Republicans, playing defense on health care, uncertain of path forward 

Republicans are on the defensive as Democrats have successfully made the shutdown fight about health care.  

Most Republicans said they don't want to see insurance premiums spike, but neither are they willing to openly support the extension of the enhanced Affordable Care Act (ACA) tax credits Democrats are asking for.  

While the GOP has remained united in refusing to even entertain the idea of an extension in the context of ending the shutdown, Republicans don't appear to have an alternate plan for what happens next. 

“We're open to a lot of different things. And the president wants to make health care work for everybody too. Once we reopen, then we'll be open to have good conversations, productive conversations,” Sen. Markwayne Mullin (R-Okla.) said. 

Asked if those conversations will be about extending the tax credits, Mullin demurred.  

“I mean, there's a lot of options there. I'm not saying that's not a possibility, just not one we’ve really discussed,” he said. 

Democrats are feeling increasingly emboldened about their position and have made it clear they do not intend to back off their health care funding demands. If Congress doesn’t act in the next three weeks, Americans across the country will see major increases in their insurance premiums when open enrollment begins in November.  

While Republicans insist that Democrats vote to fund the government before any talks on health care begin, GOP leaders have been forced to engage on an issue that’s long been a political vulnerability for the party. 

“They’re trying to make this about health care. It’s not. It’s about keeping Congress operating so we can get to health care. We always were going to. They’re lying to you,” Speaker Mike Johnson (R-La.) told reporters Thursday. “The health care issues were always going to be something discussed and deliberated and contemplated and debated in October and November.” 

Congress has extended the enhanced subsidies twice, and Democrats insist they need to do so again, citing estimates that premiums for tens of millions of people will more than double next year. 

Rep. Marjorie Taylor Greene (R-Ga.) helped drive home the point this week, warning that Republicans are hurting themselves heading into next year’s midterms if health care costs jump. 

Democrats are keen to exploit cracks in the GOP’s opposition. 

“I never thought I’d say this, but Rep. Marjorie Taylor Greene is right,” Sen. Raphael Warnock (R-Ga.) wrote Tuesday in a social platform X post. “Washington Republicans should work with us to fund health care and end this shutdown now.”

President Trump has further undermined Republican messaging around the shutdown, suggesting this week that he’s open to dealing with Democrats on health care. 

According to health research group KFF, nearly 6 in 10 people who have health coverage through the ACA marketplace live in congressional districts represented by a Republican.  

Additionally, a KFF poll found a majority of Republicans and “Make America Great Again” supporters all favor extending the enhanced tax credits. 

However, many Republicans, despite the potential political pain if they are blamed for a premium spike, can’t seem to stomach bailing out ObamaCare.

House Majority Leader Steve Scalise (R-La.) said Friday “90 percent” of the Republican conference thinks ObamaCare, and by extension the enhanced subsidies, have failed. 

"It's not worked for families. You don't answer that by propping it up with hundreds of billions of dollars of insurance company subsidies,” Scalise said.  

“Why would you keep pouring billions more tax dollars into a sinkhole when you can find a better way? We actually are working on better alternatives right now to lower premiums for families. That's where the focus should be, not propping up a failed product called ObamaCare.” 

Sen. Josh Hawley (R-Mo.) has said he’s “willing to talk about” extending the enhanced subsidies, but he isn't interested in even starting discussions until the government is open. 

"Where there's a will, there's a way. I mean, I think we could chart a path forward on the premium issue,” Hawley said, without specifying how. “But you know that the current government shutdown stalemate is very unhelpful to that, because there's not much of a willingness to talk across party lines right now.” 

Sen. Jim Justice (R-W.Va.) similarly said he wants to do something to help working families that will be hurt if premiums rise, but only once the government reopens.  

He could support a short “runway” to wind down the subsidies but thinks they should end. Republicans are working to fix the broader economy, he said, which will help soften the blow. 

“So, I truly understand that people will hurt, you know, to some degree, but we're trying to reward, reward, reward to make up for the hurt,” Justice said. “We extended tax breaks. We've done lots and lots and lots of stuff here, and we're trying to regen the whole economy.” 

Sen. Jerry Moran (R-Kan.) said he is focused on the appropriations process. Once the government is open, then lawmakers can figure out what to do about the enhanced tax credits. 

But until that happens, it’s not worth a discussion. 

“The priority for me is getting government to function and take care of the people who get the benefits from government generally,” Moran said. “The focus at the moment is getting government to function and complete our appropriations process.” 

Amid the impasse, some lawmakers have floated the idea of having GOP leaders commit to a vote on the enhanced ACA subsidies later in the year in return for Democratic votes to end the shutdown now.  

But the idea was dismissed by Democratic leaders, who want something more concrete and don’t trust Republicans because of their long record of opposition to the ACA.  

“Republicans have zero credibility, zero, on the issue of health care,” House Minority Leader Hakeem Jeffries (D-N.Y.) told reporters Friday in the Capitol. 

“What we’ve said to our Republican colleagues is we have to address the health care crisis that they’ve created decisively,” he added. “That means legislatively. And that means right now.”