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Congressional Republicans are sorting out what their plan to tackle expiring Obamacare subsidies will be, but they acknowledge that, ultimately, President Donald Trump will be the deciding factor.
Senate Democrats turned the latest record-breaking shutdown into a push to extend the subsidies, which were enhanced during the pandemic under former President Joe Biden and are set to sunset by the end of this year.
Many Republicans recognize that the subsidies must be dealt with as healthcare premiums begin to skyrocket, but most don’t want to extend them in their current form.
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And both chambers are eyeing different approaches, which could further complicate the path forward to reaching a deal by the end of the year.
In the upper chamber, Senate Majority Leader John Thune, R-S.D., has guaranteed Senate Democrats a vote on a proposal of their choice. However, whatever kind of legislation they put on the floor has to be bipartisan, given the Senate’s 60-vote filibuster threshold, in order to pass.
Whether a plan can be bipartisan is still in the early stages, and a roadblock could be the GOP’s desire to include the Hyde Amendment, which prohibits the use of federal funds from covering the costs of abortions.
Thune said the major question was “will the Democrats accept applying Hyde to any changes or reforms that might be made?”
“I mean, I think there’s an openness, because, you know, we’ve got members, and a lot of members, who are very interested in addressing the affordability of healthcare,” he said. “The question is, what’s the best way to do it?”
Senate Republicans have floated proposals since before the shutdown ended, but there is some consensus growing behind taking subsidy money and putting it directly into healthcare savings accounts (HSAs) for Americans — something Trump has backed and was first floated by Sen. Rick Scott, R-Fla.
Scott and Republicans scoffed at Senate Democrats’ proposal to extend the subsidies for one year, and contended doing so would send billions directly to insurance companies. They also want reforms and guardrails like the Hyde Amendment language.
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“They pay for abortions. Republicans are not going to vote to have taxpayers pay for abortions under their COVID-19 Biden subsidies,” Scott told Fox News Digital.
Sen. Bill Cassidy, R-La., also has his own proposal that would similarly transfer funds directly to the consumer rather than to insurance companies.
Cassidy, who chairs the Senate Health, Education, Labor and Pensions Committee, told Fox News Digital that whichever plan Republicans went with would originate in his committee and from the Senate Finance Committee, where he hoped that “we have something which is bipartisan.”
He also noted that the Hyde Amendment language is important to Republicans, but that in the end, all roads lead back to Trump.
“Anybody looking for something which actually can be signed into law has got to look at the kind of direction that President Trump has given,” he said.
In the House of Representatives, meanwhile, multiple top Republicans are eyeing a second “big, beautiful bill” via the budget reconciliation process — this time focused mostly on healthcare.
“We’ve got a variety of options for affordability, but most importantly, we want to make healthcare affordable,” Republican Study Committee Chairman August Pfluger, R-Texas, told Fox News Digital of plans for a second reconciliation bill. “We want it to be transparent, we want it to be competitive. Not a single Republican voted for any of these provisions over the last 15 years, and yet prices have gone up, so it’s a shame.”
The reconciliation process allows the party in power to change federal budgetary law while completely sidelining the minority, by effectively allowing legislation to bypass the Senate’s 60-vote filibuster threshold in favor of a simple majority.
House Freedom Caucus Chairman Andy Harris, R-Md., told Fox News Digital a healthcare-focused reconciliation effort “may come to pass.”
“It depends on whether the Democrats are serious about actually bringing down healthcare premiums for Americans. And I’m not talking about subsidized healthcare premiums, I’m talking about actual healthcare premiums,” Harris said. “If they’re not serious, then it’s going to have to be done through reconciliation.”
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Harris also backed the idea of an HSA, telling reporters, “It works with the functionality of a debit card. You can go to any provider, and that provider has to give you the most favorable rate.”
A senior House GOP lawmaker also told Fox News Digital that Republicans were in the process of working on legislation specifically aimed at reforming different sectors of the healthcare system.
Tentative plans include reforms on cost-sharing reductions, or CSRs, pharmaceutical reform, and pharmacy benefit manager (PBM) reforms, the lawmaker said.
CSRs are a discount facilitated by the federal government, written under Obamacare, which help lower how much people pay for deductibles and copayments.
PBMs, meanwhile, act as intermediaries between drug companies and insurers — a system critics have said chiefly serves to inflate the cost of prescription drugs for consumers.
But another House Republican who spoke on the condition of anonymity was skeptical that the GOP could pass another reconciliation bill after the long and politically precarious process of Trump’s “big, beautiful bill.”
“I don’t even see close to the votes for another reconciliation,” the second GOP lawmaker said. “I think some of us are a little snake-bit on where the money that was supposed to go places, isn’t going where it’s supposed to go.”
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