In 21 days, the enhanced subsidies for the Affordable Care Act’s health care marketplace will expire. This could be an extinction-level event for many Republicans as they head into the midterm elections next year.
But if Republicans are worried, their leadership does not seem to show it. House Speaker Mike Johnson has all but said that the House of Representatives will not hold a vote on the expanded subsidies.
Anywhere between 22 million and 24 million Americans get their health insurance through the subsidies. That’s not a negligible amount, especially in red states. It’s why Marjorie Taylor Greene lambasted Johnson during the shutdown for not coming up with an alternative. On CNN, Rep. Nancy Mace, who is running for governor, ripped Johnson for not having a health care bill.
And on the Senate side, Republicans are engaging in health care failure theater. Republicans will vote on Senate Finance Committee Chairman Mike Crapo and Health, Education, Labor and Pensions Committee Chairman Bill Cassidy’s bill that would give families money to deposit into a health savings account.
This will not win over any Democrats, which they know. It’s simply a measure to pretend they tried and to shore up Sen. Susan Collins in Maine, as she faces a tough re-election. But Collins told reporters she is still negotiating on the bill.
Sen. Lisa Murkowski of Alaska, who caught flak for voting for the One Big, Beautiful Bill earlier this year, also does not seem sold.
“A lot of us still have questions about implementation of some of it, but I think it’s important that the Republicans are hopefully going to be putting a plan out,” she said on Tuesday. “You need one.”
And by Wednesday, she didn’t seem in the mood to talk.
Ironically, as much as progressives might have been disappointed after a handful of moderates defected during the government shutdown, Democrats might have won the messaging war around health care.
“I think there’s no question that the Democratic effort to shine a spotlight on the ACA tax credits has has raised awareness of the issue, and also raised awareness of the fact that the likely expiration is the fault of Republicans in the House and Senate, who have demonstrated time and time again that their North Star is cutting the health care of the American people, and that includes letting the tax credits expire,” Rep. Sarah McBride of Delaware told The Independent.
Another sign that Republicans are not serious about winning over Democratic votes on this bill? It includes restrictions on money going to abortions or gender-affirming care for transgender people.
“Their proposal is chock full of culture war provisions that only demonstrate how unserious it is as a negotiating position or as a good faith proposal,” McBride, the first openly transgender member of Congress, said.
Plenty of Democratic voters lamented that Senate Democrats got a pinky promise from Republicans for a vote on the subsidies, but it ultimately might be a political winner in next year’s midterms.
“The American public knows, and they’ll know even more tomorrow, who’s with them on health care and who’s not,” Sen. Tim Kaine of Virginia told The Independent. Kaine joined seven other Democratic or independent senators to ultimately pass a continuing resolution to reopen the government, mostly to provide relief to federal workers in his home state.
But Kaine said that ultimately it might have benefited Democrats because at the time, they had to deal with the closed government and risk people going hungry if the Supplemental Nutrition Assistance Program did not provide benefits.
“But I do think one challenge with the health care battle during shutdown is you were babbling about health care, but you also had people losing SNAP benefits, air traffic kind of screwed up, people losing paychecks, other things,” Kaine said. “So it was hard to focus on the health care issue with all the background of all the other issues. Now, government’s open, no snap thing. We’re just focused on health care.”
A perfect sign that this could hurt Republicans: a handful of moderate Democrats teamed up with swing district Republicans like Brian Fitzpatrick and Rob Bresnahan, who represent swing districts in Pennsylvania, have co-sponsored legislation to extend the subsidies for two years with income caps.
“I definitely think that we’ve won the shutdown,” Rep. Alexandria Ocasio-Cortez (D-N.Y.) told The Independent. “And I mean, there’s no winning this, right, but I think that we’ve won the discourse with the American people and understanding what we were fighting for and why, and building up the fresher momentum to extend health care subsidies for people.”
Republicans also face other major challenges, such as the increasing unpopularity of Donald Trump, high tariff costs and a backlash from Hispanic and young voters. But they seem uninterested in finding a substantive solution that could win over votes.
As the House was voting, Johnson was visited by a ghost of Christmas past as former speaker Kevin McCarthy, who was ousted after his own internal revolt, waltzed into the speaker’s office.
