Despite holding one of the smallest House majorities in history, Republicans muscled their health care bill through the chamber on Wednesday — a politically important win aimed at blunting Democratic attacks on affordability, but one that is largely symbolic, with the legislation likely to languish in the Senate.
The House passed the package of conservative health proposals, 216-211, with all but one Republican, Rep. Thomas Massie, R-Ky., supporting the bill. All Democrats opposed.
Notably, the bill doesn’t address the expiring Obamacare subsidies, meaning that even if the Senate were to sign off — which again, isn’t likely to happen — millions of Obamacare enrollees would still see their premiums skyrocket on Jan. 1.
Instead, the House GOP proposal incorporates a grab bag of conservative priorities, including expanded association health plans, cost-sharing reductions in the ACA marketplace and new transparency requirements for pharmacy benefit managers.
Top Republican leaders insist the bill would lower premiums for “all Americans.” But compared with the looming increases facing Obamacare enrollees, any potential savings would be marginal. And that assumes the bill somehow becomes law — a long shot given Democratic opposition and the Senate’s 60-vote threshold.
As House Republicans acted publicly on a proposal going nowhere, however, a key group of more moderate lawmakers in both chambers were working behind the scenes on a bill that could go somewhere.
While that proposal still doesn’t quite exist — and just about everyone on Capitol Hill acknowledges it won’t come in time to avert the steep increases in Obamacare premiums — there’s a chance lawmakers could deliver something early next year that would alleviate some of the rising premiums.
Members of the bipartisan Problem Solvers Caucus met with key senators in the basement of the Capitol on Wednesday, as moderate Democrats and Republicans searched for an elusive compromise on the subsidies.
The plan, according to Rep. Brian Fitzpatrick, R-Pa. — who co-chairs the Problem Solvers Caucus — is for the House to send the Senate a three-year Obamacare extension, and then for the Senate to take up the product, make changes, and then send it back to the House.
“We will find a way to get that bill to the floor,” Fitzpatrick said.
How Fitzpatrick and other vulnerable House Republicans plan to send the Senate that initial three-year subsidy extension is no mystery.
After Speaker Mike Johnson, R-La., blocked several amendments to the health care bill that would have extended the subsidies in some form — an important vote for numerous vulnerable Republicans looking to distance themselves from the GOP strategy of letting the tax credits expire — four House Republicans broke from GOP leaders and signed a discharge petition to force a vote on a Democratic proposal to extend the subsidies for three years. Those four signatures were enough to clinch the 218 mark required to force the vote.
The four moderate Republicans who signed on — Reps. Mike Lawler, R-N.Y., Robert Bresnahan, R-Pa., Ryan Mackenzie, R-Pa., and Fitzpatrick — all face difficult reelection bids in next year’s midterms and wanted a chance to vote on the subsidies.
“We did what was in the interest of my bosses back home,” Fitzpatrick told reporters.
Lawler argued the procedural step of signing the discharge petition wasn’t “an endorsement of the bill written,” explaining that he wants to see changes made to the subsidies.
“But when leadership blocks action entirely, Congress has a responsibility to act,” Lawler said.
It’s just the latest successful discharge petition in a string of successful discharge petitions in the House — a procedural maneuver that is historically rare, as it requires members of the minority party to effectively circumvent leadership and control action on the House floor. But in recent weeks, a handful of Republicans have joined with Democrats to force votes on legislation to release the Epstein files and to protect union rights for federal workers.
Pressed by reporters Wednesday, Johnson insisted he has not lost control of the House.
“When you have the luxury of having 10 or 15 people who disagree on something, you know, you don’t have to deal with it,” he said. “But when you have a razor-thin margin, as we do, then all the procedures in the book, people think, are on the table — and that’s the difference.”
Democrats are hopeful that the combination of the discharge petition and voters paying higher premiums next month may finally shake loose a deal.
As Rep. Jim McGovern, D-Mass., put it: ”The pressure on the Senate will be so enormous that I think the winds will change.”
But the communications director for Senate Majority Leader John Thune, R-S.D., is already throwing cold water on the prospect.
“A clean, three-year extension of the Biden COVID bonuses was on the Senate floor last week, and it failed,” Ryan Wrasse posted on X.
Sen. Bernie Moreno, R-Ohio, backed up that assessment, telling reporters that they “already saw that movie” when the Senate tried — and failed — to advance a three-year extension.
“We’re not going to do a straight up extension for three years without reforms,” Moreno said.
But Moreno was also somewhat bullish on the ability of lawmakers to find some sort of agreement.
“I would say we’re not in the red zone, but we’re in the field goal range,” Moreno told MS NOW on Wednesday afternoon.
What that product will look like, however, and if the House would ever stage a vote on the final proposal, is anyone’s guess.
Lawmakers in both chambers have proposed more than a dozen health care plans — some involving the subsidies, others not — leaving members back in square one as they try to figure out what product can make its way to President Donald Trump’s desk.
Asked Wednesday afternoon if lawmakers could clinch a deal in January, Thune was noncommittal.
“We’ll see,” Thune said. “I think that’s the question. You know.”
Syedah Asghar, Peggy Helman and Lillie Boudreaux contributed to this report.
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