House Republicans are racing against the clock to finalize a health care plan ahead of a critical deadline. With insurance premiums poised to rise significantly for millions of Americans in 2024, the party is grappling with internal divisions on how to address the expiration of subsidies for the Affordable Care Act (ACA) set for December 31, 2023.
House Speaker Mike Johnson, representing Louisiana, has proposed a strategy that aligns with conservative members of his party. Instead of extending ACA subsidies, the plan would allocate funds to help Americans manage health care costs. However, many Republicans facing challenging midterm elections argue that any health care package must include bipartisan support and extend the subsidies to avoid backlash from voters.
The urgency is palpable. A group of Republicans, particularly those in competitive districts, express concerns that failing to act could jeopardize their political futures. “The consensus is we need to come up with something,” said Rep. Ralph Norman of South Carolina, a member of the Freedom Caucus, after a recent GOP meeting.
During the closed-door session, Rep. Jim Jordan of Ohio emphasized the necessity of including some form of ACA funding in the proposed legislation. He highlighted that neglecting this element could lead moderate Republicans to align with Democrats, potentially causing the party to lose control over the legislative agenda.
In response to these internal conflicts, Johnson plans to bring a GOP proposal to the House floor next week, just before lawmakers break for a two-week recess. Ideas discussed include expanding health savings accounts and funding for cost-sharing reductions. “We have some low-hanging fruit,” Johnson remarked to reporters, insisting that Republicans have solutions that Democrats would oppose.
Despite this, other members acknowledged the complexity of a comprehensive overhaul of the ACA. “Health care is unbelievably complicated,” stated Rep. Dusty Johnson from South Dakota, emphasizing that meaningful reform takes time and cannot be rushed.
A bipartisan framework, supported by Reps. Jen Kiggans of Virginia and Josh Gottheimer of New Jersey, has gained traction among some House Republicans. This plan seeks to extend ACA subsidies for two years with adjustments to the funding structure. However, these legislators represent a minority within the GOP, where a significant number remain opposed to any extension of what they label “Obamacare.”
Johnson’s stance reflects the majority view within his conference, as he reportedly “draws a line in the sand” against extending the ACA tax credits. This division raises questions about the viability of a discharge petition, which could allow some Republicans to bypass leadership and force a vote on a health care bill.
In addition to the Kiggans-Gottheimer framework, centrist Rep. Brian Fitzpatrick of Pennsylvania has introduced his own proposal aiming to extend ACA subsidies while broadening access to health savings accounts. Fitzpatrick has indicated that he might pursue a discharge petition to compel action if leadership fails to address the issue.
The urgency of the situation is underscored by Rep. Jeff Van Drew from New Jersey, who insists that extending the ACA subsidies is essential for protecting vulnerable Republican members and maintaining the party’s slim majority. He expressed concern that allowing the subsidies to lapse could lead to significant electoral losses for Republicans in the upcoming midterms.
Van Drew remarked, “If you’re a conservative and you’re a Republican, do you want a Democrat majority next year? I don’t think so. That doesn’t make sense. Let’s not be self-destructive.”
Despite these internal debates, any legislation passed by the House would still require Senate approval, which remains uncertain. The clock is ticking, as the end of the month approaches, and Rep. Ted Lieu from California warned that procedural hurdles could hinder timely action. “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,” he stated.
As House Republicans navigate these challenges, the pressure mounts to deliver a health care plan that addresses the immediate needs of constituents while maintaining party unity. The coming week will be critical in determining whether they can find common ground or risk further division.
