Republicans have said for months they had plenty of time to figure out what to do about Obamacare subsidies expiring at year\u2019s end. During a six-week government shutdown that ended last week, they said they\u2019d talk about it after. Now, with five weeks to go before New Year\u2019s, they\u2019re scrambling and divided.<\/p>\n
Moderates and lawmakers in competitive seats are anxiously throwing bills together, worried about the political fallout that could await them if the subsidies expire and premiums skyrocket. Other Republicans simply want to have some bill to offer when the Senate votes next month on a likely Democratic plan to extend the subsidies as is. Republicans rejected that when Democrats offered it during the shutdown, but agreed to hold the vote.<\/p>\n
Republicans in the Senate are latching onto President Donald Trump\u2019s last-minute idea to send the money directly to consumers. But they\u2019re finding it hard to build consensus with such a tight timeframe, and their frustration is showing. POLITICO\u2019s new poll this week found Democrats retain a solid edge on health care affordability going into the 2026 midterms in which both House and Senate control are at stake.<\/p>\n
\u201cI want all the Obamacare subsidies to be gone,\u201d retiring Sen.\u00a0Thom Tillis (R-N.C.) told reporters Thursday. \u201cBut this town is horrible about understanding the cliff nature to some of these decisions. We need to let [the subsidies] ramp down over time.\u201d<\/p>\n
Many Republicans, especially in the House, share Tillis\u2019s view. But many others would prefer to kill the increased subsidies for insurance companies Democrats created in\u00a0a 2021 law<\/u>, or replace them with direct payments. If Congress does nothing, subsidies will return to their original 2010 Obamacare levels.<\/p>\n
Republicans have opposed Obamacare from the start, and some disagree that they will be blamed for major premium spikes. But other GOP lawmakers, especially in the House, are stressing about the political fallout.<\/p>\n
POLITICO\u2019s November poll of 2,098 U.S. adults gave Democrats\u00a0a nine-point edge\u00a0as the party more trusted to bring down health care costs, with 42 percent favoring Democrats, 33 percent the Republicans and the rest trusting neither or having no opinion. The poll, from London-based Public First, had a margin of error of 2 percentage points.<\/p>\n
Democrats, for their part, remain unified behind a straight-up extension of the increased subsidies, which made health insurance plans free for some and also offered subsidies for the first time to people earning more than 400 percent of the poverty level. Democrats shut down the government in October to demand an extension \u2014 their party had set the Dec. 31 expiration date in\u00a0a 2022 law<\/u>\u00a0for budgetary reasons \u2014 but eight in their caucus relented last week on the condition that the Senate vote on the issue.<\/p>\n
\u201cIt’s critical that we come to the table and find a bipartisan path to extend enhanced tax credits,\u201d said Sen.\u00a0Maggie Hassan (D-N.H.), one of the eight.<\/p>\n
But Wednesday\u2019s Senate Finance Committee hearing on affordable health care suggested limited prospects for a bipartisan deal.<\/p>\n
Sen.\u00a0Chuck Grassley\u00a0(R-Iowa) likened the debate to that which accompanied the original Affordable Care Act in 2009. No Republicans voted for it. The committee Democrats spent their time defending Obamacare on the merits, and Republicans did little but attack it.<\/p>\n
Democrats had hoped that President Donald Trump might step in and urge at least a temporary extension of the subsidies. Instead, he\u2019s continued to blast Obamacare \u2014 which he unsuccessfully sought to repeal in his first term.<\/p>\n
\u201cTHE ONLY HEALTHCARE THAT I WILL SUPPORT\u201d is a direct payment to consumers, he wrote on his social media site Truth Social on Tuesday. He blasted the subsidies as a handout to \u201cBIG, FAT, RICH INSURANCE COMPANIES.\u201d<\/p>\n
Republicans in the Senate have taken up Trump\u2019s charge.<\/p>\n
Bill Cassidy\u00a0(R-La.), who\u2019s chair of the health committee and has a seat on Finance, has floated converting funding for the enhanced subsidy into a health savings account Americans can purchase if they opt for a bronze tier Obamacare plan, which can have higher cost-sharing such as a large deductible. An HSA can help cover deductibles, but consumers would still have to pay the premium. The unsubsidized price for the bronze plans varies by state, but runs from a\u00a0few to several hundred dollars a month<\/u>\u00a0for each person in a household.<\/p>\n
\u201cRight now, it\u2019s trench warfare,\u201d lamented Cassidy to colleagues on the Finance panel. He pitched his HSA proposal across the aisle, but it wasn\u2019t well received.<\/p>\n
Senate Majority Leader\u00a0John Thune\u00a0has said he\u2019ll hold the vote on a subsidy extension in the second week of December.<\/p>\n
It remains unclear what the terms of the Democratic bill will be, whether a permanent extension or a temporary one, but Republicans want to have their own plan to offer at the same time.<\/p>\n
Sen.\u00a0Rick Scott (R-Fla.) proposed a bill Thursday that lets the subsidies expire and enables states to get a waiver to offer \u201cTrump Freedom Accounts.\u201d The accounts would resemble HSAs, but could be used to pay premiums. States that opt in could redirect Obamacare subsidies at the original 2010 levels into the accounts.<\/p>\n
Scott\u2019s proposal would also enable insurers to sell plans across state lines, long a GOP goal. Democrats oppose that, arguing it undermines state autonomy in regulating health insurance.<\/p>\n
Some Republican senators told POLITICO that despite the scrambling on their side, they aren\u2019t worried. \u201cObamacare has failed Americans,\u201d said Wyoming Sen.\u00a0John Barrasso, the party\u2019s second-ranking leader.<\/p>\n
He said that Democrats should agree to a policy that \u201csignificantly reforms\u201d the law.<\/p>\n
Cassidy said he expected voters would see that Trump and Republicans had coalesced around a plan and that they\u2019d blame Democrats if it\u2019s not enacted.<\/p>\n
\u201cThe president is there. He wants to do it,\u201d Cassidy said, referring to a health deal. \u201cYou tell me who is at fault if something is not in place? Not Republicans. We have a deal and a plan. We are working hard to make sure something happens.\u201d<\/p>\n
Vulnerable House Republicans don\u2019t sound so confident.<\/p>\n
A quartet of bipartisan representatives introduced legislation Friday to extend the subsidies for two years, but include an income cap and other changes. The bipartisan Problem Solvers Caucus is\u00a0exploring its own legislation<\/u>\u00a0to extend the subsidies and expand flexibility for HSAs. The bill could also include a stalled bipartisan overhaul of rules governing drug middlemen called pharmacy benefit managers. Many lawmakers blame them, in part, for America\u2019s high drug prices.<\/p>\n
A group of\u00a0thirteen vulnerable lawmakers<\/u>\u00a0reached out to House leadership during the shutdown about the importance of an extension.<\/p>\n
But House GOP leaders are cool to one and have backed their Senate counterparts in preferring a new approach to helping Americans pay for health care.<\/p>\n
House Majority Leader\u00a0Steve Scalise\u00a0shared a slide deck during the GOP conference meeting<\/u>\u00a0Tuesday that highlighted statistics showing premiums have increased by 80 percent since the\u00a0Affordable Care Act<\/u>\u2019s 2010 passage.<\/p>\n
Conservatives are especially locked in against an extension. Rep.\u00a0August Pfluger\u00a0(R-Texas) said Tuesday the party should pursue a budget process that makes it possible for Senate legislation to skirt a Democratic filibuster in order to make changes to Obamacare. He said that would be better than trying to work with Democrats who cannot come up with \u201ca plan that is competitive, transparent and actually reduces costs.\u201d<\/p>\n
But any package using that process, known as reconciliation, would be hard to get done before the end of the year. It took months for Republicans to use reconciliation to pass their\u00a0One Big Beautiful Bill Act<\/u>\u00a0in July.<\/p>\n
Some House Republicans say they are open to other ideas for Obamacare subsidies, including Cassidy\u2019s approach. But they worry there\u2019s not enough time for that either.<\/p>\n
Open enrollment has already started for Obamacare plans and consumers are facing an average increase of 114 percent to their out-of-pocket premiums, according to an analysis from the health policy research group KFF.<\/p>\n
Some House Republicans are even taking Democrats\u2019 side. Rep. Jeff Van Drew (R-N.J.) said he preferred Republicans agree to a one-year extension if they can\u2019t come up with something better.<\/p>\n
\u201cWhat we\u2019ve got to do now very rapidly is get beyond several ideas and concepts for a substantive plan,\u201d he said. \u201cYou can\u2019t double or more people\u2019s premiums.\u201d<\/p>\n
Senate Minority Leader\u00a0Chuck Schumer\u00a0proposed a one-year extension<\/u>\u00a0two weeks ago.<\/p>\n
Rep.\u00a0Don Bacon\u00a0(R-Neb.), a moderate who is retiring after this term and backs a bill calling for a two-year extension of the subsidies, predicted Republicans will need 60 votes in the Senate for any legislation and suggested making a deal.<\/p>\n
\u201cWe\u2019ve got to have a better long-term plan. I don\u2019t really want people\u2019s premiums to go up,\u201d Bacon said.<\/p>\n
Jordain Carney contributed to this story.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"
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