With the House set to vote tomorrow on a Republican package of healthcare measures, Speaker Mike Johnson said Tuesday he won’t allow a vote on an amendment to extend expiring Affordable Care Act subsidies, effectively ensuring that the tax credits will expire as scheduled at the end of this month.
The Republican package doesn’t address the expiration of the ACA subsidies but instead combines several other policies favored by the GOP. Johnson told reporters that he and swing-district Republicans who wanted an amendment vote on the subsidies had failed to reach an agreement.
“Many of them did want to vote on this Obamacare COVID-era subsidy the Democrats created,” Johnson said. “We looked for a way to try to allow for that pressure release valve, and it just was not to be.”
Republican leaders reportedly refused to waive “pay-for” rules and insisted that the cost of extending the subsidies, estimated at about $35 billion a year, be offset by other healthcare savings.
The intraparty divide on the issue left GOP moderates fuming and warning that party leaders were making a costly political mistake.
“I think it’s idiotic not to have an up-or-down vote on this issue,” Republican Rep. Mike Lawler of New York told reporters, calling the decision “political malpractice” and “absolute bulls---.”
“You know what’s funny?” Lawler added. “Three-quarters of people on Obamacare are in states Donald Trump won. So maybe, just maybe, everybody should look at this and say, ‘How do we actually fix the health care system?’”
Others in the GOP very much want to see the enhanced subsidies expire, and moderates who are disappointed that they won’t get an amendment vote nevertheless indicated they’d back the underlying bill. Johnson said he expects Republicans of all stripes to support the package, which he argued would help a much larger group of Americans than Democratic proposals to extend the more generous subsidies.
The Congressional Budget Office estimates that the Gop bill would reduce the deficit by $35.6 billion over 10 years — and would decrease the number of people with health insurance by an average of 100,000 from 2027 through 2035. At the same time, average premiums on benchmark plans would be projected to fall 11%.
“If it becomes law, premiums will decrease, access will increase, and every American will have more options and flexibility to choose the coverage that works best for them,” Johnson said of the Republican bill. “It's called the free market, and we're the ones that advance those ideas.” Johnson added that the tax credits enacted by Democrats just subsidize a broken system and hide the true cost of the Affordable Care Act.
What’s next: Even if it passes the House, the Republican plan isn’t expected to get through the Senate and become law. It won’t keep premium payments from soaring for millions of Americans next year. But it may allow House Republicans to say that they did something — or tried to — to address healthcare costs.
At the same time, Republicans reportedly continue to negotiate over a possible amendment vote and bipartisan efforts to extend the ACA subsidies continue in both the House and Senate. In the House, discharge petitions requiring 218 signatures could force votes on either of two bipartisan plans or a Democratic one calling for a straight three-year extension of the higher subsidies. In the Senate, a group of more than two dozen senators reportedly met Monday night to discuss a bipartisan fix centered on a plan from Republican Sens. Bernie Moreno of Ohio and Susan Collins of Maine. That proposal would extend the subsidies for two years but impose new income limits and other reforms.
At this point, any of those bipartisan efforts won’t be able to produce results until next year. Some Democrats point out that lawmakers could have been working on this months ago, including over the weeks that the government was shut down and the House was out of session.