WATCH LIVE: House passes bill to extend ACA benefits after GOP lawmakers helped force vote

WASHINGTON (AP) — In a marked rebuke to Republican leadership, the House passed legislation Thursday, 230-196, that would extend expiring health care subsidies to those who get coverage through the Affordable Care Act as dissident Republican lawmakers joined essentially all Democrats in voting for the measure.

Watch the home floor live in our video player above.

The issue was put to a vote after a handful of Republicans signed the so-called “impeachment petition” to open the debate, overcoming the objections of House Speaker Mike Johnson. The bill now goes to the Senate, where pressure is mounting to reach a similar compromise between the two parties.

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Rare political coalitions are rushing together to resolve the standoff over enhanced tax breaks that were introduced during the Covid-19 crisis but ended late last year after no deal was reached during the government shutdown.

“The affordability crisis is not a hoax, it is very real — despite what Donald Trump has said,” House Democratic Leader Hakeem Jeffries said, citing the president’s remarks.

“Democrats made it clear before the government shutdown that we were in the affordability battle to win the affordability battle,” he said. “Today we have an opportunity to take a meaningful step forward.”

Before the vote, the nonpartisan Congressional Budget Office estimated that the bill, which would provide a three-year extension of support, would increase the nation’s deficit by about $80.6 billion over the decade. At the same time, the number of people with health insurance will increase by 100,000 this year, 3 million in 2027, 4 million in 2028, and 1.1 million in 2029, the Congressional Budget Office said.

Support is growing for expanding ACA benefits

Johnson, Republican of Los Angeles, has worked for months to prevent this situation. His office said Thursday that federal health care funding in the era of COVID-19 is rife with fraud, pointing to an investigation in Minnesota, and urging a no vote.

On the ground, Republicans argued that the subsidies in their regulated form had contributed to fraud and that the chamber should focus on lowering health insurance costs for the general population.

“Only 7% of the population relies on Obamacare marketplace plans,” said Rep. Jason Smith, Republican chairman of the House Ways and Means Committee. “This chamber should aim to help 100% of Americans.”

While the momentum from the vote shows growing support for the tax credits that helped about 22 million Americans access health insurance, the Senate will not be obligated to take up the House bill.

Instead, a small group of senators from both parties is working on an alternative plan that could find support in both chambers and become law. Senate Majority Leader John Thune, R-D., said that for any plan to gain support in his chamber, it would need income limits to ensure financial aid is focused on those who need help most. He and other Republicans also want to make sure beneficiaries will have to pay at least a nominal amount for their coverage.

Finally, Thune said there will need to be some expansion of health savings accounts, which allow people to save money and withdraw it tax-free as long as the money is spent on qualified medical expenses.

Sen. Jeanne Shaheen, D-N.H., who is involved in negotiations on reforms and subsidies for the Affordable Care Act, said there is agreement to address health care fraud.

“We realize that we have millions of people in this country who are going to lose — lose, they’ve lost — their health insurance because they can’t afford the premiums,” Shaheen said. “So we’re trying to see if we won’t be able to reach some agreement that would help, and the sooner we do that, the better.”

Trump has pushed Republicans to send money directly to Americans for health savings accounts so they can bypass the federal government and handle insurance on their own. Democrats largely reject this idea as insufficient to cover high health care costs.

Republicans rally around their leaders

The action by Republicans to force the vote was an insult to Johnson and his leadership team, who essentially lost control of what comes to the House floor when Republican lawmakers joined Democrats in the workaround.

After last year’s government shutdown failed to solve the problem, Johnson discussed allowing more politically vulnerable GOP lawmakers the chance to vote on another health care bill that would temporarily extend benefits while also adding changes.

But after days of debate, Johnson and the GOP leadership sided with the more conservative wing, which attacked the benefits as a boost to the Affordable Care Act, which they view as a failed government program. He offered a modest proposal for health care reforms, which was approved, but stalled.

That’s when rank-and-file lawmakers took matters into their own hands, as many of their constituents faced rising health insurance premiums starting this month.

Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan McKenzie, all of Pennsylvania, and Mike Lawler of New York, signed the Democrats’ petition, pushing it to the magic number of 218 needed to force a vote in the House. All four districts represent key swing districts whose races will help determine which party takes charge of the House next year.

Trump encourages the GOP to take on the health care issue

What began as a long-running effort by Democrats to file a layoff petition has become a political vindication of Democrats’ government shutdown strategy as they fight to preserve health care funds.

Democrats are making clear that the high health insurance costs facing many Americans will be a political focus of their efforts to regain majorities in the House and Senate in the fall elections.

Trump, during a lengthy speech this week to House GOP lawmakers, encouraged his party to dominate the debate over health care — an issue that has stymied Republicans since he tried, and failed, to repeal Obamacare during his first term.