WASHINGTON — House Republicans are vowing to vote on a health care plan next week before leaving for the holidays. They just can’t agree on what should be in it.
Insurance premiums are set to skyrocket for millions of Americans in the new year, if Congress fails to extend subsidies for the Affordable Care Act that are set to expire Dec. 31.
Bowing to conservatives, House Speaker Mike Johnson, R-La., and his leadership team are moving forward with a proposal that wouldn't extend those subsidies, but would instead offer Americans some funds to defray health care costs.
Meanwhile, Republicans facing tough races in next year’s midterms say any health package moving forward must be bipartisan and extend the subsidies.
Facing the looming deadline, Republicans are under enormous pressure to vote on a health plan to insulate their party from Democratic attacks over rising health insurance premiums and protect their fragile House and Senate majorities. But there’s little agreement on how to proceed.
“The consensus is we need to come up with something,” Rep. Ralph Norman, R-S.C., a member of the conservative Freedom Caucus, said after a closed-door GOP meeting on the health issue.
Inside the room, Rep. Jim Jordan, R-Ohio, stood up and warned that Republicans need to include some sort of extension of the ACA funding in their plan alongside conservative reforms, according to a source with knowledge of his remarks.
If they exclude the ACA money, Jordan warned that GOP moderates will team up with Democrats and force a bill to a vote through a discharge petition, which means the right would achieve even less.
Johnson said he plans to hold a floor vote on a GOP plan next week, just before lawmakers depart for a two-week recess. Among the ideas House Republicans discussed in a closed-door meeting Wednesday were an expansion of health savings accounts and funding cost-sharing reductions.
“We have some low-hanging fruit,” Johnson told reporters after the meeting. “We have some things that every Republican agrees to; Democrats won’t. Remember, they don’t actually want to fix this problem.”
But other Republicans acknowledged a more comprehensive overhaul of Obamacare — something the GOP has grappled with for the better part of 15 years — will take much more time.
“Health care is unbelievably complicated,” Rep. Dusty Johnson, R-S.D., said. “You’re not going to reform and bring down costs overnight.”
Fifteen House Republicans, who mostly represent swing districts, signed on to a new bipartisan bill led by Reps. Jen Kiggans, R-Va., and Josh Gottheimer, D-N.J., to extend the ACA subsidies for two years, with some changes and limitations to the funding.
Many of those Republicans have signed on to other proposals to extend ACA funds, for a year or two, with varying reforms to the money.
But those lawmakers are outnumbered in their conference, where most GOP lawmakers don’t want to lift a finger to prop up “Obamacare” and prefer to see the funds expire. Johnson is siding with the majority of his members who oppose an extension of that money. One GOP lawmaker said the speaker is “drawing a line in the sand” against extending ACA tax credits.
And despite Jordan's warning, it's unclear whether GOP lawmakers who want the ACA money extended will succeed at using a “discharge petition” to end-run him and force a health care bill to the floor, as a group of Republicans successfully did with the recent measure to force the release of the Jeffrey Epstein files. Discharge petitions need a majority of the House, or 218 members, to force a vote, meaning a handful of Republicans and all Democrats would need to sign on for it to succeed.
In addition to Kiggans-Gottheimer, centrist Rep. Brian Fitzpatrick, R-Pa., has rolled out his own ACA subsidies extension that, he says, has input from the Senate and White House. The plan — which is endorsed by Democratic Reps. Jared Golden, Tom Suozzi, Marie Gluesenkamp Perez and Don Davis — would extend the tax credits for two years, broaden access to tax-advantaged health savings accounts and overhaul rules around pharmacy benefit managers.
“That’s going to be our best product we can put together,” said Fitzpatrick, who on Wednesday afternoon filed a discharge petition to try to force a vote on his bill.
But it would be a tall order to collect 218 signatures to force it to the floor. A Democratic leadership aide said some of the provisions would be very impractical to implement next year.
Rep. Jeff Van Drew, R-N.J., said the ACA subsidies must be extended — with reforms — to protect vulnerable GOP colleagues and preserve the party’s fragile majority.
He said that allowing the subsidies to lapse is not an option and that he’d be one of the rare few who would sign the discharge petition as a last resort.
“To me, the game plan [from leadership] is get on your knees and pray. … I don’t think that’s a smart thing to do. I respect the speaker tremendously, but I disagree with them on this,” Van Drew said of leadership’s desire to see the tax credits expire.
He said there are at least 20 Republicans — many at risk in 2026 — who don’t want to see the subsidies expire. Letting the money lapse could cost Republicans seats or even their majority in the midterms, Van Drew said.
“If you’re a conservative and you’re a Republican, do you want a Democrat majority next year? I don’t think so. That doesn’t make sense. Let’s not be self-destructive,” he said.
But any bill, even if it succeeded in the House, would still need to pass the Senate, which is far from guaranteed. And even a House vote would likely not come until next year — after ACA funding expires, Rep. Ted Lieu of California noted.
Lieu, a member of Democratic leadership, said Republicans should have gotten serious about a discharge petition months ago.
“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,” he said, while adding that he hasn’t reviewed Fitzpatrick’s bill.
“And if they want to prevent that, we simply need to extend the ACA tax credits. Now there’s nothing keeping Republicans from doing it for two years, and then we can work on legislation for those reforms.”
