The House passed legislation Thursday to revive and extend expired ObamaCare tax credits in a bipartisan vote that is boosting hopes of centrist Republicans for a bipartisan deal to revive the tax credits.
The tally, 230 to 196, highlighted the tenuous grip Speaker Mike Johnson (R-La.) has over his restive GOP conference. Seventeen centrist Republicans crossed the aisle to join every voting Democrat in support of the measure.
The measure, which would provide a three-year extension to the enhanced Affordable Care Act (ACA) subsidies that originally passed in response to COVID-19, now heads to the Senate, which defeated the same proposal last month in a largely partisan vote. Indeed, Senate Majority Leader John Thune (R-S.D.) has suggested he’ll ignore the House bill altogether.
Still, lawmakers think it could light a fire and pressure the bipartisan Senate group working to reach a bipartisan deal.
Negotiators from both parties in the Senate, who revived compromise talks in response to centrist Republicans forcing the vote in the House, have said they are close to a deal to bring back the tax credits, which expired at the end of 2025, and extend the open enrollment period.
“We want to show momentum coming out of the House today,” said Rep. Tom Suozzi (D-N.Y.), who has been working with GOP moderates on the subsidy extension plans. “And the Senate is very far along on finding an agreement on their side.”
Rep. Brian Fitzpatrick (R-Pa.), who huddled with bipartisan Senate negotiators Thursday, said the vote should be a pressure point for the Senate.
“Senators made it abundantly clear that, but for this action in the House … that that was incredibly important for them to breathe life back into this issue and really force the Senate to take this up,” Fitzpatrick told reporters.
The 17 GOP members voting yes on the bill were Fitzpatrick and Reps. Rob Bresnahan (Pa.), Mike Carey (Ohio), Monica De La Cruz (Texas), Andrew Garbarino (N.Y.), Jeff Hurd (Colo.), Dave Joyce (Ohio), Tom Kean Jr. (N.J.), Nick LaLota (N.Y.), Mike Lawler (N.Y.), Ryan Mackenzie (Pa.), Max Miller (Ohio), Zach Nunn (Iowa), Maria Elvira Salazar (Fla.), David Valadao (Calif.), Derrick Van Orden (Wis.), and Robert Wittman (Va.).
The vote marked an uptick in support for the extension compared with the previous day, when nine Republicans supported a procedural vote on the matter — a vote seen as a signal in support of the bipartisan negotiations on a compromise.
Passage in the House marked a major victory for Democrats and the handful of centrist Republicans who had bucked their leadership to endorse a procedural gambit, known as a discharge petition, that forced the bill to the floor over the opposition of Johnson and other GOP leaders.
It was an extraordinary demonstration of defiance, because discharge petitions are rarely successful. And the vote was particularly notable because it centered around ObamaCare, which Republicans have sought to dismantle since its very inception in 2010.
Heading into the vote, Democratic leaders in both chambers were already calling on Thune to bring the proposal to the floor again, predicting the House vote would be enough to compel more Senate Republicans to drop their opposition.
“American people should ask Leader Thune: Are you willing to put this bill that the House now is moving forward on, on the floor of the Senate? Because it will pass,” Senate Minority Leader Chuck Schumer (D-N.Y.) said Thursday, hours before the House vote. “And that is the way to get this done.”
Yet even some of the most vocal supporters of the ACA subsidies say the House bill is dead in the water when it’s sent to the Senate.
“The three-year extension is never going to become law. We know that. The Senate already voted on it. They voted it down,” said Lawler, who was one of the four Republicans who endorsed the Democrats’ discharge petition forcing Thursday’s House vote. “So the question becomes, procedurally, how do you actually get to a compromise?”
Many Republicans remain opposed to reviving the tax credits at all, seeing them as unnecessarily expensive. Indeed, the Congressional Budget Office said Thursday the three-year extension would cost $80 billion.
The centrist Republicans supporting the subsidy extension made clear that they have plenty of problems with the underlying benefits; they want to alter the program to tighten the income eligibility limits and tackle fraud.
The bipartisan deal emerging in the Senate would extend the enhanced subsidies for two years and come with an income cap and language requiring a minimum premium of $5 a month to eliminate the $0 premium plans Republicans say are rife with fraud. It also would give patients the option of receiving funding in a health savings account.
But with millions of people poised to see a spike in health care costs in the early months of this year, those Republicans — many of whom are in competitive midterm races — also felt they had to step in to protect their constituents.
Another major sticking point are demands from conservative Republicans, who have never supported ObamaCare, to increase restrictions against ObamaCare health plans covering abortion.
President Trump gave fuel to GOP moderates’ hopes of overcoming the impasse on abortion and striking a bipartisan deal when he pleaded in a speech to House Republicans on Tuesday to be “flexible on Hyde” — in reference to the Hyde Amendment, which prevents federal funds from directly paying for abortion — when talking about health care.
The Hyde amendment does not prohibit Affordable Care Act plans from covering abortions, so long as there are no federal dollars being used for that coverage.
The law has a mechanism that segregates taxpayer money, and any plan that covers abortion needs to charge each enrollee $1 per month extra.
But anti-abortion activists and Republicans argue that current law does not sufficiently prevent federal funds from subsidizing health plans that cover abortion in some states.
Lawmakers involved in the negotiations have acknowledged that Hyde remains a sticking point.
“I think all the other things can be resolved,” Fitzpatrick said, but Hyde is “really the toughest for them to navigate.”
But he said there is a growing consensus not to add any additional restrictions and to reinforce the existing law.
“This is an affordability issue. That’s how it should be viewed. Health care affordability, and I don’t think Hyde has any place in this.”
Updated at 5:50 p.m. EST