Il Nuovo Postiglione - US House revolt advances Obamacare subsidy extension

The bill, which passed with Democratic support and backing from a small bloc of Republicans defying their own leadership, would extend enhanced subsidies under the Affordable Care Act -- widely known as Obamacare -- for three years.

Those subsidies lower monthly insurance costs for Americans who buy coverage on government-run marketplaces.

Their expiration on January 1 more than doubled payments for many households, reigniting a politically sensitive debate over health care affordability in a year set to be dominated by the high-stakes midterm congressional elections.

Even supporters concede the House bill is unlikely to become law in its current form.

President Donald Trump has criticized the subsidies as wasteful and has urged Republicans to push for changes, though he has also told lawmakers they may need to be flexible to reach a deal.

House Speaker Mike Johnson, a staunch Trump loyalist, had resisted allowing the measure onto the floor, reflecting deep divisions within his party over the program.

But a handful of centrist Republicans joined Democrats in using a rarely successful procedural maneuver -- a discharge petition -- to force the vote over leadership's objections.

Ultimately, 17 Republicans voted with Democrats to pass the bill, a public break that underscored growing anxiety among lawmakers from competitive districts about voter backlash over rising healthcare costs.

"The affordability crisis is not a hoax. It is very real despite what Donald Trump has had to say," Hakeem Jeffries, the leader of the House Democratic minority, told reporters.

"Housing costs are too high. Grocery costs are too high. Utility bills are too high. Childcare costs are too high. And healthcare costs are out of control."

The subsidies were originally created under the Affordable Care Act and expanded during the Covid-19 pandemic, making coverage cheaper and available to more people. An estimated 22 million Americans currently benefit from the enhanced assistance.

The bill now heads to the Senate, where its fate is uncertain. A similar three-year extension failed there in December, falling short of the 60-vote threshold needed to advance.

The nonpartisan Congressional Budget Office estimates a three-year clean extension of enhanced Obamacare subsidies would cost almost $81 billion over a decade -- but would lead to eight million more people getting health insurance by 2029.

The House vote appears to have injected new momentum into bipartisan talks now underway in the upper chamber.

A small group of senators from both parties has been negotiating a narrower compromise that could include a shorter extension, tighter income limits and new options for directing aid straight to patients rather than insurers.

A.Rastelli--INP