GOP healthcare plan tests how far centrist frustration will go
House Republicans are currently facing intense internal conflict over their healthcare plan, the Lower Health Care Premiums for all Americans Act, which aims to address the expiration of Obamacare subsidies at year-end. The party is divided, with centrist Republicans pushing for some extension of these subsidies, while leadership resists any amendments.Speaker Mike Johnson has declined to allow a vote on extending the subsidies, leading to frustration among moderates who argue that letting the subsidies expire would harm Americans’ access to affordable healthcare. Democrats criticize the GOP plan as inadequate and are advocating for a three-year extension, though centrists in the GOP remain hesitant, citing recent Senate failures on similar proposals. A House vote is scheduled, highlighting tensions between party leadership and centrist republicans, especially those in competitive districts. Even if the bill passes the House, Senate opposition means the legislation is unlikely to advance before 2026, prolonging the uncertainty surrounding healthcare subsidies.
Republican frustration on healthcare hits boiling point
House Republicans have found themselves once again staring down the barrel of an 11th-hour vote ahead of the holidays that risks fracturing the party.
The item before the House this time around is their healthcare plan, the Lower Health Care Premiums for All Americans Act, a response to the Obamacare subsidies that are set to expire at the end of this year.
However, the bill has split the Republican conference, as centrist lawmakers have pushed for a vote to extend the subsidies in some capacity, while leadership on both sides of the aisle has refused to budge.
Centrist Republicans were unable to convince the Rules Committee to adopt any of their amendments that sought to extend the subsidies.
This came after Speaker Mike Johnson (R-LA) said on Tuesday that there would be no vote on ACA subsidies because “it just was not to be” and a heated luncheon with many of the party’s centrists.
Without speaker support, the Rules Committee unsurprisingly rejected the amendments — including an amendment from Rep. Nick LaLota (R-NY), which would have allowed ACA recipients to have a two-year tax deduction instead of a temporary extension that gives the money to insurance companies.
Johnson had signaled there was a “real possibility they get a vote” on LaLota’s proposal, but in the end, it was not enough.
Democrats have criticized the GOP’s healthcare plan as “unserious” and the scheduled vote on Wednesday as a “show vote,” noting that the Senate is unlikely to pass the legislation.
“You guys have been in charge for the last three years,” Rep. Jim McGovern (D-MA) said during Tuesday’s Rules hearing. “If this were a priority, this would have been one of the first things that you brought up. But it isn’t, and I think this is being done — in Massachusetts, we call this ‘ass covering,’ because you’re about to go home for the holidays and people are about to see the tax credits expire, and people are going to make the choice to go without healthcare or pay exorbitantly more for their healthcare.”
Democrats have been pushing for a three-year extension of the subsidies. A discharge petition introduced by House Minority Leader Hakeem Jeffries (D-NY) that pushes for this has 214 Democratic signatures, requiring only four Republicans to sign on toforce a vote.
But centrist Republicans have been hesitant to throw their weight behind that bill, arguing a three-year extension is a waste of time given a similar Democratic proposal failed in the Senate last week.
Bacon said he didn’t think any Republicans would sign onto Jeffries’s discharge petition to unlock the three-year bill, saying Obamacare needs reform and a blanket extension is not the answer.
Other centrists haven’t ruled out that option, with Lawler saying “everything is on the table” Tuesday. Fitzpatrick has acknowledged the program needs reforms, as GOP leadership has said, but that extending the credits at least for a short timeframe will allow for those reforms without hurting Americans.
“Letting the credits expire is not a good option, so I just think we need a responsible bridge,” Fitzpatrick said Tuesday afternoon. “We are leaving no stone unturned. We want to pursue every single path, exhaust every remedy.”
Wednesday’s vote will be a test to see whether moderates are willing to buck leadership or not. It is not often that centrist Republicans are the thorns in Johnson’s side. But they have been insistent on the healthcare issue, particularly those sitting in blue or swing districts.
Despite frustrations, many of the group who brought the amendments forward have said they will vote for the Lower Health Care Premiums for All Americans Act.
“I’m not against the basis of the bill,” Lawler said. “I’m not going to vote against something out of spite. The issue here is about the premium tax credit, and that’s what we’re working to dislodge.”
He added: “The deadline is December 31, so that’s why I’m here, fighting to get this dislodged and get a vote. Put it on the floor, let the American people see how their representatives vote on this issue.”
Fitzpatrick said “there will be consequences” if the ACA subsidies are not extended, but he’d still support the GOP healthcare package because he votes “for rules and bills based on the merits, not out of retaliation or spite.”
Even if the bill passes the House on Wednesday, it won’t see any further action until 2026. Senate Majority Leader John Thune (R-SD) said healthcare is a “complicated issue” and there are many “different visions” as to how to solve it.
The Senate has already rejected a Republican healthcare proposal that does not include an ACA extension, so it’s all but assured the Lower Health Care Premiums for All Americans Act will be dead on arrival in the upper chamber.
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