House OKs Bill,Extends Health Subsidies01/09 06:06

   In a remarkable rebuke of Republican leadership, the House passed 
legislation Thursday that would extend expired health care subsidies for those 
who get coverage through the Affordable Care Act as 17 renegade GOP lawmakers 
joined every Democrat in support.

   WASHINGTON (AP) -- In a remarkable rebuke of Republican leadership, the 
House passed legislation Thursday that would extend expired health care 
subsidies for those who get coverage through the Affordable Care Act as 17 
renegade GOP lawmakers joined every Democrat in support.

   The tally, 230-196, signified growing political concern over Americans' 
health care costs. Forcing the issue to a vote came about after a handful of 
Republicans signed on to a so-called "discharge petition" to unlock debate, 
bypassing objections from House Speaker Mike Johnson. The bill now goes to the 
Senate, where pressure is building for a bipartisan compromise.

   Together, the rare political coalitions are rushing to resolve the standoff 
over the enhanced tax credits that were put in place during the COVID-19 crisis 
but expired late last year after no agreement was reached during the government 
shutdown.

   "The affordability crisis is not a 'hoax,' it is very real -- despite what 
Donald Trump has had to say," said House Democratic Leader Hakeem Jeffries, 
invoking the president's remarks.

   "Democrats made clear before the government was shut down that we were in 
this affordability fight until we win this affordability fight," he said. 
"Today we have an opportunity to take a meaningful step forward."

   Ahead of voting, the nonpartisan Congressional Budget Office estimated that 
the bill, which would provide a three-year extension of the subsidy, would 
increase the nation's deficit by about $80.6 billion over the decade. At the 
same time, it would increase the number of people with health insurance by 
100,000 this year, 3 million in 2027, 4 million in 2028 and 1.1 million in 
2029, the CBO said.

   Growing support for extending ACA subsidies

   Johnson, R-La., worked for months to prevent this situation. His office 
argued Thursday that the federal health care funding from the COVID-19 era is 
rife with fraud and urged a no vote.

   On the floor, Republicans also argued that the lawmakers should be focused 
on lowering health insurance costs for the broader population, not just those 
enrolled in ACA plans.

   "Only 7% of the population relies on Obamacare marketplace plans. This 
chamber should be about helping 100% of Americans," said Rep. Jason Smith, the 
Republican chairman of the House Ways and Means Committee.

   While the momentum from the vote shows the growing support for the tax 
breaks that have helped some 22 million Americans have access to health 
insurance, the Senate would be under no requirement to take up the House bill 
and has already rejected it once before.

   Instead, a small group of senators from both parties has been working on an 
alternative plan that could find support in both chambers and become law. 
Senate Majority Leader John Thune, R-S.D., said that for any plan to find 
support in his chamber, it will need to have income limits to ensure that the 
financial aid is focused on those who most need the help. He and other 
Republicans also want to ensure that beneficiaries would have to at least pay a 
nominal amount for their coverage.

   Finally, Thune said there would need to be some expansion of health savings 
accounts, which allow people to save money and withdraw it tax-free as long as 
the money is spent on qualified medical expenses.

   GOP Sen. Bernie Moreno of Ohio, a leader in the group of about a dozen 
senators, said they hope to deliver a framework next week. He and others met 
with House colleagues on options.

   Sen. Jeanne Shaheen, D-N.H., who is part of the negotiations, said there is 
agreement on addressing fraud in health care.

   "We recognize that we have millions of people in this country who are going 
to lose -- are losing, have lost -- their health insurance because they can't 
afford the premiums," Shaheen said. "And so we're trying to see if we can't get 
to some agreement that's going to help, and the sooner we can do that, the 
better."

   Trump has pushed Republicans to send money directly to Americans for health 
savings accounts so they can bypass the federal government and handle insurance 
on their own. Democrats largely reject this idea as insufficient for covering 
the high costs of health care.

   Republicans go around their leaders

   The action by Republicans to force a vote has been an affront to Johnson and 
his leadership team, who essentially lost control of what comes to the House 
floor as the Republican lawmakers joined Democrats for the workaround.

   After last year's government shutdown failed to resolve the issue, Johnson 
had discussed allowing more politically vulnerable GOP lawmakers a chance to 
vote on another health care bill that would temporarily extend the subsidies 
while also adding changes.

   But after days of discussions, Johnson and the GOP leadership sided with the 
more conservative wing, which has assailed the subsidies as propping up ACA, 
which they consider a failed government program. He offered a modest proposal 
of health care reforms that was approved, but has stalled.

   It was then that rank-and-file lawmakers took matters into their own hands, 
as many of their constituents faced soaring health insurance premiums beginning 
this month.

   Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan Mackenzie, all 
from Pennsylvania, and Mike Lawler of New York, signed the Democrats' petition, 
pushing it to the magic number of 218 needed to force a House vote. All four 
represent key swing districts whose races will help determine which party takes 
charge of the House next year.

   Jeffries said in a celebratory press conference afterward that Thune should 
bring the Democratic bill to the Senate floor for an immediate vote.

   Trump encourages GOP to take on health care issue

   What started as a long shot effort by Democrats to offer a discharge 
petition has become a political vindication of the Democrats' government 
shutdown strategy as they fought to preserve the health care funds.

   Democrats are making clear that the higher health insurance costs many 
Americans are facing will be a political centerpiece of their efforts to retake 
the majority in the House and Senate in the fall elections.

   Trump, during a lengthy speech this week to House GOP lawmakers, encouraged 
his party to take control of the health care debate -- an issue that has 
stymied Republicans since he tried, and failed, to repeal Obamacare during his 
first term.