House Republicans are under pressure to finalize a health care plan before the holiday recess, with a looming deadline of December 31, 2023, for the extension of subsidies related to the Affordable Care Act (ACA). The disagreement among party members on the specifics of the plan could lead to significant consequences for millions of Americans, as insurance premiums are expected to rise sharply if the subsidies are not extended.
House Speaker Mike Johnson and his leadership team are advancing a proposal that does not include an extension of the ACA subsidies. Instead, they are suggesting alternative funding to help Americans manage health care costs. This position is met with resistance from some Republicans who argue that a bipartisan approach is necessary, especially as midterm elections approach.
During a closed-door meeting, Rep. Ralph Norman of South Carolina, a member of the conservative Freedom Caucus, expressed the need for a solution, stating, “The consensus is we need to come up with something.” Meanwhile, Rep. Jim Jordan of Ohio warned that excluding ACA funding could lead moderate Republicans to collaborate with Democrats, potentially forcing a vote that would undermine the party’s position.
Johnson is determined to hold a vote on a GOP health care plan next week, just before lawmakers take a two-week break. Among the proposals discussed were the expansion of health savings accounts and increased funding for cost-sharing reductions. Johnson noted, “We have some low-hanging fruit… things that every Republican agrees to; Democrats won’t,” hinting at a strategy that diverges from broad ACA reforms.
Despite this, some Republicans recognize that a comprehensive overhaul of the ACA will require more time and collaboration. Rep. Dusty Johnson from South Dakota remarked, “Health care is unbelievably complicated. You’re not going to reform and bring down costs overnight.”
A group of fifteen House Republicans representing swing districts have shown support for a bipartisan framework, led by Reps. Jen Kiggans and Josh Gottheimer, which proposes a two-year extension of the ACA subsidies with certain modifications. However, this group is outnumbered within the party, as many Republicans remain opposed to further funding for what they term “Obamacare.”
Johnson appears to be aligning with the majority sentiment among his colleagues, which does not favor extending the subsidies. One GOP lawmaker indicated that Johnson is “drawing a line in the sand” against extending ACA tax credits. The possibility of using a discharge petition to force a vote remains uncertain, as it requires a majority of House members to succeed.
In an effort to unify the party, Rep. Brian Fitzpatrick of Pennsylvania has introduced his own proposal for extending the ACA subsidies, claiming the plan has input from both the Senate and the White House. Fitzpatrick’s initiative, which enjoys support from several Democratic representatives, seeks to extend tax credits for two years while broadening access to health savings accounts.
Despite the urgency, any potential legislation would still face hurdles in the Senate, where its passage is not guaranteed. Rep. Ted Lieu, a member of Democratic leadership, criticized the Republicans for not prioritizing the discharge petition earlier, stating, “These ACA tax credits expire at the end of this month, and so the procedural problems will make it so that everyone’s health care premiums skyrocket.”
As the deadline approaches, the stakes for House Republicans are high. Failure to extend the ACA subsidies could jeopardize their majority in upcoming elections, with Rep. Jeff Van Drew of New Jersey emphasizing that allowing the subsidies to lapse would be detrimental to vulnerable GOP colleagues. He warned, “If you’re a conservative and you’re a Republican, do you want a Democrat majority next year? I don’t think so.”
With the clock ticking, the House Republican leadership faces the dual challenge of crafting a unifying health care plan and addressing the immediate needs of millions of Americans relying on ACA subsidies.
