With dueling health care bills expected to fail in the Senate on Thursday, lawmakers are already asking themselves a simple question: What comes next?
In all likelihood, the answer is higher premiums for those purchasing their health insurance on the Obamacare exchanges.
But before premiums spike on Jan. 1, lawmakers are clinging to the hope that Thursday’s failed votes might jumpstart a bipartisan solution — even as Congress rapidly runs out of time.
“The time frame is: urgent, urgent, urgent,” Sen. Josh Hawley, R-Mo., told MS NOW.
Sen. Jeanne Shaheen, D-N.H., who has recently been involved in bipartisan talks, said she hopes lawmakers will be able to address rising premiums “whenever we can get the votes.”
That almost certainly won’t be in time to prevent the increases, but Republicans and Democrats continue to float a range of alternative health care proposals, each with a different — and often slim — chance of enactment.
One of the more viable options is a bipartisan bill that would extend the enhanced subsidies for two years, implement new income caps and expand access to Health Savings Accounts, or HSAs. Rep. Brian Fitzpatrick, R-Pa., the co-chair of the bipartisan Problem Solvers Caucus, filed a discharge petition for the legislation on Wednesday, with the measure already drawing enough GOP signatures that, with every House Democrat, lawmakers could force a vote in the House.
“It’s a time-sensitive matter and it’s an existential matter for people back home that we care about, where this is a very real problem,” said Fitzpatrick, who represents one of three Republican congressional districts that Kamala Harris won in 2024.
Still, despite the Democratic interest in extending the subsidies, there are early signs that not enough Democrats will join the small smattering of Republicans who support the legislation.
An aide to House Democratic leadership summed up the bill this way to MS NOW: “The legislation isn’t workable.”
House Minority Leader Hakeem Jeffries, D-N.Y., previously filed his own discharge petition, demanding a three-year extension of the enhanced subsidies — akin to what Senate Democrats are demanding. Asked about the Fitzpatrick discharge petition, Jeffries told reporters Wednesday evening: “I have no position on it.”
House Republicans, however, have other plans.
Speaker Mike Johnson, R-La., told reporters on Wednesday that his conference plans to unveil its own proposal to lower health care costs by the end of this week, with the intention of bringing the measure to the floor for a vote next week.
What that bill will include, however, is anyone’s guess. Republicans tossed out several different proposals during a closed-door conference meeting on Wednesday, with leaders displaying a slide at one point that had 10 ideas on it, though hardly any detail about what those ideas might actually do.
Included on that slide, according to a lawmaker in the room who took a photo of the slide and asked not to be identified because the discussion is supposed to be private, were the following ideas:
- Association Health Plans
- Choice Accounts
- Health Savings Accounts
- Cost Sharing Reductions
- Codify Trump Administration rules to fix Unaffordable Care Act
- [Pharmacy Benefit Manager] Reform
- Innovation
- Price Transparency
- Site Neutrality
- Provider-owned Hospitals
Notably missing from the list? Extending the subsidies, with an increasing number of Republicans saying an extension is a nonstarter for them.
“The Democrats are the ones who actually put Obamacare in place,” said Rep. Andy Harris, R-Md., the chairman of the conservative House Freedom Caucus.
“It’s not our responsibility to fix Obamacare,” Harris added. “They broke it. They should fix it.”
Of course, with Republicans controlling the House, Senate and the White House, there’s no real way for Democrats to “fix it” without Republican help. And even some of the most conservative voices in the House are suggesting it’d be a mistake to let the subsidies lapse in their entirety without an alternative plan in place.
On Wednesday, Punchbowl reported that Rep. Jim Jordan of Ohio — the founding chairman of the House Freedom Caucus, a longtime critic of Obamacare and a prominent ally of President Donald Trump — told Republicans during their closed-door meeting that they should couple an extension of the ACA subsidies with the health care reforms. Otherwise, he argued, moderates could win on their discharge petition. Thus far, however, Republicans seem more interested in deflecting blame for the rising premiums than actually addressing them. A major part of the blame-casting exercises for both parties will take place on Thursday, when the Senate will vote on two competing health care measures: one led by Democrats, and another spearheaded by Republicans. All signs are that the votes will fall almost exclusively along party lines, with neither measure receiving the 60 votes needed to overcome the Senate’s filibuster. The Democratic plan calls for extending enhanced Obamacare subsidies for three years, but without any of the reforms — such as income caps — that Republicans are demanding. The Republican bill doesn’t extend the subsidies at all, instead replacing the subsidies with direct-to-consumer HSAs, alongside a host of other reforms, including enshrining restrictions on the HSA funds so they can’t be used for abortions. Among the many issues Democrats take with this proposal, the new abortion funding restrictions is a big one. But again, several senators suggested to MS NOW that the failure of these competing bills could be a wake up call, sparking renewed interest in bipartisan talks after such negotiations fizzled out in recent weeks. Sen. John Boozman, R-Ark., told MS NOW the “next step is to regroup and continue to come up with a plan.” Asked how long that could take, Boozman said simply: “Who knows?” Others — even those eager to see talks continue — warn that things will have to change if there’s any hope of an offramp. “I haven’t seen much willingness on the part of Republicans to be negotiating in good faith,” said Sen. Gary Peters, D-Mich. “We’re just going to keep working, talking about the issue and trying to get the Republicans engaged.” Of course, time is of the essence. Both the House and Senate are currently set to leave town at the end of next week for the holidays. And while some lawmakers have said they’d be willing to stay longer if Congress were making progress on a deal, the prospect is unlikely. One of those lawmakers who said they’d stay — Sen. Roger Marshall, R-Kan. — has his own health care plan combining a temporary extension of the enhanced subsidies with a transition to HSA-style accounts. And he was clear that he doesn’t see Congress canceling its Christmas break for a health care negotiation. “I really think we’re making progress on a bipartisan basis pointing towards a January solution,” Marshall said. Jack Fitzpatrick contributed to this report.
Kevin Frey is a congressional reporter for MS NOW.
Mychael Schnell is a reporter for MS NOW. Recommended
