House advanced a GOP health-care bill Wednesday, even as moderate Republicans signed a Democratic discharge petition to extend ACA subsidies, a direct challenge to House leadership.
The chamber voted 213-209 on the rule that teed up debate and a final vote on the measure. Rep. Jen Kiggans (Va.) was the only Republican to vote no on the rule; she went on to support the bill on the final vote.
The GOP package would not address the expiring ObamaCare subsidies. Instead, it would appropriate funds to pay for cost-sharing reductions in ObamaCare, a complicated move that would lower premiums for some people but decrease the overall number of subsidies and make premiums more expensive for others.
Moderate Republicans had been sounding the alarm for weeks that failing to extend the subsidies would drive up American health-care premiums and cost the party its majority in the 2026 midterms. The subsidies will expire at the end of this month, and lawmakers will be leaving for a winter recess later this week.
They were furious Tuesday when Speaker Mike Johnson (R-La.) said the House wouldn’t vote on an amendment to extend the subsidies.
Wednesday’s vote came shortly after four GOP centrists – Reps. Brian Fitzpatrick (Pa.), Mike Lawler (R-N.Y.), Rob Bresnahan (Pa.) and Ryan Mackenzie (Pa.) – signed on to a discharge petition from House Minority Leader Hakeem Jeffries (D-N.Y.) to extend the subsidies for three years, in a major act of defiance against House leadership. Their votes were enough to push the petition to the 218-signature threshold to force a vote.
But the moderate Republicans still allowed the rule that tees up votes on the GOP health-care bill and other measures to be adopted. Several had said Tuesday they backed the provisions in the legislation, even if they were frustrated by the lack of action on the subsidies.
Negotiations between moderates and GOP leadership to try to get an amendment vote to extend the subsidies fell apart after leadership insisted any extension would need to be paired with spending cuts.
Johnson told reporters Tuesday that there would not be an amendment vote, noting many Republicans in competitive districts “did want to vote on this ObamaCare COVID-era subsidy the Democrats created.” “We looked for a way to try to allow for that pressure release valve, and it just was not to be,” Johnson said.
Even so, moderates introduced amendments at the House Rules Committee in an eleventh-hour push. Republicans on the panel ended up ruling them all out of order.
“I think the only thing worse than a clean extension without any income limits and any reforms – because it’s not a perfect system – the only thing worse than that will be expiration,” Fitzpatrick, who introduced an amendment at the hearing, said.
Fitzpatrick had been leading a separate discharge petition effort to force floor action on a bipartisan bill he and Rep. Jared Golden (D-Maine) introduced to extend the subsidies for two years while implementing certain eligibility reforms. Rep. Josh Gottheimer (D-N.J.) had led another discharge petition effort to force action on a separate bill he Kiggans introduced to extend the subsidies for one year with modest eligibility reforms. But neither petition had gotten significant Democratic backing. Jeffries had been urging Republicans to endorse his petition, instead, and the quartet of moderates did so Wednesday.
Key Takeaways
- The House adopted a GOP health-care bill while moderate Republicans defied leadership by signing a discharge petition to extend ACA subsidies.
- The GOP package does not extend subsidies; it funds cost-sharing reductions that could raise premiums for some.
- Negotiations to add an amendment fell apart after leadership tied any extension to spending cuts.
“Mike Johnson should bring the bill to the floor immediately,” Jeffries wrote in a post on the social platform X after his petition reached the 218-signature mark. The clash over subsidies and the GOP health-care bill underscores a deep divide within the House, with moderates pushing for continuity of coverage while leadership pushes a different agenda.
