This is scheduled to be the final week in session for Congress this year, and lawmakers are trudging to the finish line, hoping to take care of a few last bits of business while leaving much work to be done in the new year.
House Republican leaders are planning a Wednesday vote on a healthcare package they released Friday afternoon called the Lower Health Care Premiums for All Americans Act — but the 111-page bill does not include an extension of enhanced Obamacare subsidies that are set to expire at the end of the month and an agreement between GOP leaders and moderates in the party for an amendment vote on such an extension, paired with program reforms, reportedly has run into trouble.
Punchbowl News reported that the agreement with moderates fell apart due to a disagreement over the amendment text. GOP leaders reportedly told moderates that they would have to offset the cost of the subsidy extension, estimated to be $35 billion a year, with other healthcare-related spending cuts — a demand that left moderates with “no good options,” per Punchbowl. So instead, the centrist Republicans will offer their amendment before the House Rules Committee, where it is likely to be rejected.
That may please conservatives who want nothing to do with shoring up Obamacare. But it leaves the fate of the GOP package uncertain. That legislation, as we outlined last week, would:
- Expand association health plans, which let employers join together to buy health insurance;
- Fund “cost-sharing reduction” payments to insurers, canceled under the first Trump administration, starting in 2027;
- Require increased transparency on drug prices and spending from pharmacy benefit managers;
- Shore up 2019 rules allowing employers to give money to workers to buy their own coverage and pay premiums with pre-tax funds;
- Allow small and mid-sized businesses to get “stop-loss” insurance to self-fund their insurance plans and protect themselves from catastrophic losses.
“While Democrats demand that taxpayers write bigger checks to insurance companies to hide the cost of their failed law, House Republicans are tackling the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation’s health care system for all Americans,” Speaker Mike Johnson said in a statement.
In addition to letting the Affordable Care Act subsidies expire as scheduled, leaving millions facing a surge in costs, the GOP package notably also does not redirect the subsidy funding into health savings accounts, as a Senate Republican plan rejected last week would have done.
Still, Larry Levitt, executive vice president for health policy at KFF, a nonpartisan healthcare research organization, told CNN that the package “is kind of a greatest hits of Republican health care ideas of the last decade.” (Levitt also noted in a post on X that appropriating money for cost-sharing reductions “would actually decrease premium assistance and increase out-of-pocket premiums for many ACA enrollees.”)
Perhaps it’s not surprising, then, that Republicans continue to struggle to coalesce behind a healthcare plan — just as they have been for the past 15 years. And it’s certainly no surprise that Democrats panned the GOP plan. They continue to insist on a clean extension of the ACA subsidies.
“This so-called plan is the height of irresponsibility, with just five legislative days until premiums skyrocket by as much as $1,000 or $2,000 per month for working class Americans,” House Minority Leader Hakeem Jeffries said Friday. “The bill will cause millions of people to lose coverage, promotes junk health insurance plans and further limits the freedom of women to make their own reproductive healthcare decisions.”
The bottom line: The Senate deadlocked on a pair of competing healthcare bills last week. The House may struggle to pass a GOP plan this week. It’s not clear yet what amendments will get a vote, and Republican hardliners are pressing some demands of their own. It’s also still not clear whether Democrats will get behind either of two discharge petitions that require 218 signatures to force votes on bipartisan plans for subsidy extensions — or if GOP moderates might sign on to a Jeffries discharge petition to bring up a straight three-year extension of the ACA tax credits. Much remains up in the air, but the strongest likelihood appears to be that Congress’s healthcare gridlock will continue into 2026.