Speaker Johnson ekes out healthcare bill victory after House GOP Obamacare rebellion
House Republicans passed a bill they say will lower healthcare costs for a broad swath of Americans by roughly 11%.
It's a victory for Speaker Mike Johnson, R-La., who has been managing deep divisions within the House GOP on the topic of healthcare as insurance premiums are set to spike across the country in a matter of weeks.
One glaring issue that remains unresolved is Obamacare subsidies, which were enhanced during the COVID-19 pandemic but are set to expire at the end of this year.
The legislation passed 216 to 211. Just one Republican, Rep. Thomas Massie, R-Ky., voted against it along with all House Democrats.
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The bill's passage comes hours after a group of moderate Republicans joined a Democrat-led discharge petition to force a vote on extending the subsidies for another three years.
A discharge petition is a mechanism for overriding the will of House leaders to get a chamberwide vote on specific legislation, provided it has support from a majority of lawmakers. It sets up the legislation for a vote sometime in the new year.
Each of the four House Republicans made clear that backing Democrats' bill was not their first choice, but they felt they were left with few options after Johnson made clear this week that there would not be a separate vote on extending the subsidies before the end of this year.
But the majority of House Republicans are against extending the subsidies, at least without significant reforms. Conservatives have argued the subsidies amount to throwing more money at a long-broken system that does little to tackle the actual cost of healthcare.
"Obamacare has been an unmitigated disaster for 15 years, crushing families with high premiums and rampant fraud while enriching insurance companies. It's time for conservatives to get serious about advancing policies that can become law and therefore actually reduce costs," Republican Study Committee Chairman August Pfluger, R-Texas, who called the House bill a "solid first step," told Fox News Digital.
Republicans who are for extending them have also conceded that reforms are needed, but have positioned a short-term extension as the best course of action to buy more time to work on an off-ramp.
The House GOP bill, the Lower Health Care Premiums for All Americans Act, includes provisions to codify association health plans, which allow small businesses and people who are self-employed to band together to purchase healthcare coverage plans, giving them access to greater bargaining power.
Republicans also plan to appropriate funding for cost-sharing reductions beginning in 2027, which are designed to lower out-of-pocket medical costs in the individual healthcare market. House GOP leadership aides said it would bring down the cost of premiums by 12%.
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New transparency requirements for pharmacy benefit managers (PBMs) are also in the legislation, aimed at forcing PBMs to be more upfront about costs to employers.
PBMs are third parties that act as intermediaries between pharmaceutical companies and those responsible for insurance coverage, often responsible for administrative tasks and negotiating drug prices.
PBMs have also been the subject of bipartisan ire in Congress, with both Republicans and Democrats accusing them of being part of a broken system to inflate health costs.
The nonpartisan Congressional Budget Office (CBO) estimated that enacting the bill would reduce the federal deficit by $35.6 billion for a 10-year period through 2035.
If the bill became law, it would also decrease the number of people with health insurance by an average of 100,000 per year between 2027-2035 and lower gross benchmark premium costs by an average 11% through 2035, CBO said.
However, it's not immediately clear whether it will be taken up by the Senate.
Republicans in the upper chamber failed to advance their own healthcare plan last week after also rejecting Democrats' plan to extend the Obamacare subsidies.