House Republicans passed a contentious healthcare bill on Wednesday that has drawn criticism for failing to tackle the impending expiration of Affordable Care Act (ACA) subsidies, which are set to lapse in a matter of weeks.
The Republican-backed legislation aims to empower small businesses to provide their own health plans while enhancing oversight and transparency concerning pharmacy benefit managers. Additionally, it introduces a new type of subsidy focused on cost-sharing reductions designed to lessen out-of-pocket expenses for certain participants in federal market exchanges. Eligibility for these cost-sharing reductions requires an enrollee’s income to be between 100% and 250% of the federal poverty level, with the extent of expense reductions contingent on specific income levels.
Support for the bill included notable backing from U.S. Representative Ryan Zinke of Montana, whose spokesperson, Garrett Brown, highlighted that the proposal is projected to lower healthcare costs by an average of over 12%.
The Congressional Budget Office (CBO), which provides nonpartisan analysis for Congress, has estimated that the bill could save the government approximately $35.6 billion from 2026 to 2035, while simultaneously reducing gross benchmark premiums by 11%. However, this reduction in premiums is expected to come at a cost, with the CBO projecting that around 300,000 individuals may end up dropping their health insurance coverage as a consequence.
The bill narrowly passed the House by a vote of 216-211, with one Republican joining all Democratic members in dissent. Observers anticipate its failure in the Senate.
This legislative development follows the Senate’s recent rejection of two competing healthcare proposals that aimed to address the crucial ACA subsidies before the year’s end. As Congress approaches its session’s conclusion on Friday, the CBO warns that nearly 4 million Americans could lose their health coverage over the next decade as premiums soar due to the expiration of enhanced subsidies.
Earlier on the same day the vote took place, a group of four House Republicans rebelled, aligning with Democrats in a bid to initiate a floor vote concerning ACA subsidies through a discharge petition. With the petition now exceeding the necessary signatures, the House is poised to hold a vote in January on a proposal to extend the ACA subsidies for an additional three years. However, Senate Majority Leader John Thune has indicated that this bill may also face a similar fate in the Senate.
