House Speaker Mike Johnson is facing his latest challenge as Republicans attempt to move forward Wednesday with a package that aims tolower the cost of health carebut ignores bipartisan calls to extend Obamacare subsidies set to expire for upwards of 20 million Americans.
The speaker on Tuesday met with the full Republican Conference to tee up the vote -- with some moderates fuming to reporters as they left because the speaker has resisted an up or down vote to extend the subsidies for the near-term.
"I am pissed for the American people. This is absolute b-------!" New York Rep. Mike Lawler told reporters.
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Moderates in Johnson's party clashed with him behind closed doors later Tuesday afternoon, questioning the speaker not only on his intent to allow the COVID-era subsidies for health care premiums to expire, but also the party's messaging as lawmakers brace for the backlash from their constituents.
"We're just trying to solve the equation for everybody," Johnson told reporters after Republicans were overheard airing their frustrations to the speaker. "It's a very collegial meeting. Everybody in there is close friends. We're all trying to solve very complicated questions and challenges and sometimes there's frustrations with the process, but it's not about individuals. Everybody's working in good faith on this.
"As always, this is a consensus building exercise around here," Johnson told ABC News.
But inside the meeting, the speaker listened to a laundry list of complaints from moderates on health care. Rep. Maria Elvira Salazar of Florida worried about the impending impact of the expiring subsidies in her district. Lawler and Johnson were also overheard disagreeing on the prospects for another reconciliation bill in 2026, and New York Rep. Nick LaLota expressed his frustrations with the Republican Conference's latest talking points -- particularly that only 7% of Americans are impacted when the health care subsidies expire at the end of the year.
LaLota told Johnson, "7% keeps on getting dismissed. The 7% matters for the majority and a heck of a lot of people in this room. It's what defines us."
Johnson responded, "I'm not dismissing it" and blamed Democrats for creating a "false narrative" that the subsidy impacts everyone's health care costs.
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"That's just a damn lie. It's a false narrative," Johnson was overheard remarking. "It's a darn lie, and we got to cut through it."
Johnson says he is moving forward with plans to vote on the House GOP's health care reform package aimed at addressing the rising costs of health care -- mixing a range of provisions that has not yet satisfied moderates who remain optimistic Congress will extend the Obamacare subsidies.
"I think it should be a standalone bill. I like the measures that we're going to put on the floor, but I also think we need an extension," Nebraska Rep. Don Bacon told ABC News. "I understand a lot of pushback from our side of the aisle. The ACA is not affordable, as the costs are exploding and people want to throw good money after bad. I understand that, but it's our constituents that are going to be paying more premiums, and it's not their fault."
The Rules Committee on Tuesday night advanced the measure by a vote of 6-4, teeing up floor action on the bill with a final passage vote expected Wednesday afternoon. However, amendments to extend and reform the ACA subsidies -- proposed by moderates Lawler, LaLota and Rep. Brian Fitzpatrick -- were blocked from advancing.
"There will be consequences if these amendments are not made in order. I think the only thing worse than a clean extension, without any income limits and any reforms, because it's not a perfect system, the only thing worse than that would be expiration," Fitzpatrick warned during the Rules Committee hearing.
The measure would expand the availability of association health plans and what are known as "CHOICE arrangements;" impose new transparency requirements on pharmacy benefit managers to lower drug costs; and appropriate money for cost-sharing reductions to reduce premiums in the individual market.
Democrats are expected to vote against the Republican bill -- following Minority Leader Hakeem Jeffries, who is not willing to support any of the bipartisan proposals intended to break the impasse.
"House Republicans from the very beginning have been determined to rip away health care from the American people," Jeffries told ABC News on Tuesday. "That is why they enacted the largest cut to Medicaid in American history."
The nonpartisan Congressional Budget Office estimates the GOP bill would decrease the number of people with health insurance by an average of 100,000 per year over the 2027-2035 period. The bill would also reduce the federal deficit by $35.6 billion and reduce some health care premiums by 11 percent, according to the CBO.
Inside the speaker's meeting with moderates, he signaled that Republicans could use reconciliation -- which provides procedural advantages for the majority -- to enact additional health care reform in the New Year.
"We are never getting a second reconciliation bill!" Lawler shouted at the speaker, who responded, "Take those words out of your mouth."