As the House of Representatives prepares to vote on the U.S. Senate's bill to reopen the federal government — which does not include an extension of Affordable Care Act (ACA, or Obamacare) tax credits expiring at the end of 2025 — all eyes are on House Speaker Mike Johnson (R-La.).
One former Republican staffer is now predicting the speaker may about to face significant pressure from within the House Republican Conference. In a Tuesday interview interview with The Bulwark's Jonathan Cohn, Brendan Buck, who was a staffer to former House Speakers John Boehner (R-Ohio) and Paul Ryan (R-Wis.), said that while Johnson has refused to commit to holding a vote on extending the tax credits, that could change if he gets an earful from House Republicans.
According to Buck, there's a possibility that Senate Republicans representing states where health insurance premiums are expected to increase by as much as 387 percent may end up voting for an short-term extension. And because Senate Majority Leader John Thune (R-S.D.) agreed to hold a separate vote on extending the ACA tax credits as part of the shutdown deal negotiated with Senate Democrats, Buck didn't rule out the chances of Johnson being faced with the conundrum of keeping Obamacare subsidies in place or being responsible for significant increases in the cost of health insurance starting in 2026.
"The world looks very different if the Senate does pass something with 60 votes, and it’s now in [Johnson's] lap, and he has a lot of his own members who don’t want to allow this to happen either," Buck said.
Currently, House Minority Leader Hakeem Jeffries (D-N.Y.) is pushing for a three-year extension of the Obamacare tax credits. President Donald Trump has floated the idea of sending Americans a one-time payment of $2,000 to put in a health savings account, though experts have said such a proposal would be both ineffective at lowering healthcare costs and nearly impossible to implement. Cohn wrote that a compromise solution could come about in several ways.
First, Republicans could simply agree to a short-term extension of the ACA tax credits. The one-year extension Senate Minority Leader Chuck Schumer (D-N.Y.) proposed would cost roughly $30 billion, which the Committee for a Responsible Federal Budget has said could be funded by making small reforms to Medicare that have bipartisan support.
Cohn also suggested Republicans could be in favor of limiting who would be eligible for the renewed tax credits, and reminded readers that Sen. Jeanne Shaheen (R-N.H.) is "open to an extension that cuts off assistance at six times the poverty line rather than four." And he noted there was some interest among Republicans in imposing additional conservative reforms, like breaking up insurance pools so that healthier people pay less into the system while older, sicker people pay more.
"The question is whether you can thread a very thin needle by avoiding big out-of-pocket premium increases for over 20 million people and undermining the ACA, while appealing to some Republicans who have never liked the ACA from the start," Kaiser Family Foundation executive vice president Larry Levitt said.
Click here to read Cohn's full article in The Bulwark.