by Kristin Rowan, Editor

Since the temporary appropriations passed to reopen the government last month, the House and the Senate have been playing chicken with the health care plan for 2026. The lack of consensus threatens both Affordable Care Act (ACA) subsidies to keep health insurance rates down and the extension of the additional subsidies needed to keep the government open after January 30.

Today, four GOP members broke rank and sided with their Democrat counterparts on a discharge petition that would force a vote on the House floor on extending the subsidies. The House quickly called for an expedited vote on the Democratic-backed bill to extend the subsidies for three years without any changes.

In an uncommon move that Democrats decried as “outrageous,” House Leader Johnson closed the vote while some House members were still trying to vote. The vote against the bill passed 204-203. There are 435 voting members of the House. The subsequent vote for the Republican-backed plan passed 213-209. With 15 missing votes, the discharge petition vote may have passed.

House Speaker Johnson said it is “inevitable” that the discharge petition will come up for a vote when the House reconvenes in January.

Both Republicans and Democrats want votes on their own House bills. 

The Democratic-backed bill from Leader Hakeem Jeffries is a straight forward extension to the existing ACA subsidies with no policy changes.

The Republican-backed bill does not extend the subsidies or address them at all. Instead, it appropriates funds to pay for cost-sharing reductions that would decrease overall subsidies, lower premiums for some, and raise premiums for others.

Some moderates disagree with their own party’s leadership. Fitzpatrick (R-Pa) and Golden (D-Maine) introduced their own bill that extends the subsidies for two years and includes some eligibility changes. In addition, Gottenheimer (D- NJ) introduced a separte bill with Kiggans (R-VA) that extends the subsidies for one year and includes modest eligibility reforms. Neither petition has near enough support to force a vote.

Despite the moderates’s support of Jeffries’s bill, the House voted today on the Republican-backed bill from Miller-Meeks (R-IA). This bill also includes reform of Pharmacy Benefit Managers and provide more control for small business owners through Association Health Plans.

The vote for Lower Health Care Premiums for All Act was 213-209 (some reports say 216-211) and the bill will advance to the Senate. It is unlikely the Senate will vote on the bill before the end-of-year recess, leaving the bill undecided until the Senate returns on January 5th.

Both the House and the Senate will start their end-of-year recess this week. The House of Representatives is scheduled to close their session on December 18th. The Senate will conclude on December 19th. They will return to session on January 6th and January 5th, respectively.

With only two days left on the Senate calendar, they are unlikely to vote on the House bill this session. Most experts predict the bill is unlikely to pass regardless of when the vote is scheduled.

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Kristin Rowan has been working at The Rowan Report since 2008. She is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news, and speaker on Artificial Intelligence and Lone Worker Safety and state and national conferences.

She also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing.  Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

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