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U.S. House Republicans Reveal Health Care Bill Without 'Premium Support'

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The House GOP revealed their health care bill today.  The Democratic reaction - without even bothering to read it - was negative.  Most of the federal health care news lately has come from the trials and tribulations of the U.S. Senate to extend premium support subsidies for PPACA health insurance plans.  The 111 page House GOP proposal revealed today covers a lot more ground in other areas:

https://thehill.com/homenews/house/5646973-house-gop-health-care-bill-obamacare/

https://docs.house.gov/billsthisweek/20251215/FILE_3948.pdf

House GOP unveils health care bill without ObamaCare subsidies extension
By Emily Brooks and Nathaniel Weixel - December 12, 2025

House Republicans on Friday unveiled a health care bill they will bring to a vote next week that includes items that are broadly popular in the party, like cost sharing reductions and reforms to the pharmacy benefit manager industry, but will exclude extension of expiring enhanced ObamaCare subsidies.

The process will allow for an amendment on extending those subsidies, House Republican leadership aides said. Moderate Republicans were in negotiations with GOP leaders Friday morning to allow an amendment vote on an extension.

“We expect that there will be an amendment that I believe is being worked on. So, the process will allow for that amendment,” a House Republican leadership aide said.

Provisions in the bill, dubbed the “Lower Health Care Premiums for All Americans Act,” include policies that have already cleared key committees, House Republican leadership aides said.

The bill will appropriate funds to pay for “cost-sharing reductions” in ObamaCare, a complicated move that will lower premiums for some people but decrease the overall amount of subsidies and make premiums more expensive for others. Such a provision was stripped from the “One Big Beautiful Bill” over the summer because it violated Senate rules.

Hundreds of thousands of people would be estimated to lose insurance as a result of that provision.

The bill will also include a provision to make it easier for businesses to fund their own insurance plans, and protect themselves from going bankrupt from large, expensive claims.

It will expand association health plans, and will also include provisions to make the PBM industry more transparent.

The bill will not include an expansion of health savings accounts that have been floated in several other Republican health care plans. A GOP leadership aide said that more conversations on health care will continue in the future.

Republicans are fiercely divided on the expiring ObamaCare subsidies. Conservatives argue they are too costly and prop up a system they despise, while moderates say letting the subsidies expire is political suicide. They are set to expire at the end of the year without action, leading to drastically increased premium payments for 22 million Americans.

Because of that division — and opposition to the subsidies from Republican leaders themselves — GOP leaders opted against including a subsidy extension in their health care bill. But after moderates rebelled by trying to force votes on subsidy extension plans through discharge petitions, negotiations started on allowing an amendment vote.

Any such amendment vote would be designed to give moderate Republicans political cover, but would have little chance of becoming law. Democrats are not expected to support such an amendment, and even if it was adopted, it would be a poison pill for the larger GOP health care plan, eroding support from conservatives.

“Their health care package, as I understand it, is likely to be a disaster and actually not enhance the health care of the American people. It will take away from it. So it’s not clear to me that, even if it’s amended … that it will actually solve the problem of addressing the Republican health crisis,” House Minority Leader Hakeem Jeffries (D-N.Y.) told MS NOW on Friday.



   
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The U.S. House of Representatives passed H.R. 6703, the Lower Health Care Premiums for All Americans Act today -  213 to 209 - with one Republican defection:

https://thehill.com/homenews/house/5652831-house-advances-gop-health-care-package-that-doesnt-include-obamacare-subsidy-extension/

House advances GOP health care package that doesn’t include ObamaCare subsidy extension
By Sudiksha Kochi - December 17, 2025

The House advanced a GOP health care bill Wednesday, even as moderate Republicans signed a Democratic discharge petition to extend the Affordable Care Act subsidies in an act of defiance against leadership.

The vote was 213-209. Rep. Jen Kiggans (Va.) was the only Republican to vote no.

The GOP package would not address the expiring ObamaCare subsidies. Rather, 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.

“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.



   
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