The U.S. House of Representatives and Senate adjourned Thursday into the new year without a plan to keep Affordable Care Act subsidies alive, setting the stage for a sharp political showdown that could raise premiums for roughly 22 million Americans.
No Solution on the Horizon
When the chambers closed, no resolution had emerged to extend the enhanced subsidies that keep insurance costs affordable for many. The lack of a plan means that premiums will climb next month for about 22 million people. House Speaker Mike Johnson, R-La., and Senate Majority Leader John Thune, R-S.D., both opposed to extending the money, have kept the debate at a stalemate.
Republicans and Democrats Rally for a Three-Year Extension
Despite the deadlock, some lawmakers from both parties are still looking for a path forward. Four swing-district Republicans-Brian Fitzpatrick, Rob Bresnahan, Ryan Mackenzie of Pennsylvania, and Mike Lawler of New York-joined 214 Democratic signatories on a discharge petition to force a vote on a three-year extension of ACA funds. The vote is slated for the week of Jan. 5 when the House reconvenes.
Lawler told NBC’s “Meet The Press Now” that he believes the bill will pass if it reaches the floor and that it could give the Senate a chance to craft a bipartisan compromise that actually becomes law. “I do believe if the bill comes to the floor, not only will it pass, but it’ll give the Senate the ability to come back with a bipartisan compromise and actually get something passed into law,” he said Wednesday.
Democratic Alarm and Political Stakes
Rep. Pat Ryan, D-N.Y., voiced frustration at the status quo. “They are absolutely screwing over millions of people, including my constituents, which pisses me off,” Ryan said. She added, “It’s just pathetic. The last time there was a major national Republican effort to repeal the ACA, we had an overwhelming wave where they got absolutely wiped out, and I think that’s likely what will happen here again.”
Ryan’s comments reflect a broader Democratic strategy: to use the looming subsidy expiration as a political weapon in the upcoming midterm elections. Democrats warn that a failure to act will inflict maximum pain on Republicans in next year’s contests.
Senate’s Mixed Signals and the 51-48 Vote
Senate action has mirrored the House’s impasse. The Senate voted down the three-year ACA funding extension last Thursday by 51-48, with four Republicans joining Democrats-far short of the 60 votes needed to break a filibuster. The Senate’s failure to pass the extension underscores the difficulty of securing bipartisan support.
Retiring Sen. Thom Tillis, R-N.C., who had early advocated for an extension, told NBC News that the House bill is “dead on arrival” across the Capitol. “There’s no way it’s going to sail through,” he said. “I would expect the vote count if it were just purely this wouldn’t be probably the same as it was last week.”
Sen. Susan Collins, R-Maine, declined to endorse the House bill even if it passed. “What we’re trying to do is to put together a bipartisan bill that would have reforms plus a two-year extension,” Collins told NBC News. “That is the best approach, in my opinion, and we’re making good progress. I think we need a bill that also has some reforms, such as an income cap, to just give you an example.”
Sen. Lisa Murkowski, R-Alaska, echoed Collins’s cautious optimism. “It’s too late to avoid the shock factor, but it’s not too late to do something about it,” Murkowski said. “And so I refuse to be in the camp that says, well, you just have to give it up then.”
Republicans Push for a Quick Exit
Sen. Jim Justice, R-W.Va., warned that the ACA funds’ expiration would hit his constituents hard if no off-ramp is provided. “We’ve got to give people an exit ramp. My proposal was: do 90% now, 60% in a year, 30% in the year, and then it wouldn’t be too easy, too difficult to step away from it,” Justice said.
Sen. Mike Rounds, R-S.D., highlighted a stumbling block in potential bipartisan deals: the Hyde language that restricts federal abortion funding. “There’s people working on it,” Rounds said, adding that he’s not sure if they’ll find a way to resolve the issue.
Sen. John Thune demurred on the Senate’s next steps. “We’ll cross that bridge when we come to it,” he said.
The Cost of Delay
Senate Minority Leader Chuck Schumer, D-N.Y., warned that once Jan. 1 arrives and higher premiums kick in, it will be “very hard to put that toothpaste back in the tube.” Democrats also signaled that they will not tie ACA funding to the Jan. 30 deadline that was used to force a government shutdown last fall.
Sen. Jeanne Shaheen, D-N.H., who had voted to reopen the government, said she did not see the Senate tying ACA funding to that deadline. “I don’t see that,” she said. “That’s just me.”
Sen. Josh Hawley, R-Mo., one of four GOP senators who voted to advance an ACA funding extension, urged Republicans to move past their long-standing opposition to Obamacare. “People want us to do something to help them with the costs,” he said. “And I don’t think they really care about who voted for what 20 years ago. They care about their health care costs going up.”
Key Takeaways
- The House and Senate adjourned without a plan to extend ACA subsidies, setting premiums up for a rise next month.
- A discharge petition led by swing-district Republicans and Democrats seeks a vote on a three-year ACA funding extension in early January.
- The Senate’s 51-48 rejection of the extension highlights the challenge of bipartisan cooperation.
The debate over ACA subsidies has moved beyond policy into the realm of electoral strategy, with both parties weighing the political costs of inaction. As the new year unfolds, lawmakers will face a critical decision that could shape the health care landscape for millions of Americans.
Closing
With the House scheduled to reconvene next week, the political clock is ticking. Whether a compromise can be reached before premiums rise remains uncertain, but the stakes-both for voters and for the future of the Affordable Care Act-are clear.
