WASHINGTON — The House voted to revive the enhanced Obamacare subsidies that expired at the end of last year after more than a dozen Republicans bucked party leadership to back the Democratic proposal.
Lawmakers voted 230-196 to extend the COVID-era tax credits for three years without any reforms to the program, handing a major win to Democrats who have fought for the proposal for months. The vote marks a major rebellion after 17 Republicans crossed party lines to support the measure after lamenting GOP leaders haven’t done enough to address health care costs.
All four members of Utah’s delegation voted against the bill.
The break comes after a major fallout between House Speaker Mike Johnson, R-La., and moderate Republicans last year stemming from disagreements on how to pay for the Obamacare subsidies. Republican leaders initially promised centrists an amendment vote on temporarily extending the ACA credits that could be attached to their larger package reforming the health care system as a whole.
But those plans were scrapped over disagreements on how to offset the costs of the extended subsidies, according to a source familiar with the talks. House Republicans ultimately passed their alternative health care bill, but its status is in limbo in the Senate.
After that, four centrist Republicans decided to sign on to the Democratic-led discharge petition forcing a vote on the three-year extension — allowing for consideration even without GOP leaders’ approval.
The bill now heads to the Senate, where it is likely dead on arrival as senators already rejected a clean three-year extension last year. The Congressional Budget Office has projected that a clean extension would likely increase the deficit by more than $80 billion.
However, it creates an opportunity for bipartisan negotiators to propose some other kind of health care package.
As senators negotiate a plan to fuse Republican and Democratic priorities, one suggestion is to take the three-year extension bill and replace its language with a more concrete framework, according to a lawmaker involved in the talks. Doing so would only require an amendment vote in the Senate and future approval by the House.
What that final framework will look like is not yet clear. Lawmakers have been engaged for months to craft some sort of health care system to ease the expiration of subsidies from last year while implementing certain reforms to bring down costs and root out fraud.
But the main source of contention is the Hyde Amendment, a decades-old abortion policy that prohibits the use of federal taxpayer dollars for abortion procedures. While not a law itself, the language has been attached to annual spending bills every year since 1976.
Republicans have pushed to further restrict which funds can be used for abortion-related procedures under certain insurance plans — something Democrats have refused to agree to. But that demand from Republicans may be softening, especially after President Donald Trump told GOP lawmakers on Tuesday to “be more flexible.”
“You heard what the president had to say about flexibility,” Rep. Dan Meuser, R-Penn., said leaving a health care meeting on Thursday. “I mean, it’s already in the (Affordable Care Act), so we’ll see how it can be handled, but I don’t think it will be a deal breaker.”
That reflects the main argument from Democrats, who believe current policy is restrictive enough and that stricter requirements are unnecessary.
“So the debate is, do we really need to do more?” Rep. Don Bacon, R-Neb., said on Thursday. “It’s already in the ACA bill, the Hyde Amendment, so we’re having a hard time trying to figure out what is the real problem here.”
Negotiators are working to finalize text of a health care bill, although it’s not clear when that will be. Sen. Jeanne Shaheen, the top Democrat involved in negotiations, said she hopes it could be released by next week, but said it was not definitive.