The House will conduct a procedural vote on Jan. 7, paving the way for consideration of a bill to extend the enhanced subsidies for Obamacare Marketplaces as early as Jan. 8.
The vote was prompted on Dec. 17 when four Republicans joined Democrats in signing a discharge petition, a parliamentary maneuver to bring a bill to the floor without a recommendation from the relevant committee.
House Republican leaders had refused to allow a vote on the matter.
The enhanced subsidies, which expired on Dec. 31, have been a major point of contention since early in the fall when Democrats refused to authorize funding for the federal government until Republicans negotiated on the subsidies.
The standoff resulted in a partial shutdown of the federal government for 43 days.
The enhanced subsidies were created in 2021 to mitigate the economic impact of the COVID-19 national health emergency. The subsidies were originally meant to expire after two years but were extended for three years amid the rampant inflation of 2022.
Democrats succeeded in getting a Senate vote on making the enhanced subsidies permanent, but it failed a procedural vote on Dec. 11.
Proponents of enhanced subsidies say rapidly rising health insurance premiums prove that middle and lower-income Americans cannot afford health coverage without help from an employer or the federal government.
House Minority Leader Hakeem Jeffries (D-N.Y.) told reporters on Jan. 6 that passage of the three-year extension is necessary to shield millions of Americans from rising premiums and other out-of-pocket health expenses.
“In some cases, [that] could result in everyday Americans paying $1,000 or $2,000 more per month,” Jeffries said, calling that situation unacceptable in a wealthy nation.
The measure is expected to pass in the House with the help of at least the four Republicans who signed the discharge petition: Reps. Brian Fitzpatrick (R-Pa.), Mike Lawler (R-N.Y.), Robert Bresnahan (R-Pa.), and Ryan Mackenzie (R-Pa.).
If the bill does pass, it will face an uncertain outcome in the Senate, where it would require 60 votes to end debate and bring the matter to an up-or-down vote.
Majority Leader John Thune (R-S.D.) has been unwilling to consider a clean extension of the subsidies.
Yet Thune told reporters on Dec. 16 that he would consider working with Democrats on premium reductions under the right circumstances.
“Our views on health care and the Democrats’ views on health care are very different,” Thune said.
“But if they’re willing to accept changes that actually would put more power and control and resources in the hands of the American people, and less of that in the pockets of the insurance companies, I think there’s a path forward.”
A permanent extension of the subsidies would add $350 billion to the federal deficit from 2026 to 2035 and increase the number of people with health insurance by 3.8 million, according to the Congressional Budget Office.
The enhanced subsidies removed the income cap for eligibility for federal assistance in purchasing health coverage through the Obamacare Marketplaces.
The enhancements also lowered the maximum amount customers would be required to pay toward premiums, based on household income.
The average Obamacare premium for 2025 was $619 per month, of which federal subsidies covered more than $500.
More than 10 million enrollees, 46 percent of those receiving aid, paid $10 or less per month out of pocket for premiums.
About 8 million paid zero dollars.
Sen. Susan Collins (R-Maine) is part of a group working on health care legislation.
She offered few details to reporters on Jan. 6, but did say the ideas under consideration included a two-year extension of the enhanced subsidies, accompanied by some program reforms in the first year and more substantial reforms in the second year.
Sen. Brian Schatz (D-Hawaii) said he doubted that the Senate could reach a bipartisan agreement on health care.
“I can’t even find seven or eight [Republicans] who are interested in the discussion, let alone 13 people who are going to vote ‘yes,’” Schatz told reporters on Jan. 6.
“My observation is they don’t have the votes.”
A sticking point in any negotiation on health care is likely to be the provision of federal funds for abortion.
Republicans for decades have insisted on a provision in federal funding known as the Hyde amendment, which prohibits the use of taxpayer funds to provide abortions except in cases that endanger the life of the mother or that are a result of rape or incest.
Twelve states’ Obamacare plans currently pay for abortions within those parameters.
A complete ban on the use of Obamacare funding for abortions would likely be opposed by Democrats.
Without such a ban some Republicans might oppose funding, according to an analysis by health care research group KFF.
“I’m not flexible on the value of human life,” Sen. Jim Lankford (R-Okla.) told reporters on Jan. 6.
“Life is valuable. I don’t believe some children are disposable and some children are valuable,” he said.
I SAY DO NOT extend them.
Why extend a failed system.