House Republicans are in preliminary discussions on a healthcare package, as Obamacare continues to be the central sticking point in the ongoing government shutdown.
Speaker Mike Johnson, R-La., said on Thursday that lawmakers have begun discussions in ‘informal working groups’ on what healthcare reform, aimed at lowering ballooning medical costs, would look like.
But the fight over Obamacare, also known as the Affordable Care Act (ACA), continues to drive a wedge within the House GOP. At the heart of the issue are Obamacare subsidies enhanced significantly during the COVID-19 pandemic — enhancements that are set to expire at the end of this year without congressional action.
Democrats have been demanding that any deal to end the shutdown be paired with an extension of those credits. And Republicans, while united in wanting to keep the shutdown and Obamacare two separate issues, are divided over how to handle that issue once the shutdown ends.
On one side of the divide are members of the House Freedom Caucus, who have signaled vehement opposition to any straightforward extension of the Obamacare credits.
‘What we really need to do is stop talking about the COVID subsidies, because it’s not working, and the entire system that they’re based on is a complete and total Titanic that’s going down,’ said Rep. Eric Burlison, R-Mo., a member of the conservative group. ‘Why would we throw any more bad money after this sinking ship?’
But some Republican lawmakers are floating a one-year extension as a way to buy Congress more time to find an off-ramp to eventually ending the Obamacare subsidies — something all GOP lawmakers who spoke with Fox News Digital agreed on.
‘I am not at all in love with the ACA or Obamacare. I get the concern that many of the members have with it. But as I’ve said before, if you don’t have something good to replace it with, it is political insanity, and it’s just the wrong thing to do — to let it lapse, get rid of it and have nothing else because the rates are going to go up a lot,’ said Rep. Jeff Van Drew, R-N.J., who styled himself a ‘populist conservative.’
He called on Republicans to ‘hold our nose, have a one-year extension, make some minor to moderate modifications.’
‘And during that year, instead of waiting till the last week or the last few days during that year, to really hammer out something that’s real, that isn’t B.S., where we are offering people health care, where it’s relatively affordable, and then we can make the big change that people want to make,’ Van Drew said.
He’s one of 14 House Republicans backing a bipartisan bill, led by Rep. Jen Kiggans, R-Va., to extend the Obamacare subsidies for one year.
Rep. Carlos Gimenez, R-Fla., another backer, pointed out that Democrats created the enhancements and their 2025 expiry.
‘I think we need it, because there is a cliff that was created by the Democrats,’ he said of the extension. ‘A lot of American families are going to be hurt by it. So I am in favor of extending it for a year and then looking at ways that we can, number one, fix Obamacare, and two, a way to end the subsidies, but not in a cliff-like fashion.’
Burlison suggested heavy opposition from the House Freedom Caucus, however.
‘It’s not only a non-starter, but because of the conversations that we’ve had, we would consider it a betrayal,’ he said.
Freedom Caucus member Rep. Andy Ogles, R-Tenn., similarly anticipated the ‘vast majority of Republicans’ would be against the bipartisan bill. However, he left the door open to some extension, provided a plan was in place to end Obamacare already.
‘At the end of the day, the subsidies are going away. It’s just a matter of how quickly. They are going to be phased out. Now, do you want it to be a hard stop, or do you want to phase out? I think the hospitals and the healthcare infrastructure in Nashville would prefer a phase-out, and I totally understand that,’ Ogles said. ‘Quite frankly, fiscal conservatives are not going to stand for more subsidies that were designed for a period of time during COVID. COVID is over.’
Van Drew told Fox News Digital that Republicans’ chances of keeping the House majority in 2026 hinged on a healthcare deal.
‘If you lose the majority, you’ve got nothing. You’re a spectator in the sport. You’re not even involved. So to me, keeping the majority is extremely important, and we’ve got to work to compromise on that,’ he said.
He and Rep. Ryan Mackenzie, R-Pa., another sponsor of the one-year extension, both floated income caps and reforms to the pricing middlemen known as pharmacy benefit managers, or PBMs.
A House Republican familiar with leadership dynamics suggested that income caps for Obamacare are part of the discussion on a potential healthcare package.
That House Republican also suggested that tighter ‘guardrails’ like income verification standards for government healthcare could also be on the table.
‘If you have a right to a benefit, you have a responsibility to prove you are eligible for that benefit,’ they said. ‘That would save a ton of dollars.’
House Majority Leader Steve Scalise, R-La., floated several ideas up for discussion but signaled that any moves to extend Obamacare would require significant changes to the system first.
‘You’ve seen additional ideas on health savings accounts and pooling together amongst small businesses, other ideas like PBM reform,’ he told reporters earlier this week. ‘So all the things we’ve been working on are focused on lowering costs for families as opposed to just shoveling more money into a failed, broken system.’