance to say they tried to do something to address healthcare costs, but the ACA subsidies still appear likely to expire within days. Congress has one work week left in 2025.