GOP struggles to avoid Obamacare boomerang amid shutdown

The shutdown debate over the expiration of extended Obamacare subsidies has put Republicans on the defensive over health care, reopening old wounds over efforts to repeal and replace the 2017 law.

Fifteen years after the Affordable Care Act was passed, the scars of the repeal effort and the GOP’s lingering distaste for the law are affecting the party’s scattered response.

While Republicans are united in their criticism of the law and the need for subsidies, there is no clear plan on how to deal with rising premiums when those subsidies expire.

Democrats maintain they won’t vote for any spending bill unless Republicans agree to an extension of enhanced tax credits that help millions of Americans buy cheaper health plans.

They are seizing on the potential for consumer sticker shock when faced with premium payments that could double on average next year, hoping that will bring Republicans to the negotiating table.

Democrats are feeling increasingly bold about their position.

Republicans’ efforts to repeal Obamacare cost them control of the House in 2018, and Democrats are confident their strategy will yield similar results in the midterm elections.

“Democrats think it’s a problem that people are going to lose their health coverage. Meanwhile, some Republicans think it’s a problem that people are covered in the first place. Frankly, some of my colleagues across the aisle can’t open their mouths without saying ‘repeal Obamacare,'” Sen. Patty Murray (D-Wash.) said Tuesday.

Republicans never voted to increase the overdue subsidies that were first introduced and then extended twice under former President Biden. They insist that Democrats vote to fund the government before any discussion on health care takes place.

Senate Majority Leader John Thune (R.S.D.) said he offered Democrats a vote on the increased subsidies if they support the GOP continuing resolution to fund the government — a sign he’s open to at least the idea of ​​an extension.

But many Republicans are pushing for conservative changes to the health care system, if not repealing Obamacare entirely.

They also object to tax credit funding, which they say is an insurance company bailout that is riddled with fraud.

A September analysis from the nonpartisan Congressional Budget Office estimated that permanently extending the extended tax credit would cost $350 billion over the next decade. When the credits expire, there will be about 4 million fewer people with health insurance.

Complicating matters is the absence of a strong message from President Trump about health care or especially increased subsidies.

Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said on “Meet the Press Now” last week that Trump has plans to replace the Affordable Care Act.

“I absolutely believe the president has a plan,” Oz said, without giving specifics.

Speaker Mike Johnson (R-La.) said earlier this month that he suffered “PTSD” from the 2017 repeal effort and acknowledged that the “roots are so deep” that it would be very difficult to completely repeal the law.

But during Monday’s news conference on whether the GOP has plans to work on expired tax credits, Johnson talked about broader reforms and the subsidies masked a broken system.

“Obamacare subsidies expiring at the end of the year is a serious problem,” Johnson said. “If you look at it objectively, you know it’s subsidizing bad policy. We’re throwing good money at a bad, broken system, and so it needs real reform.”

Johnson said House Majority Leader Steve Scalise (R-La.) is working with the chairs of three House committees to compile a Republican health care plan.

Johnson did not elaborate on what the plan was or provide further details.

“We believe in the private sector and the free market and private providers,” he added.

Johnson highlighted past GOP plans, including one he unveiled while chairman of the Republican Study Committee in 2019 that closely resembled the party’s Obamacare replacement bill, the American Health Care Act (AHCA).

In recent days, Republicans have floated ideas like expanding health savings accounts and overhauling the pharmacy benefit manager industry.

They also touted a provision in the House version of the tax-and-spend megabill on reimbursement funds for cost-sharing reductions in private health plans that was stripped from the final version of that law in the Senate.

Yet it will be difficult to pass any significant health reform before the end of the year, without a public plan to deal with Republicans’ expiring extended tax credits.

Meanwhile, those enrolled in Affordable Care Act plans are being notified of premium increases for 2026, putting political pressure on Republicans.

A group of 13 battleground House Republicans wrote to Johnson earlier this month saying the party must “immediately turn our attention to the growing crisis in health care affordability” once the shutdown ends.

“While we did not create this crisis, we now have both the responsibility and the opportunity to address it,” the lawmakers wrote.

According to the health research group KFF, nearly 6 in 10 people who receive health coverage through the ACA marketplace live in congressional districts represented by Republicans.

Other prominent conservative lawmakers, notably Rep. Marjorie Taylor Green (Ga.) and Sen. Josh Hawley (Mo.), also sounded the alarm about the impact of rising insurance rates

During a private call with House Republicans on Tuesday, Green called out Johnson for not offering a plan to deal with expiring subsidies.

“Johnson said he’s got ideas and pages of policy ideas and jurisdictional committees are working on them, but he refused to offer a policy proposal to our GOP conference on our own conference call. Apparently I have to go to a SCIF to find out the Republican healthcare plan!!!” Green wrote.