U.S. House Republicans have finally introduced their own health care plan and have scheduled a vote for this week; however, given Democratic opposition, Congress will likely recess for Christmas after failing to pass any legislation cushioning the blow of rising premiums in 2026.
Most of the provisions in the relatively narrow House bill, which the House Rules Committee will mark up Tuesday, are not inherently controversial.
The Lower Health Care Premiums for All Act includes bipartisan measures like requiring Pharmacy Benefit Manager transparency and expanding Association Health Plans to allow employers across industries to pool insurance plans.
It even provides funding for Cost Sharing Reduction payments, an original provision in the Affordable Care Act. Federal courts had later ruled CSR payments were illegal because the ACA had neglected to properly appropriate funding for the subsidies.
House Democrats, however, will likely tank the proposal because it does not extend the enhanced Obamacare Premium Tax Credit.
Congress temporarily expanded the PTC during the COVID-19 pandemic, and its reversion to original pre-pandemic levels Jan. 31 will partially contribute to rising premiums in 2026.
Though House Speaker Mike Johnson, R-La., is allowing for a separate vote on extending the ACA subsidies as an olive branch to Democrats, it is almost certain to fail as it did in the Senate. Democratic leaders are refusing to support any health care plan if it does not ensure a renewal of the subsidies.
House Minority Leader Hakeem Jeffries, D-N.Y., called House Republicans’ plan “a deeply unserious proposal.”
“After promising legislation for months, this 11th hour measure fails to extend the [enhanced] Affordable Care Act Tax Credits that tens of millions of Americans rely on to afford their healthcare,” Jeffries said on social media. “This so-called plan is the height of irresponsibility…and is not designed to secure bipartisan support.”
But some health organizations, including the Paragon Health Institute, are praising the bill as a step in the right direction.
“This legislation stands in stark contrast to proposals that seek to extend the inflationary ACA subsidies-proposals that would mask rising premiums and exacerbate waste, fraud, and abuse in the exchanges,” Ryan Long, a senior research fellow at Paragon Health Institute, said in an email Monday.
Long added that while more health care reforms are needed, the bill “contains a strong initial set of policies that expand choice, particularly for small employers, enhance competition and transparency, and reduce ACA silver plan premiums by 12 percent while lowering federal spending by roughly $30 billion.”
By contrast, extending the enhanced PTC would cost at least $350 billion over the next ten years, according to the Congressional Budget Office.
Recognizing that neither Democrats’ extension bill – which is devoid of antifraud reforms – or Republicans’ bill – which makes no concessions to Democrats – will succeed, a bipartisan group of lawmakers is pushing for a compromise.
Reps. Jen Kiggans, R-Va., and Josh Gottheimer, D-N.J., are hoping to bring their bill, which includes a two-year extension with targeted reforms, to the floor before ACA open enrollment ends Jan. 15.
