House Passes Three-Year ACA Subsidy Extension 230-196 Over Speaker’s Objection

The House voted 230-196 on Thursday to extend the enhanced Affordable Care Act premium subsidies for three years, a rebuke of Speaker Mike Johnson, whose objections the vote bypassed. Seventeen Republicans joined Democrats in supporting it, according to KMPH and ABC News.

The vote was forced by a discharge petition, a procedure that lets a majority of House members bypass the leadership and bring a bill to the floor. Four Republicans signed the Democrats’ petition, ABC News reported: Reps. Brian Fitzpatrick, Rob Bresnahan and Ryan Mackenzie of Pennsylvania and Mike Lawler of New York. The pandemic-era subsidies, which lowered premiums for people buying coverage on the ACA marketplaces, expired late last year, after the fall government shutdown ended without an agreement on extending them, ABC News reported.

The bill is a straightforward three-year extension with no changes. The nonpartisan Congressional Budget Office estimated before the vote that it would add about $80.6 billion to the federal deficit over 10 years while increasing the number of insured Americans by about 100,000 this year, 3 million in 2027, 4 million in 2028 and 1.1 million in 2029, both outlets reported.

House Democratic Leader Hakeem Jeffries said, “The affordability crisis is not a ‘hoax,’ it is very real - despite what Donald Trump has had to say,” according to ABC News, adding that Democrats had made clear before the government shut down that they were “in this affordability fight until we win this affordability fight.”

Republican opponents argued the subsidies are the wrong tool. Johnson urged a no vote, and ABC News reported that his office called the pandemic-era funding rife with fraud and pointed to an investigation in Minnesota. Ways and Means Committee Chairman Jason Smith said, “Only 7% of the population relies on Obamacare marketplace plans,” arguing that Congress should focus on lowering costs for the broader public. President Donald Trump has instead urged sending money directly to Americans for health savings accounts, an approach Democrats reject as insufficient, ABC reported.

Supporters of the extension point to the CBO’s projection that millions more people would be covered with it than without it, while opponents say the credits prop up a program they view as failed, ABC News reported.

The Senate is under no obligation to take up the House bill, and neither outlet described it as poised to advance. A small bipartisan group of senators is instead working on an alternative. Majority Leader John Thune has said any plan needs income limits, a nominal premium payment for beneficiaries and some expansion of health savings accounts, ABC reported. Sen. Jeanne Shaheen, a New Hampshire Democrat, said both sides agree on addressing fraud. Reports that the Senate could amend the House bill, rather than pass it as written, were noted by KMPH.

Thursday’s vote did not by itself restore any subsidies. It sends the Senate a bill that has already cleared the House with bipartisan support, even as the details of a possible compromise remain unsettled.