WASHINGTON — Congress will not vote on an extension of the enhanced Obamacare subsidies, all but ensuring the tax credits will expire at the end of the year and millions of Americans will be risk of having their health care premiums skyrocket in 2026.
The House will vote on a health care package this week to expand association health plans and self-insurance protections as part of an effort to overhaul the health care system at large. But the package won’t include any language to temporarily extend the Obamacare subsidies despite initial plans to do so after talks broke down between GOP leaders and moderate Republicans.
The decision makes official what some lawmakers have feared for months: that the COVID-era enhanced tax credits will lapse after Dec. 31 without a backup plan. And it comes even after a bipartisan push to salvage the subsidies gained traction in recent weeks — but ultimately fell apart.
Democrats first raised the alarm bells about extending the subsidies during funding negotiations, which led to the record-long shutdown in which Democrats refused to reopen the government without a deal and Republicans argued it was a separate issue that could wait until later.
Even after the 43-day shutdown, Democrats emerged without a set plan to extend the tax credits. And not all Republicans were that interested in preserving them.
Senate Republicans instead began negotiating broader health care reforms such as extending health savings accounts to replace the subsidies. Meanwhile, Democrats landed on a three-year extension with no systemic changes as their non-negotiable demand.
Senate Majority Leader John Thune, R-S.D., put the competing proposals on the Senate floor last week where they both failed, as expected. That prompted the top Senate Republican to concede a deal likely wasn’t going to come this year.
“There are a lot of moving parts and we have different visions of what health care ought to look like,” Thune said on Tuesday. “You’re right, we’re not going to pass anything by the end of this week, but I do think there is a potential pathway in January if Democrats are willing to come to the table to do things that will actually drive down the cost of health care.”
Those failed votes put pressure on House Republican leaders to craft some sort of health care package to appease both fiscal conservatives and centrist members running in competitive races next year.
That led to the Lower Health Care Premiums for All Americans Act that was unveiled last week, alongside a promise to have an amendment vote on temporarily extending the ACA credits. But after talks over the weekend, those plans were scrapped over disagreements on how to offset the costs of the extended subsidies, according to a source familiar with the talks.
“We worked on it all the way through the weekend, and at the end, an agreement wasn’t made,” House Speaker Mike Johnson, R-La., told reporters. “Everybody was at the table in good faith, and I certainly appreciate the views and the opinions about everything.”
Johnson informed Republican members there would be no ACA vote during a closed-door meeting on Tuesday morning, prompting anger from several in the moderate camp who have pushed for a short-term extension.
Rep. Mike Lawler, R-N.Y., said he was angry “for the American people,” after the meeting. “To not have a vote on the extension with reforms, with conservative reforms (such as) income limits, elimination of zero premium plans, PBM reform, HSA expansion. To not do that is idiotic. It is political malpractice.”
But centrists such as Lawler placed just as much blame on Democratic leaders, accusing the minority party of being more concerned with political messaging rather than a bipartisan solution.
“I’m very frustrated with (Hakeem) Jeffries as well,” Rep. Kevin Kiley, R-Calif., said, referring to the top House Democrat. “He has taken this, I’d say, pretty rigid view, that it’s that one solution and none of these compromise measures that have bipartisan support. He’s not willing to consider any of them.”
After an intense meeting with the speaker on Tuesday — which resulted in raised voices and exchanges heard by reporters in the hallway — moderate Republicans pushed ahead with plans to force a vote on their amendment by introducing it to the powerful House Rules Committee, which sets the parameters on debate and procedure for nearly every piece of legislation that is brought to the floor.
Rep. Brian Fitzpatrick, who has led GOP efforts on the matter, was among those who introduced a proposal to extend the subsidies, but the amendment, along with a handful others, were shot down by conservatives on the panel.
The House will move forward with voting on the Republican-led health care plan without any ACA language on Wednesday, although its fate is not yet clear. Johnson can only afford to lose two GOP votes before the bill is at risk of failing if all members are present and Democrats vote against it.
Some of the centrist Republicans, including Fitzpatrick and Kiley, have already said they’re inclined to vote for the alternative healthcare package despite the absence of Obamacare credits.
“I think the policy is good,” Kiley said. “I tend to vote for things based upon what’s in them, as opposed to what’s out of them.”
“But,” he added, “I think the idea that this is somehow compensating for the failure of Congress to act on the issue that actually matters to people. I don’t buy that at all.”
Others are taking the opportunity to push their own discharge petitions, which would force a vote on extending the subsidies without GOP leadership support so long as a majority of House members sign on.
Republicans introduced two discharge petitions last week, but they would require all House Democrats to sign on — something the minority party has so far rejected, instead pushing for a three-year clean extension.
As the deadline approaches, rank-and-file members have begun holding their own meetings to discuss a path forward with optimism they can come up with a new health care package early next year. A bipartisan group of senators and House members are set to meet on Wednesday.