House Republicans are under pressure to finalize a health care plan ahead of the holiday recess, but internal divisions are complicating progress. A vote is scheduled for next week, as millions of Americans face soaring insurance premiums if Congress does not extend subsidies for the Affordable Care Act (ACA), which are set to expire on December 31, 2023.
House Speaker Mike Johnson and his leadership team are leaning towards a proposal that does not extend the ACA subsidies. Instead, they plan to allocate funds to help Americans manage health care costs. This decision faces backlash from some lawmakers, particularly those in competitive districts, who argue that any health care initiative must be bipartisan and include an extension of the subsidies.
During a closed-door meeting, Representative Ralph Norman from South Carolina echoed the sentiment of urgency, stating, “The consensus is we need to come up with something.” Meanwhile, Jim Jordan of Ohio cautioned that excluding ACA funding could lead to a coalition of moderate Republicans and Democrats pushing through their own proposal via a discharge petition. This tactic would require a majority of the House, meaning at least 218 members would need to support it.
In light of the approaching deadline, Johnson has committed to holding a floor vote next week. Among the proposals discussed were expanding health savings accounts and enhancing cost-sharing reductions. Johnson remarked, “We have some low-hanging fruit… things that every Republican agrees to; Democrats won’t.”
Nevertheless, some Republicans recognize that a comprehensive overhaul of the ACA is a complex issue that will require more time and deliberation. Representative Dusty Johnson from South Dakota stated, “Health care is unbelievably complicated. You’re not going to reform and bring down costs overnight.”
A bipartisan framework has garnered interest from a faction of House Republicans. Reps. Jen Kiggans from Virginia and Josh Gottheimer from New Jersey are leading an effort to extend the ACA subsidies for two years, albeit with certain modifications. This plan has attracted support from fifteen House Republicans, particularly those in swing districts. However, they remain a minority within the party, as many GOP lawmakers oppose any measures that could be perceived as supporting “Obamacare.”
As Johnson aligns with the majority view in his conference, he has drawn criticism for his stance against extending ACA tax credits. Despite warnings from Jordan, the viability of using a discharge petition remains uncertain. Representative Brian Fitzpatrick from Pennsylvania has proposed his own plan to extend the ACA subsidies for two years, alongside measures to broaden access to health savings accounts. Fitzpatrick has indicated that he may pursue a discharge petition if leadership fails to act.
The complexities of the current situation are further underscored by the potential consequences of allowing the ACA subsidies to expire. Representative Jeff Van Drew from New Jersey emphasized the importance of extending the subsidies, suggesting that failing to do so could jeopardize the party’s fragile majority. Van Drew stated, “Letting the money lapse could cost Republicans seats or even their majority in the midterms.”
Although a successful vote in the House could be on the horizon, any proposed legislation would still need to navigate the Senate, where its fate remains uncertain. Representative Ted Lieu from California criticized the Republican leadership for not addressing the urgency of the situation sooner. He pointed out that without action, health care premiums are likely to rise significantly in the new year.
The House Republicans’ struggle to craft a consensus health care plan illustrates the ongoing challenges within the party, especially as they head into a critical election year. As lawmakers grapple with these issues, the clock is ticking towards a potential crisis in health care affordability for millions of Americans.
