House Republicans are planning to vote on a health care package next week that does not renew enhanced Obamacare premium subsidies, prompting a group of centrist Republicans to launch a discharge petition to try to force a vote on a two-year extension.
GOP leaders presented 10 health care proposals to their conference on Wednesday and are planning to vote on some next week, while continuing work on the others next year.
One proposal they ruled out is extending enhanced Obamacare premium subsidies set to expire Dec. 31. Allowing the COVID-era expansion of the subsidies to lapse is expected to more than double out-of-pocket premium costs for the 22 million Americans who are currently on subsidized Obamacare plans.
Democrats “broke the American health care system,” said House Speaker Mike Johnson.
“They caused premiums to skyrocket,” he said. “And now they have the audacity to tell Republicans that the only way to save it is to throw hundreds of billions of dollars to health insurance companies, which would merely fuel a system that is ripe with fraud, waste and abuse. You cannot be an arsonist and a firefighter at the same time.”
Mr. Johnson, Louisiana Republican, said the health care package his conference is putting together will reduce premiums for 100% of Americans who are on health insurance, not just the 7% on Obamacare plans.
Some Republicans were upset that GOP leaders’ plan did not include at least a temporary extension of the enhanced Obamacare subsidies to provide a bridge to the larger health policy changes.
Rep. Brian Fitzpatrick, Pennsylvania Republican, launched the discharge petition to try to force a vote on his bill to extend the enhanced subsidies for two years with some changes, like an income cap and fraud guardrails.
He said lawmakers need to look at the issue from outside Washington’s “echo chamber” and think about the people who may not be able to afford health coverage for 2026 if Congress doesn’t act.
“Too many of them are not connected with their districts where they’re actually hearing what we’re hearing,” Mr. Fitzpatrick said. “These are friends. These are our neighbors. We care about them.”
The discharge petition needs 218 signatures, a majority of the House, to be successful. Six Republicans, including Mr. Fitzpatrick, and two Democrats signed the petition when it launched Wednesday.
“Affordability is the most important issue for folks facing the country right now,” said Rep. Kevin Kiley, California Republican who signed the petition. “There’s perhaps no single policy measure that would have a more dramatic impact on affordability in the year ahead than doing something about the expiration of these subsidies.”
Mr. Kiley said he will still vote for the health care package GOP leaders put together if he believes it is good policy.
House Majority Leader Steve Scalise, Louisiana Republican, said he expects votes next week on two to four of the proposals that were presented to the conference, but they have yet to decide which ones, or whether to bring them up individually or package them for a single vote.
“We’ve got to bring items right now that we have full consensus on, because we have such a small majority,” he said.
Some of the proposals discussed have bipartisan support, like cracking down on pharmacy benefit managers, the intermediaries between drug companies and pharmacies that lawmakers blame for driving up prices. That issue is also addressed in Mr. Fitzpatrick’s bill.
Another proposal that could earn Democratic support is price transparency legislation that would require health care providers to publish the costs of their services so consumers can make more informed decisions.
Others are more partisan, like efforts to codify Trump administration rules to fix perceived flaws in Obamacare.
Republicans have also floated expanding tax-exempt Health Savings Accounts, currently limited to use with high-deductible plans.
Another proposal on Association Health Plans would allow membership-based entities such as Amazon, Costco credit unions, churches and associations to provide new coverage options by negotiating with insurers for lower group rates.
Mr. Johnson mentioned cost-sharing reductions as a likely candidate for inclusion because House Republicans already passed that earlier this year as part of the One Big Beautiful Bill Act. It was stripped in the Senate after Democrats flagged it as out of compliance with the budget reconciliation rules.
Cost-sharing reductions, or CSRs, were enacted as part of the Affordable Care Act to lower deductibles for families earning 100% to 250% of the poverty level who purchase silver-level Obamacare plans.
A federal judge ruled in 2016 that the government could not fund direct CSR payments without an explicit congressional appropriation. The ruling was stayed upon appeal, but the Trump administration chose to end the CSR payments in 2017 as Republicans worked on their failed effort to repeal and replace the ACA.
To compensate for the loss of the CSR payments, insurers inflated premium prices for silver plans. Republicans argue that funding CSRs will reverse the “silver loading” and lower premium costs.
Rep. Ralph Norman, South Carolina Republican, said there was no consensus leaving the meeting on which proposals could get 218 votes needed for passage if brought the floor next week.
“It’s a game of elimination,” he said. “We’re doing this hurriedly. … No one’s going to get everything they want, me included.”
• Lindsey McPherson can be reached at lmcpherson@washingtontimes.com.
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