Democrats are concerned about the GOP’s promise to negotiate on health care after the shutdown ends

WASHINGTON (AP) — Now that the government shutdown is over, Republicans in the House and Senate say they will negotiate with Democrats over whether to extend coronavirus-era tax breaks that help tens of millions of Americans afford their health care premiums. But reaching an agreement between the two parties may be difficult, if not impossible, before the support period expires at the end of the year.

The shutdown ended this week after a small group of Democrats reached an agreement with Republican senators who promised to vote by mid-December on extending Affordable Care Act benefits. But no outcome is guaranteed, and many Republicans have made clear they want the appropriations to expire.

Read more: The shutdown deal does not extend health benefits that expire. What happens to them now?

House Speaker Mike Johnson, R-Los Angeles, called the benefits “invalid” immediately after the House voted Wednesday to end the shutdown, and President Donald Trump said Obama-era health reform was a “disaster” as he signed the reopening bill into law.

It is a far cry from the outcome Democrats were hoping for as they kept the government shut down for 43 days, demanding Republicans negotiate an extension with them before sharply increasing premiums. But they say they will try again as the expiration date approaches.

“It remains to be seen if they are serious,” said House Democratic Leader Hakeem Jeffries of New York. But he said Democrats are “just getting started.”

Republicans are meeting privately to discuss this issue. Some want to extend the subsidy, with changes, to avoid widespread increases in insurance premiums. Others, like Johnson and Trump, want to start a new conversation about completely overhauling Obamacare — a reboot after similar efforts failed in 2017.

Democrats are pushing for an extension

Health care has long been one of the toughest issues on Capitol Hill, marked by deep ideological and political divisions. The partisan dispute over the 2010 law has continued for more than a decade, and relations are already tense after weeks of partisan tensions over the shutdown.

Connecticut Rep. Rosa DeLauro, the top Democrat on the House Appropriations Committee, said that while Republicans have promised negotiations and a vote in the Senate, Democrats are concerned. She pointed out that Johnson did not commit to anything in the House of Representatives.

“Do I trust any of them? No, no,” DeLauro said.

If the two sides cannot agree, up to 24 million people who get their health care on the exchanges created by the law could see their insurance premiums rise on January 1. New Hampshire Senator Jeanne Shaheen, one of the Democrats who struck a deal with Senate Majority Leader John Thune to reopen the government, said she believes an agreement on tax breaks is possible.

Read more: Health care subsidies are at the heart of the lockdown fight. Here who loses if it expires

During the talks that led to ending the shutdown, Shaheen said she and other moderate Democrats sat across from Thune and “looked at him eye to eye” as he committed to making a serious effort.

“We will have an opportunity to vote on the bill that we will be writing by mid-December, in a way that gives us an opportunity to build — and hopefully build — bipartisan support to pass this,” Shaheen said.

While Democrats would like to see a permanent extension of the tax breaks, most recognize that this is unlikely. Just before the shutdown ended, Senate Democratic Leader Chuck Schumer of New York proposed a one-year extension and a bipartisan commission to address Republican demands for changes to the Affordable Care Act. But Thune said that was “unacceptable” because the government remained closed.

In the House, Democrats proposed a three-year extension.

What Republicans want

While Republicans have long sought to repeal Obamacare, they have faced challenges over the years in figuring out what could replace it. That problem plagued the 2017 effort, when then-Sen. John McCain, Republican of Arizona, cast the deciding vote to kill a bill on the Senate floor that lacked details.

Republican Sen. Bill Cassidy of Louisiana, chairman of the Senate Health Education, Labor and Pensions Committee, and Sen. Rick Scott, Republican of Florida, have proposed reforming the law to create accounts that would direct money to individuals rather than insurance companies. These are the thoughts Trump echoed when he signed the funding bill on Wednesday evening.

“I want the money to go directly to you, the people,” Trump said.

It is unclear exactly how this would work, and repealing the law in its current form would take months, if not years, to negotiate, even if Republicans were able to get the votes to do so.

Slow start to negotiations

Some moderate House Republicans have said they want to work with Democrats to extend benefits before the deadline, which is only a few weeks away. In a letter to Thune and Schumer on Wednesday, Pennsylvania Rep. Brian Fitzpatrick, Republican co-chair of the bipartisan Problem Solving Caucus, encouraged negotiations.

“Our sense of urgency could not be greater,” Fitzpatrick wrote. “Our willingness to cooperate knows no bounds.”

However, until now, Senate Republicans have been meeting on their own to iron out their differences.

“Right now, it’s just getting consensus among us,” Sen. Thom Tillis, R-North Carolina, said Monday after GOP members of the Senate Finance Committee met to discuss possible ways forward.

Tillis supports extending the tax breaks, but said lawmakers also need to find a way to reduce costs. If the two sides ultimately can’t agree, Tillis said, Republicans may have to try to figure out a way to do it on their own, perhaps using the budget maneuvers that enabled them to pass Trump’s “big, beautiful bill” this summer without any Democratic votes.

“We should have that in our back pockets, too,” Tillis said.

Another closing?

Some House Democrats have raised the possibility of another shutdown if they can’t get concessions on health care. The bill signed by Trump will fully fund some parts of the government, but other funds will run out again at the end of January if Congress does not act.

“I think it depends on the weak Republicans in the House who are not going to be able to go back to their constituents without telling them they did something on health care,” said Rep. Pramila Jayapal, D-Wash.

“We’ll just have to see” if there could be another shutdown, said Rep. Mark Takano, Democrat of California.

Rep. Jim McGovern, Democrat of Massachusetts, said he “will not vote for their cruelty” if Republicans do not extend benefits.

Republicans have wanted to repeal the ACA since it was first passed, DeLauro said. “This is where they’re trying to go,” she said.

“When it comes to January 30, we will see how much progress has been made,” she said.