WASHINGTON — House Speaker Mike Johnson says he still has “PTSD” from the GOP’s failed effort to repeal and replace the Affordable Care Act during President Donald Trump’s first term.
Now, the party is about to plunge back into the tricky policy debate that once cost them seats in the House.
This time around, though, Republicans are mostly stopping short of calling for a full-scale repeal of President Barack Obama’s signature health care law, even as they slam the policy as a failure. Instead, the mantra among Republicans is “fix Obamacare.”
But the clock is ticking. Open enrollment for health insurance has already begun and enhanced Obamacare subsidies are set to expire at the end of the year, more than doubling insurance premiums for millions of Americans in red and blue states alike, with some seeing increases of thousands of dollars per month.
Republicans, under pressure from Democrats after the government shutdown revived the health care clash, have not coalesced around legislation or even an abstract idea, and are only now starting serious discussions about putting proposals together.
As the party scrambles to craft an alternative, multiple Republicans are vying for Trump’s endorsement of ideas that could alleviate skyrocketing costs that are just around the corner. Two Republican senators have competing plans to create federally funded spending accounts that would help Obamacare enrollees directly, rather than subsidize insurers to keep costs down.
Johnson, R-La., said House Republicans have also been brainstorming proposals behind the scenes and will “be rolling out some of those ideas,” but he declined to put a timeline on it.
“I haven’t prejudged that or put any dates on it, but I mean, we worked on it today. We’ve been working on it every day. We got more members joining the discussion,” Johnson told NBC News on Wednesday evening. “This is how it works. It’s a deliberative process, where you build out the consensus, and we’ll be working on that in earnest in the days ahead.”
Johnson also said he recently traded texts with House Minority Leader Hakeem Jeffries, D-N.Y., about the possibility of working on a bipartisan solution. But Jeffries is pushing for a three-year extension of the expiring ACA tax credits, which Johnson has said is a nonstarter.
If Republicans aren’t able to agree on an alternative solution before the end of this year, they’ll have to decide whether to join with Democrats in extending the ACA tax credits, which risks drawing Trump’s ire, or letting them expire, which risks infuriating voters ahead of next year’s midterm elections.
Republican Rep. Jeff Van Drew of New Jersey, who said he talked to Trump at length last week about the importance of health care, warned, “not only is it morally bankrupt, it’s political suicide” for Republicans to let the subsidies expire without an alternative in place.
Sen. Rick Scott, R-Fla., told NBC News he pitched Trump on his plan, which would put federal money in health savings account-style accounts for individuals to “increase competition and drive down costs.”
A sign advertising Obamacare health insurance enrollment
A sign advertising Obamacare health insurance enrollment is viewed outside of a business, on March 12, 2024, in Orlando, Fla.Phelan M. Ebenhack via AP file
Scott hopes to release the text of the bill as soon as possible, citing a mid-December deadline set by Senate Majority Leader John Thune, R-S.D., to give Democrats a vote on the expiring ACA subsidies.
Scott, who chairs the Senate Republicans’ policy committee, invited health care-focused guest speakers to weekly party lunches over the last six weeks to illustrate why members should oppose extending the ACA subsidies, as Democrats were demanding during the shutdown.
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