Republican House leadership is pushing ahead with a bill they will bring to a vote next week that includes items that are broadly popular in the party. They will allow an amendment on the expiring enhanced subsidies, but it won't be in the bill.
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Even with two failed votes in the Senate, and the real risk of disastrous midterm elections, House Republicans remain deeply divided on the issue of the subsidies.
Because of that division — and opposition to the subsidies from Republican leaders themselves — GOP leaders opted against including a subsidy extension in their health care bill.
But after moderates rebelled by trying to force votes on subsidy extension plans through discharge petitions, leadership began negotiations. Now, House GOP leadership aides said they will allow a vote on an amendment to extend the ACA subsidies in some form. Any such amendment vote would give moderate Republicans political cover, but would have little chance of becoming law. Even if it passes the House, it will need 60 votes in the Senate.
The underlying legislation is a grab bag of ideas that have already passed through various committees:
- A measure to expand association health plans, which allow employers to band together to purchase coverage.
- A provision that would impose new transparency measures on pharmacy benefit managers, aimed at lowering drug costs.
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Funding cost-sharing reduction payments, which would lower overall ACA premiums but also reduce subsidies, making coverage more expensive for some enrollees
- Easing the ability for small businesses to purchase health coverage.
Both sides are now playing political hot potato with who will be blamed for spiking health care costs next year.
The enhanced subsidies are still likely to expire, but Republicans can say they introduced a plan.
Democrats insist a “clean” extension is the only answer to avoid a steep rise in out-of-pocket premiums.
But they also risk shouldering some blame if they don’t endorse one of the two bipartisan bills that have been introduced. |
Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel and Joseph Choi — every week we follow the latest moves on how Washington impacts your health.
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