Congress
Republicans again find themselves in an Obamacare pickle
The ongoing debate over soon-to-expire Affordable Care Act insurance subsidies has reopened an old wound for Republicans: What should they do about the health care law they have railed against for more than a decade but has now taken root with their own constituents?
While some GOP hard-liners are again embracing repeal-and-replace rhetoric, the scars from the party’s failed attempt to undo the ACA in 2017 have left a broader swath of Republicans extremely wary of trying to rip out the law — even as they continue to criticize it.
Instead, as Democrats put the ACA at the center of the ongoing government shutdown fight, Republican leaders and key senators are acknowledging the political reality that Obamacare, at least for the immediate future, is here to stay. Republicans are, instead, eyeing a bipartisan end-of-year health care push that could pair a conservative overhaul of the expiring subsidies with modest proposals that would tweak — but not fully uproot — the 2010 law.
Speaker Mike Johnson is downplaying prospects for nixing the ACA ahead of the midterms, saying this week he still has “PTSD” from the GOP’s 2017 repeal-and-replace debacle.
Senate Majority Leader John Thune made clear in an interview his members are making plans for a bigger health policy push, including “reforms” to the subsidies, in the next government funding package and potentially elsewhere before the end of the year.
“There’s some very interesting potential health care discussions and even solutions out there, and obviously reforms that need to be made to the Obamacare enhanced subsidies,” Thune said, adding that a bipartisan agreement could move as part of a “broader package” or “independently” after the shutdown ends.
The expiring tax credits, expanded by Democrats in 2021, are driving the desire to act on health care this year — millions could go uninsured come the new year without legislative action, according to the Congressional Budget Office. At the same time, Republicans have been discussing a menu of other options in the health care policy arena, both among themselves and with White House officials.
Ideas include overhauling the operation of drug intermediaries, known as pharmacy benefit managers; granting Americans additional options around Health Savings Accounts; and allowing more flexible employer-provided health insurance plans.
“Our members have been working on plans to reduce premiums for families for months now,“ House Majority Leader Steve Scalise said in an interview, mentioning HSAs and “things that are focused on reducing premiums.” But, he added, Republicans haven’t yet worked out how to bring those proposals to the floor.
Another big question is how much buy-in from Democrats those proposals might have. Republicans appear unlikely at this point to pursue a party-line reconciliation bill that would include health care policies — at one point a possibility following the success of the tax and spending megabill passed over the summer — which means some bipartisan support will be necessary to get any legislation passed in the Senate.
Senate Finance Committee Chair Mike Crapo said in a brief interview that Senate Republicans have been discussing a year-end health care package, including on HSA flexibility, and “my hope is to have it be bipartisan.”
Asked about the possibility of linking that to a potential extension of the ACA tax credits, he said, “If we have a vehicle that’s moving, I see no reason not to add it.”
But Democrats are already seizing on the repeal talk in some corners of the GOP, with Sen. Patty Murray of Washington comparing it to the cataclysmic sinking of the Titanic.
“It is bad enough so many of them can see the iceberg coming and are saying, ‘Ah, we’ll worry about that after the ship goes down.’ But we’ve also got Republicans saying that you wish this ship had sunk earlier,” Murray, the Senate’s top Democratic appropriator, told reporters. She was referring to the GOP’s refusal to extend the Obamacare subsidies before Nov. 1, at which point notices will go out alerting enrollees to massive premium hikes.
One favorite GOP proposal, known as a “CHOICE arrangement,” would allow employers to reimburse employees on a tax-free basis for health insurance premiums or medical expenses. It was one of several health policies that passed the House as part of the GOP megabill but didn’t get enacted in the final product.
House Republicans have indicated that there is appetite to revisit dropped policies such as this one, but a senior House Republican aide who works in health policy, granted anonymity to speak candidly, said it wouldn’t be enough to satisfy hard-liners.
“I don’t see an extension of the Obamacare subsidies happening without a bunch of reforms alongside conservative health care policy wins, and CHOICE arrangements alone is not enough,” the aide said. “That’s not getting members to vote for Obamacare.”
Nothing under serious discussion has so far come close to what some GOP lawmakers are most eager to discuss as the year-end deadline for the tax credits barrels closer: a complete reversal of the ACA. And while appetite within the GOP leadership for gutting the ACA is minimal at this point, vocal opponents of the law could have an influence in a narrowly-divided House Republican majority.
Rep. Rick Allen (R-Ga.) spoke up on a private House Republican call earlier this month in support of redoubling efforts to repeal Obamacare. And Rep. Eric Burlison (R-Mo.), a member of the House Freedom Caucus, said during a teletown hall this week that Democrats’ calls for bipartisan negotiations around the fate of the subsidies are falling flat.
“Well, I’ve got a compromise for them: How about we repeal all of Obamacare?” he said, floating the prospect of a second reconciliation bill.
Conservative opponents of the tax credits say they are too costly and rife with waste, fraud and abuse.
Other Republicans are trying to urge their colleagues away from igniting a politically explosive debate just over a year out from the midterms, recalling the 2018 Democratic wave election that was attributable to backlash from the GOP repeal-and-replace efforts.
Even Sen. Rick Scott (R-Fla.), a longtime critic of the Democratic health law, stopped short when asked if he backed the call from some of his colleagues to nix Obamacare entirely.
“I just think we ought to focus on fixing it,” he said in a brief interview.
Johnson also warned this week that the ACA’s “roots are so deep” that many Republicans are wary of trying to “completely repeal and replace” it. The law now provides coverage for more than 20 million Americans and touches a significant segment of the economy.
“It was really sinister the way, in my view, the way it was created,” he said of the 2010 law. “I believe Obamacare was created to implode upon itself, to collapse upon itself.”
Republicans are now also mired in internal discussions about whether to extend the ACA credits, and what changes they could make to the subsidies to appeal to a broader set of conservatives. They have floated ideas such as instituting new income caps, minimum co-pays, a cutoff for new enrollees and abortion restrictions.
Republicans insist those talks won’t get underway until after the shutdown ends, though some of them also warn negotiations will totally unravel if too many ambitious GOP policy proposals get added to the mix.
Sen. Markwayne Mullin, an Oklahoma Republican who’s been tapped by the White House to work with Democrats on a shutdown offramp, said in an interview this week said the current imperative for government funding negotiations is to “keep it simple” with “some just very easy changes that both sides can agree to and then get in the weeds at a later date.”
“I’m afraid once we dive into health care,” Mullin added. “It’s going to take a while to unpack that.”
Speaker Mike Johnson said Monday he plans to deploy an unusual procedural maneuver in a bid to unfreeze the House floor this week, seeking to send the annual Pentagon policy bill and the GOP elections bill known as the SAVE America Act to the Senate in a single package.
That is likely a recipe for a continued standoff between the two chambers over the SAVE America Act, which has stalled in the Senate for months due to internal GOP divides. Under Johnson’s plan, the annual defense policy bill, which typically passes every year with large bipartisan majorities, could become a collateral victim of the impasse.
Asked in brief interview if he had talked to Senate Majority Leader John Thune about his plans, Johnson replied, “I have to do my job in the House, and they’ve got to do their job in the Senate, so we’ll see what happens.”
Johnson is seeking to placate House conservative hard-liners, led by Florida Rep. Anna Paulina Luna, who have threatened to oppose the procedural measures that give Republicans control of the floor unless they agree to tougher tactics meant to force the Senate into passing the elections bill.
House GOP leaders discussed the plan to merge the two bills over the weekend as Luna pushed to amend the defense bill directly.
She did not say in an interview Monday whether Johnson’s gambit would suffice: “We want it baked together, not able to be stripped out,” she said.
But the Senate is free to work its own will, and members of that chamber are likely to reject any defense bill that has the partisan elections bill attached. That would set the stage for GOP leaders to strip it out when the House and Senate hash out the differences between their competing Pentagon bills later this year.
Johnson, meanwhile, is pushing a separate plan to pass a slimmed-down version of the SAVE America Act through the party-line budget reconciliation process — an option hard-liners have all but rejected.
“I don’t think that that can be done,” Luna told reporters Monday.
He’s also facing another complication: The version of the SAVE America Act he is proposing to attach to the Pentagon bill doesn’t include the latest demands for the bill from President Donald Trump — including a near-total ban on mail voting that is opposed by many Republicans.
Jennifer Scholtes contributed to this report.
Lawmakers of both parties questioned Secretary of State Marco Rubio and top Middle East envoy Steve Witkoff Monday in the first broad congressional briefings on President Donald Trump’s Iran deal.
While Democrats asked some of the sharpest questions, participants in an afternoon conference call with House members said, Rep. Darrell Issa (R-Calif.) at one point pressed the administration officials on the fate of Iran’s stockpile of near-bomb-grade uranium.
According to two people granted anonymity to disclose the private remarks, Witkoff and Rubio repeated assurances the administration has privately made to select lawmakers in prior briefings — that the goal is to negotiate a final deal that would prohibit Iran from keeping its highly enriched uranium.
The memorandum of understanding Trump signed earlier this month, they said, was meant to launch those negotiations. Witkoff, the people said, added that the technical team involved in that part of the talks was traveling from Switzerland to Qatar, where talks between the U.S. and Iran are set to happen Tuesday.
Democrats, meanwhile, pushed the administration for more details on what financial benefits Iran could reap under the memorandum — including proceeds from previously sanctioned oil sales.
Rep. Debbie Wasserman Schultz (D-Fla.) went back and forth with Rubio and Witkoff over the lifting of the oil sanctions, two other people granted anonymity on the House call said. The officials eventually cut off the conversation and ended the call.
At another point, Rep. Madeleine Dean (D-Pa.) raised concerns about Witkoff’s business interests in the Middle East as he’s negotiating with Iran, prompting a sharp defense from Rubio, those people said.
Senate Minority Leader Chuck Schumer asked Rubio and Witkoff about the oil sanctions during a separate all-senators call Monday, saying in a statement afterward that they “confirmed to me that Iran will reap billions in oil revenue while retaining dangerous leverage over the Strait of Hormuz.”
“If this is the administration’s defense behind closed doors, Secretary Rubio should make it under oath, in public, before the Foreign Relations Committee,” Schumer added, calling the briefing “delayed, deficient, and devoid of details.”
An administration official granted anonymity to speak candidly countered on Schumer’s characterization, noting that he had previously gotten a briefing of the deal as part of a group of top leaders engaged on national security matters. Schumer, the official said, had the opportunity to ask multiple follow-up questions on the Senate call.
A separate group of White House officials briefed top congressional leaders and key committee chairs in a classified briefing in the Capitol later Monday.
The administration has faced bipartisan skepticism over multiple provisions of the memorandum of understanding — particularly the lifting of oil sanctions and a $300 billion reconstruction fund that many Senate Republicans fear will help fuel Iran’s military and regional proxies.
Rubio and Witkoff sought to ease concerns about the slow reopening of the Strait of Hormuz — the critical trade route whose closure has sparked higher fuel and fertilizer costs. Both officials said more mine removal is required, and Witkoff indicated that Iran broke the terms of the Trump-signed deal by launching a drone attack on a passing ship over the weekend.
They also sought to assure lawmakers that Iran has received no money under the memorandum — especially not directly from American sources. Administration officials have previously pledged in smaller briefings that the reconstruction fund won’t include U.S. funds.
Sen. Steve Daines (R-Mont.) called the Senate briefing a “productive conversation” but said “much of what I heard today is similar to what I heard last week” during a dinner at Vice President JD Vance’s residence.
The Senate Ethics Committee has dismissed allegations of misconduct levied against Sen. Ruben Gallego, who stood accused by Rep. Anna Paulina Luna of “campaign finance violations and inappropriate conduct of a sexual nature.”
The charges came following the resignation of the Arizona Democrat’s longtime friend, Rep. Eric Swalwell (D-Calif.), who was forced to step down amid accusations of serious sexual misconduct. Luna, a Florida Republican, sought to implicate Gallego by claiming in an interview on CBS that a woman would come forward about an “incident that occurred between the two of them at the same time and the event was sexual in nature allegedly.”
But in a letter to Gallego sent Monday — which he shared in a public news release — the notoriously inactive Ethics Committee cited Gallego’s “prompt contact with the Committee following media reports of the allegations and appreciated your full cooperation with the Committee throughout the investigation.”
Gallego has maintained he was unaware of the allegations against Swalwell and said in a statement he was a victim of “right-wing conspiracies peddled by far-right activists like Anna Paulina Luna, the White House, and their allies.”
He continued, “I look forward to an apology from Rep. Luna for weaponizing the ethics process while refusing to investigate historic corruption that’s making life harder for families.”
Luna, in a post on X, defended her referral to the Senate Ethics Committee.
“The good news about DC is everyone talks, and eventually the reporters come forward with your texts,” Luna wrote on social media. “Do yourself a favor and keep raising for your legal defense fund. Once a creep always a creep, and you’re gonna need it.”
CORRECTION: An earlier version of this report misstated Rep. Anna Paulina Luna’s state. She represents Florida.
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