House Republican leaders on Wednesday withstood a standoff with renegade members over expiring Affordable Care Act subsidies and passed a GOP health care bill with conservative priorities that wouldn't renew the aid.
Why it matters: The 216-211 vote all but assures that out-of-pocket premiums will more than double on average for roughly 20 million ACA enrollees when the enhanced subsidies expire Jan. 1.
Driving the news: The House bill contains an assortment of GOP-backed measures that Republicans argue will help lower health care costs for a wider swath of Americans than those in the ACA exchanges.
- It would expand association health plans, which allow small businesses to band together and purchase coverage, impose new transparency requirements on pharmacy benefit managers aimed at lowering drug costs, and fund ACA payments known as cost-sharing reductions.
- The Senate, which gridlocked on an ACA subsidy extension and competing GOP plan, isn't expected to take up the House package. But some of the ideas could resurface in late January, when Congress faces another deadline to keep the government funded.
The intrigue: A group of House GOP moderates on Tuesday night pushed hard to include an amendment extending the ACA subsidies for at least a year but were rebuffed by House leaders over concerns about the cost.
- Four GOP moderates on Wednesday morning then signed onto to a Democratic discharge petition, providing enough votes to bring up a clean three-year extension.
- That vote may not happen until the new year, despite Democratic calls for immediate action.
By the numbers: The GOP bill would increase the uninsured population by 100,000 and save the government $35.6 billion over 10 years, according to the Congressional Budget Office.
- The driver is the cost sharing reduction payments to health insurers, which will have the effect of lowering the benchmark ACA insurance premium 11% but also cut the subsidies that some ACA enrollees receive.
- The lower subsidy amounts will cause some enrollees to go without coverage, CBO projects.
What they're saying: GOP leaders have argued that extending the enhanced ACA subsidies would be wasteful spending that benefits insurance companies.
- Speaker Mike Johnson said a subsidy extension "only hides the true cost of the failed law."
- But moderates facing re-election next year are worried about the political fallout from spiking premiums at a time when affordability is on many consumers' minds.
The big picture: The renegade GOP members nonetheless voted for the GOP health bill, saying they didn't object to what's in it.
- Moderate GOP Rep. Kevin Kiley (Calif.) said the bill is "fine" though it is "pretty narrow" and "hastily thrown together."
- "It doesn't actually address the issue that's right in front of us which is that these tax credits are going to go away," he added.
Go deeper: How Democrats orchestrated a GOP revolt against Mike Johnson
