Speaker Mike Johnson clashed publicly on Tuesday with moderate Republicans demanding a vote to extend expiring Affordable Care subsidies, casting doubt on whether he would allow the House to weigh in on the issue.
At a news conference on Tuesday morning, Mr. Johnson said that he would not allow the House to vote on an extension of the subsidies, which will expire at the end of the year. In doing so, he rejected a plea from politically vulnerable lawmakers in his party who have urged action to prevent health care costs from rising for millions of Americans.
That was an apparent reversal from last week, when a House leadership aide told reporters that Republicans expected to allow a floor vote adding a proposal to address the subsidies to a health care bill slated for debate on Wednesday.
But hours after he rejected any House action — and after a meeting with moderate Republicans who had publicly blasted him — Mr. Johnson suggested the decision had not yet been made, as lawmakers tried to craft a proposal that would appease more conservative members of the party.
“There’s a real possibility to get a vote on it,” Mr. Johnson said. “I’ve certainly tried my best to provide for that, so we’ll see what happens.”
His waffling was the latest sign of deep disarray in G.O.P. ranks over health care, an issue that Democrats have promised to make a centerpiece of their midterm election campaigns.
Most Republicans are vehemently opposed to the Affordable Care Act, but they have not been able to coalesce around a plan to replace it. And a small group of Republicans from swing districts, alarmed about the political consequences of allowing the subsidies to expire, had been urging Mr. Johnson to allow a vote on allowing them to continue at some level, at least temporarily.
After he ruled it out publicly on Tuesday, they made their displeasure with the speaker’s decision known.
“It’s idiotic,” Representative Mike Lawler of New York, who represents a suburban swing district, told reporters, adding that the decision was “political malpractice.”
Mr. Lawler was among the Republicans who met with Mr. Johnson before the speaker said a vote was still possible.
The fate of the subsidies was all but sealed last week, after the Senate deadlocked on competing Democratic and Republican proposals to extend them. With lawmakers expecting to depart Washington at the end of this week, there was little practical time left.
Then, Mr. Johnson on Friday released a narrow health care bill that did not address the subsidies. The moderates’ proposal to extend them had been expected to be brought to the floor as an amendment to that measure.
But on Tuesday morning, Mr. Johnson said that Republicans had been discussing the details, including how to pay for an extension, and could not reach an agreement to allow that vote to proceed.
“We looked for a way to try to allow for that pressure release valve, and it just was not to be,” Mr. Johnson said at a news conference.
Even if the moderates’ proposal were to make it to the floor, it appears unlikely to pass. But the effort would give Republicans campaigning for re-election a way to show they had tried to protect the subsidies.
Some Republican lawmakers have backed two separate discharge petitions that would force a vote on the matter.
But both petitions would need the support of 218 members of the House to succeed. Democrats have instead been circulating a petition to force a vote on their plan to extend the subsidies for three years, but they would need the backing of at least a handful of Republicans. Even if any of those measures were to draw sufficient support this week, they would not come to the floor before the end of the year, when the subsidies expire.
Some of the moderate Republicans said they would propose their measures as amendments later Tuesday at a meeting of the powerful Rules Committee, which determines which legislation and amendments can come to a vote. But Mr. Johnson controls the committee, which does not have any members from that centrist faction.
In the Senate, a bipartisan group of about 20 lawmakers met Monday night to see if they could find agreement on a way forward on the subsidies, with an eye toward trying to advance legislation in January.
Organizers of the group said there appeared to be an early consensus to extend the tax credits for two years, scaling them back during the second. The group hoped to issue a legislative framework before leaving for the holidays.
“This was a very constructive meeting,” said Senator Susan Collins, Republican of Maine and one of those who put the meeting together. She said the group was united in trying to “prevent huge spikes in insurance premiums that will make insurance unaffordable for lower and middle-income Americans.”
Ms. Collins added: “The fact that the enhanced premium tax credits are going to expire hits hard.”
Michael Gold covers Congress for The Times, with a focus on immigration policy and congressional oversight.
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