Washington — The House approved on Thursday a three-year extension of health care tax credits that expired at the end of last year, with a group of Republicans joining Democrats to propel the measure to passage in the lower chamber.
In a 230 to 196 vote, 17 Republicans joined all Democrats in favor of the measure. The legislation is unlikely to pass the Senate in its current form, but some lawmakers are hopeful it will serve as the starting point for a broader compromise.
“Today, let’s celebrate a victory of getting something done,” Democratic Rep. Tom Suozzi of New York told reporters Thursday. “And then, we’ll start working on the policy issue next week related to what’s the common ground in the Senate that we can get to the next step.”
The outcome came after four Republicans crossed the aisle last month, revolting against their leadership to join Democrats in forcing a vote on the issue. The Affordable Care Act tax credits subsidized premiums for millions of Americans who have coverage in state-run exchanges. One analysis found that premiums were set to double without the enhanced credits.
The tax credits’ extension was at the center of the government shutdown, which stretched through October and into November to become the longest in history. After a handful of Senate Democrats broke with their party to end the shutdown without securing an extension for the enhanced tax credits, House Democrats pushed ahead on an effort of their own — but needed GOP support to make it successful.
House Minority Leader Hakeem Jeffries, a New York Democrat, led the effort to force the vote with a discharge petition in the final weeks of the year. Moderate Republicans have generally criticized a straight extension of the tax credits without reforms. But a handful of GOP members signed onto the petition, arguing that an extension of the tax credits without reforms was preferable to letting them expire.
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Rep. Mike Lawler of New York was one of the four Republicans who signed onto the petition last month, along with Reps. Brian Fitzpatrick, Ryan Mackenzie and Rob Bresnahan of Pennsylvania.
“We endeavored in a bipartisan negotiation after the shutdown to come up with a compromise bill that would extend the subsidies, but put in place necessary reforms,” Lawler told reporters Tuesday. “Unfortunately, we couldn’t get a vote on that before Christmas, and so the only alternative was to sign the three-year discharge.”
The moderate Republicans are banking on the measure being a vehicle for a compromise bill in the Senate.
“I’m hopeful that when we pass the discharge through the House, the Senate will be able to use that vehicle and garner enough support to get a bipartisan compromise across the finish line,” Lawler said.
The search for a Senate compromise
A number of moderate Democrats and Republicans in both chambers have been seeking a solution on health care costs. And the discharge petition added momentum to a bipartisan effort to reach a health care compromise before lawmakers broke for recess in December. Now, lawmakers are looking to the Senate to move ahead with a long-sought agreement to extend the credits, with some reforms.
The Senate rejected a Democrat-led effort to pass a three-year extension of the enhanced tax credits last month. Republicans offered an alternative plan to send funds directly to consumers through health savings accounts that also fell short. But a number of Senate Republicans expressed willingness to reach a compromise.
GOP Sen. Susan Collins of Maine, who’s been involved in the discussions, told reporters on Tuesday that “we’re continuing to work hard” on a compromise measure. She said parts of the measure would be similar to what she and Sen. Bernie Moreno, an Ohio Republican, originally proposed last month. That plan would extend the tax credits for two years, with some reforms in the first year and then “more substantial reforms” in the second.
Moreno outlined the emerging deal Thursday, telling reporters that it would include a two-year extension of the enhanced tax credits and an extension of the open enrollment period until March 1. It would also impose a new income eligibility cap for the subsidies at 700% of the federal poverty level; a $5 per month or $60 per year minimum premium; and a $100,000 fine of insurance companies “for deliberately causing fraud” by signing someone up without their consent. In the second year, the plan would give individuals an option to choose a lower-tier plan and receive the funds in a health savings account.
Leaving a bicameral meeting of the so-called “problem solvers” on Thursday, multiple lawmakers said they expected language from the compromise bill to be released next week.
Asked after Thursday’s vote whether he would back such a deal, Jeffries told reporters that House Democrats are “focused on a straightforward extension of the Affordable Care Act tax credits at the moment.”
“But we’ve always said that we will consider in good faith anything that emerges from the Senate in a bipartisan way, if it decisively deals with the Republican health care crisis, including by providing a meaningful extension of the Affordable Care Act tax credits,” Jeffries said.
Senate Majority Leader John Thune, asked about the timeline for addressing the tax credits in the upper chamber, told reporters Wednesday that the conversations among the bipartisan group of lawmakers have been productive and “we’ll see where the discussions are going.”
“There’s some thorny issues they have to resolve,” the South Dakota Republican said. “You got to deal with reforms, you got to deal with a bridge to an HSA, and then obviously, Hyde is a big, big challenge.”
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President Trump encouraged Republicans in Congress to be “flexible” on the Hyde amendment, which restricts federal funding for abortions, in order to find a solution on health care costs. But conservatives in Congress haven’t expressed willingness to move on the issue, seeking additional Hyde amendment language within the health care bill to ensure it applies to coverage in state-run exchanges.
“There’s no flexibility. You’re either using public funds to pay for abortion or you’re not. We’re not sure there’s a compromise available on that,” Republican Rep. Andy Harris of Maryland, who leads the House Freedom Caucus, told reporters Wednesday.
Thune said while Collins and Moreno are trying to address the challenging issues, there isn’t “a landing spot just yet.”
“The conversations are constructive,” he added. “But at this point, there’s nothing that I’m aware of that we’ll be voting on soon.”
