House Backs Renewing Obamacare Subsidies, Defying GOP Leaders

Swing-district Republicans defied party leaders to join Democrats in advancing legislation to revive expired Obamacare subsidies for three years, an indication of the political risks facing the GOP majority in the US House heading into this year’s midterm elections.

Nine House Republicans joined Democrats on a procedural vote Wednesday, a striking sign of lawmakers’ concerns over a surge in out-of-pocket Obamacare premium costs for the more than 20 million people enrolled in those insurance plans.

Democrats, seeking to flip control of the House and with it a chance to curb Donald Trump’s agenda, have hammered the president and his party on affordability, with the rising cost of living poised to be a potent issue heading into November’s elections.

Almost all of the nine Republicans who voted with Democrats on the measure represent districts considered likely to be competitive in the November elections.

Read more: Democrats Pounce as Congress Allows Obamacare Premiums to Spike

The procedural vote tees up floor consideration of a clean, three-year subsidy extension later this week, which is expected to achieve similar levels of support.

The extension is unlikely to be made law. Senate Majority Leader John Thune has said the House bill would be dead on arrival in his chamber, while Trump has repeatedly opposed a straight extension — the central demand Democrats made during last year’s historic government shutdown.

However, House passage — which now appears likely — would increase pressure on the White House and Senate lawmakers to reach a bipartisan deal to revive the enhanced tax credits that lowered out-of-pocket premiums.

The vote itself was forced after Republican leaders denied moderate Republicans a vote on a modified extension of subsidies negotiated with centrist Democrats. With no other vehicle available, four of the moderates broke ranks late last year to back Democratic Leader Hakeem Jeffries’ effort to force a floor vote on the three-year extension plan.

Political risk

The vote illustrates the political risk rising health care costs pose for Republicans in the November midterms.

Democrats, who have seen the issue of Obamacare transform from a weight to a political asset in the last decade and a half as Republicans failed to propose a viable alternative, have linked health care to their broader pitch to voters on affordability.

The issue is particularly risky politically for incumbent Republicans, because Obamacare enrollment tends to be higher in Republican-controlled states that declined to expand Medicaid under former President Barack Obama’s landmark health care law. Out-of-pocket Obamacare premiums more than doubled on average with the expiration of the subsidies, according to the nonpartisan health research organization KFF.

Read more: Republican-Held Congressional Districts’ Rising Obamacare Use Is Risk

President Donald Trump, who has sought a number of policy changes as a starting point for any subsidy talks, in a speech Tuesday urged House Republicans to act on health care.

Trump reiterated his support for sending subsidies directly to consumers, rather than merely extend the tax credits, which are allocated to insurance companies. He also advised the GOP to loosen their demands for stricter abortion restrictions attached to the policy.

“Take the health care issue away from them,” Trump urged his political allies at the House GOP retreat.

Long shot

Meanwhile, those relying on the subsidies have been left to wait without them.

They have until Jan. 15 to sign up for health plans for the rest of 2026, with no guarantee lawmakers will come to an agreement. If subsidies are revived after that point, it’s likely that the enrollment period will also have to be reopened.

Even with a strong showing in the House, a deal to extend Obamacare subsidies is still a long shot.

Read more: Why Obamacare Premiums Are Set to Rise Sharply

While he’s rejected the Democratic-backed House measure, Thune has indicated an openness to bring a compromise to the floor.

Any such deal would need sweeping changes, Thune indicated Tuesday. The Republican majority leader wants to impose income limits on the subsidies, eliminate $0 premiums, include abortion restrictions and eventually transition from the tax credits to federally funded tax-advantaged health savings accounts, he said.

Some of those demands, including stricter abortion restrictions and replacing the tax credit with health savings accounts, are non-starters for Democrats.

Trump signoff needed

Still, a bipartisan group of senators led by Republican Susan Collins of Maine is trying to broker a deal. Those pushing for a compromise say House passage of the extension will increase their momentum. At the very least, it would give the Senate a legislative vehicle to pass a bipartisan compromise, if lawmakers reach one, as tax measures must originate in the House.

Bernie Moreno, an Ohio Republican who’s part of the Senate talks, said the group is close to clinching a deal, though thorny issues like abortion restrictions are still under discussion. If senators reach a deal, it would include extending open enrollment to March 1, he added.

“We’re in the red zone. I’m optimistic,” Moreno said. “But by the way, as a Cleveland Browns fan, being in the red zone doesn’t mean you’re gonna win.”

Democratic Senator Peter Welch of Vermont agreed the group has made progress, but ultimately any agreement will come down to Trump.

“It won’t happen unless President Trump gets involved,” Welch said. “The only way Republicans will agree is if he gives the ‘okay.’”

Listen to The Big Take podcast: The Fight Over ACA Subsidies Is Back On

--With assistance from Skylar Woodhouse.

To contact the reporter on this story:
Caitlin Reilly in Washington at creilly106@bloomberg.net

To contact the editors responsible for this story:
Megan Scully at mscully32@bloomberg.net

Derek Wallbank, Mike Dorning

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