House votes to renew Obamacare subsidies in blow to GOP leaders

A band of House Republicans bucked party leaders to join Democrats in passing a measure to restore expired Obamacare subsidies through the end of President Donald Trump's term, as rising healthcare costs drive midterm election anxieties.

The House voted 230-196 Thursday to send a three-year extension of the expired tax credits to the Senate. Seventeen Republicans supported the measure. 

The measure is unlikely to overcome Republican opposition in the Senate, but several of the Republican defectors said they hoped a strong showing in the House would increase pressure on the Senate to reach a bipartisan compromise.

The House Republicans who crossed party lines included some of the party's most politically vulnerable lawmakers, a glaring signal of members' concerns over the surge in out-of-pocket premium costs for more than 20 million people who buy their own insurance.

Democrats, seeking to take back the House in November's midterm elections, have hammered Republicans over rising healthcare costs as part of broader criticism that Trump has failed to deliver on campaign promises to bring down the cost of living. 

House Republican leaders have fought an extension of the pandemic-era subsidies. The vote itself was forced only after four GOP moderates broke ranks to join a rare maneuver to bypass the party leaders' control of the House agenda to bring the renewal to a vote. 

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The issue is particularly risky politically for incumbent Republicans, because Obamacare enrollment tends to be higher in Republican-controlled states that declined to expand Medicaid under former President Barack Obama's landmark healthcare law. Out-of-pocket Obamacare premiums more than doubled on average with the expiration of the subsidies, according to the nonpartisan health research organization KFF. 

Trump, mindful of Democrats' attacks over healthcare, has urged congressional Republicans to take action on the issue, but favors sending subsidies to people through tax-advantaged health savings accounts, rather than reviving the tax credits, allocated to insurance companies.

A group of senators lead by Maine Republican Susan Collins is working to strike a deal that would revive the subsidies with modifications. Bernie Moreno, an Ohio Republican involved in those talks, said the group is close to reaching a deal. The House-passed measure could serve as a legislative vehicle for a Senate compromise, if lawmakers can reach one that satisfies enough other senators.

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The group must balance Democrats' desire to leave the tax credits largely unchanged, and Republicans' demands to impose income caps, eliminate cost-free premiums, and bolster abortion restrictions and fraud protections.

"If it's a bipartisan solution, everybody will have something they want, and they'll have something they won't want," said Senator Raphael Warnock, a Georgia Democrat involved in talks. "Let's see where it lands."