House Republicans are under pressure to finalize a health care plan before the holiday recess, with a vote expected next week. The urgency arises as insurance premiums for millions of Americans are poised to increase if Congress does not extend key subsidies for the Affordable Care Act (ACA) that are set to expire on December 31, 2023. Despite this looming deadline, a consensus on the plan remains elusive among party members.
House Speaker Mike Johnson, representing Louisiana, is leading efforts that cater to conservative factions within the party. His proposal does not include an extension of ACA subsidies but suggests providing financial assistance to help Americans manage health care costs. This approach has drawn criticism from moderate Republicans, particularly those facing challenging races in the upcoming midterm elections, who argue that any viable health care package must be bipartisan and extend these subsidies.
During a closed-door meeting, Republican Representative Ralph Norman from South Carolina noted, “The consensus is we need to come up with something.” This sentiment reflects the urgency felt by many lawmakers who recognize the potential fallout from rising health care costs. Representative Jim Jordan from Ohio emphasized the need to incorporate some form of ACA funding in their proposals. He warned that excluding this funding could lead moderate Republicans to align with Democrats to push a more favorable bill through a discharge petition.
Johnson has indicated plans to hold a floor vote next week before Congress takes a two-week break. Among the potential measures discussed were expansions of health savings accounts and funding for cost-sharing reductions. Johnson remarked, “We have some low-hanging fruit,” referring to ideas that enjoy broad support among Republicans but may not appeal to Democrats.
Despite this, many Republicans acknowledge that a comprehensive overhaul of the ACA, a challenge the party has grappled with for over 15 years, requires more time and effort. “Health care is unbelievably complicated,” stated Representative Dusty Johnson from South Dakota. “You’re not going to reform and bring down costs overnight.”
A faction of 15 House Republicans, primarily from competitive districts, recently endorsed a bipartisan framework led by Representatives Jen Kiggans from Virginia and Josh Gottheimer from New Jersey. This plan proposes a two-year extension of ACA subsidies with modifications. However, this group represents a minority within the party, as many GOP members remain opposed to extending support for what they label “Obamacare.”
Johnson appears to align with the majority opposition to extending ACA funding, drawing a “line in the sand” against such measures. The possibility of a discharge petition to bring the ACA funding extension to the floor remains uncertain. A discharge petition requires a majority of the House, or 218 members, to force a vote, necessitating support from both moderate Republicans and Democrats.
In addition to the Kiggans-Gottheimer framework, centrist Representative Brian Fitzpatrick from Pennsylvania has proposed his own extension plan, which he claims includes input from the Senate and the White House. His bill aims to extend the tax credits for two years while also expanding access to health savings accounts. Fitzpatrick has expressed readiness to file a discharge petition if party leadership does not act on the issue.
The stakes are high, as allowing ACA subsidies to lapse could jeopardize the electoral prospects for Republicans in the midterms. Representative Jeff Van Drew from New Jersey highlighted the potential risks of failing to extend these subsidies, noting that many Republicans are concerned about the impact on their chances in 2026. “If you’re a conservative and you’re a Republican, do you want a Democrat majority next year? I don’t think so,” he stated.
Despite the urgency, any health care bill passed in the House would still need to navigate the Senate, where its fate is uncertain. Representative Ted Lieu from California criticized Republicans for their lack of action regarding the discharge petition, 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 lawmakers head into the final stretch before the holiday recess, the pressure mounts for House Republicans to reach a consensus on a health care plan that addresses the impending expiration of ACA subsidies and the financial impact on millions of Americans.
