STEVE INSKEEP, HOST:
Today is the last day to sign up for health care coverage next year through Affordable Care Act marketplaces. Congress has not passed a bill to address rising prices for around 22 million people. Tax credits for them expire. House Speaker Mike Johnson has promised a vote this week on his health care proposal, which does something different, which NPR's Luke Garrett is here to tell us about. Luke, good morning.
LUKE GARRETT, BYLINE: Good morning, Steve.
INSKEEP: What is Speaker Johnson's health care plan?
GARRETT: So, Steve, to start, it's worth noting what Speaker Johnson's health care proposal leaves out. It does...
INSKEEP: OK.
GARRETT: ...Not extend ACA tax subsidies, which millions of Americans have really grown accustomed to. This makes the proposal a nonstarter for Democrats, as well as some moderate Republicans. Minority Leader Hakeem Jeffries called it, quote, "toxic legislation." And Speaker Johnson's package also doesn't include President Trump's idea to send money directly to those personal health saving accounts.
INSKEEP: OK. So nothing for health savings accounts here, and also no subsidies here. So what is in the plan?
GARRETT: Right. Let's get into it. So the plan puts forward a long-sought GOP proposal to increase access to employer-sponsored health insurance plans. This bill would give eligible Americans access to what's known as association health plans. A lot of names there, but basically, small businesses and self-employed folks could band together, leverage their power and purchase health care. The idea is it would create competition and therefore lower prices.
INSKEEP: OK.
GARRETT: The GOP proposal would also require pharmacy benefit managers to report more data, in hopes of shrinking drug costs. Speaker Johnson said this initiative tackles the real drivers of health care costs. And the Rules Committee is set to mark up the bill Tuesday, and GOP leadership tells me that they're eyeing a Wednesday vote. And that's according to a senior aide not authorized to speak publicly.
INSKEEP: So Johnson is aiming at larger problems in the health care system, in the hopes of eventually driving down costs. Is that the only plan before the House?
GARRETT: It's not. There are a couple other ideas circulating in the House, but they don't have the support of the speaker, so their sponsors are filing discharge petitions. That's a procedural maneuver to try to get around leadership and force a vote.
INSKEEP: Right.
GARRETT: Republican Representative Brian Fitzpatrick of Pennsylvania filed one of these discharge petitions last week, defying his leadership and teaming up with a few other moderate GOP members and Democratic ones. Democratic Representative Josh Gottheimer of New Jersey also filed another discharge petition. Both would extend ACA subsidies for two years. So far, these petitions have at least a dozen signatures from either side of the political aisle, building momentum. But they still have to reach that 218 threshold mark, which is a long way to go.
INSKEEP: Especially since the Democratic Party leaders have not gone along with this yet, right?
GARRETT: That's right.
INSKEEP: OK. Is this going to be the new norm - discharge petitions, even from Republicans who are dissatisfied with their own leaders?
GARRETT: Well, it certainly represents growing dissatisfaction within the Republican conference in the House. Speaker of the House controls floor votes. But in the last few months, we've seen GOP members challenge Speaker Johnson's power with a handful of these petitions. You know, most notably, we saw this with the release of the Epstein files bill, which members forced onto the floor with a discharge petition. We'll see if this happens with the health care bills.
INSKEEP: Can you just tell me about the Senate? Are they working on anything after two plans failed last week?
GARRETT: So as it stands, there are no scheduled health care votes in the Senate. But Republican Senator Bill Cassidy of Louisiana said he sees a deal coming together. He told CNN that he was optimistic about a compromise that would extend ACA subsidies in exchange for reforms to the government health care program.
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BILL CASSIDY: If we do that, I think there could be interest in a short-term extension. I think that could be the deal.
GARRETT: But Cassidy was also optimistic about his bill that failed last week.
INSKEEP: OK. No idea what, if anything, is going to pass. Luke, thanks so much.
GARRETT: Thanks, Steve.
INSKEEP: NPR's Luke Garrett. Transcript provided by NPR, Copyright NPR.
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