House Republicans are set to mark their final session week of 2025 with a muddled health care message that’s poised to have a big impact — a nationwide spike in insurance costs after Obamacare subsidies expire in less than three weeks.
— The plan: GOP leaders are eyeing a Wednesday vote on a package of conservative-friendly health policies they released last Friday (Pro subscribers can read more of the specifics here).
The proposal — a narrowly-focused attempt at striking consensus in a divided GOP conference — doesn’t include an extension of Affordable Care Act tax credits that lapse on Dec. 31. Instead, leadership is expected to throw a bone to anxious rank-and-file members by giving them the chance to vote on an amendment that would continue the subsidies — a vote that’s almost guaranteed to fail.
“I expect people are going to have an opportunity to vote their conscience and then go defend their votes back home like we always do,” House Budget Chair Jodey Arrington (R-Texas) said.
— Mods scramble: Moderate Republicans in the House and Senate are privately strategizing about how to pull off an unlikely last-minute deal to avert a health care price shock that could have big ramifications for the midterms. A number of vulnerable Republicans have argued they will lose their seats if the ACA subsidies aren’t extended.
The Obamacare amendment that GOP moderates are set to offer this week is expected to be a two-year extension of the subsidies with an income cap and other changes — a plan modeled after a proposal from Reps. Brian Fitzpatrick (R-Pa.) and Jared Golden (D-Maine).
House Democratic leaders are waiting to see what the final amendment looks like. They could try to tank the bill by helping adopt the amendment, though many Democrats have criticized the Fitzpatrick-Golden plan.
— More unhappy campers: Key GOP hard-liners are upset that Republican leaders are allowing an ACA vote at all, and they know they have leverage. They’re pushing for more restrictive language in the Obamacare amendment and want commitments on conservative policy wins in health legislation early next year, in exchange for letting the bill proceed. To shore up support with conservatives, GOP leaders are pairing the health care package with two bills that would limit transgender surgeries for minors.
— Why it matters for the midterms: This week’s vote is clear evidence that the GOP is struggling to define an easily digestible message on health care costs heading into next year’s elections, as Democrats stay mostly unified around extending the ACA subsidies.
Every Senate Democrat voted to advance an Obamacare tax credit extension last week, and House Minority Leader Hakeem Jeffries has managed to keep most of his members from endorsing compromise proposals from purple-district Republicans.
House GOP leaders have been unwilling to rethink a 15-year-old party message that Obamacare is a costly disaster, despite growing anxiety from their members about the electoral consequences.
The saga has left many House Republicans frustrated even if they share concerns about the cost of the subsidies and the legacy of the ACA.
“A lot of people are receiving this health care — they don’t need the rug pulled out from under them,” Rep. Dan Meuser (R-Pa.) told POLITICO last week. “Definitely should have been done a ways back, we could say, because of the shutdown. But we’ve got to do everything we can and then do more.”
“I don’t see how we just leave things in limbo.”
What else we’re watching:
— House to take up permitting: House GOP leaders are eyeing a Thursday morning vote on bipartisan legislation that would aim to speed up energy project permitting. Republicans are working to shore up their votes, with resistant hard-liners arguing the bill would undermine President Donald Trump’s authority to block offshore wind energy projects.
— Thune’s busy week: Senate Majority Leader John Thune is looking to wrap the NDAA and confirm dozens of nominees before Congress leaves town for the holidays. Potential bonus items include some appropriations action and a war powers vote.
Meredith Lee Hill, Jordain Carney, Nicholas Wu and Josh Siegel contributed to this report.
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