‘Malpractice’: Moderates Fume at Mike Johnson Over Blocked Subsidy Vote

House Republicans declined to advance any piece of legislation or amendment to extend the enhanced Affordable Care Act subsidies, making all but certain the subsidies will expire at the end of the year and premiums will spike for millions of Americans.

Moderate Republicans had been feeling bullish that Speaker Mike Johnson would, at the very least, allow a floor vote on extending the subsidies. But on Tuesday, it was clear there would be no vote. The day was peppered with plans and arguments — Johnson and several lawmakers were yelling at each other behind closed doors, with one side saying Johnson had pulled the rug out from under them, and the other side saying moderates were going back on a deal.

“There’s a lot of different factions and viewpoints within our conference, but the best way to resolve that is just to let people vote because they vote their conscience,” Rep. Kevin Kiley said after it was clear there would not be a vote. “If we brought one of these compromise measures to the floor, it would pass pretty decisively.”

Last Thursday, Johnson signaled to a group of moderate Republicans that he was leaning toward allowing a floor vote on an amendment to extend the subsidies. By Friday, things began to fall apart.

During a meeting of the heads of the various Republican caucuses, dubbed the “Five Families,” it was clear there was no consensus on precisely what an amendment would look like. Sources in the room said that one member noted that such an amendment might run afoul of House rules. Because the extension was going to be added as an amendment to the GOP-led health care bill, it had to be “deficit neutral” to the underlying bill, per House rules.

Over the weekend, Johnson and others in leadership proposed different pay-fors to offset the bill’s cost, but moderates weren’t going for it, two sources told NOTUS. In their view, adding pay-for clauses would have diluted the subsidies they were trying to extend.

It further infuriated moderates that GOP leadership used similar gimmicks in the reconciliation bill for extending the Tax Cuts and Jobs Act, and by that logic, the amendment would not violate any rules.

“We don’t think we need (an offset) because current policy baseline says that’s cost free, right?” Rep. Brian Fitzpatrick told NOTUS. “That’s the Republican Conference position. That’s what they used for H.R. 1, so we don’t think there needs to be a pay-for.”

Johnson wasn’t swayed by that argument, and moderates were informed that without the pay-fors, their amendment would be ruled out of order and they would not receive a vote on the House floor.

While they continued to work toward consensus on Monday, it quickly became clear leadership wasn’t looking for a way to get the amendment to the floor.

On Tuesday morning, Johnson put the final nail in the coffin. He told members he was moving forward with the GOP health care bill that did not extend the subsidies.

Rep. Mike Lawler stood up in the closed-door Republican Conference meeting and expressed his frustration with Johnson for not giving them a vote on the extension, calling the decision “malpractice,” according to a source in the room.

Rep. Jim McGovern, ranking member of the Rules Committee, mentioned the exchange in the committee hearing Tuesday: “He’s right,” McGovern told Republicans on the committee. “You should listen to him.”

Moderates made one more attempt to try to get a floor vote on extending the subsidies. As NOTUS first reported, they decided to put up a second amendment vote, this time on a one-year extension of the enhanced ACA subsidies but with a pay-for, in hopes of getting the amendment through the Rules Committee.

Vulnerable centrist members tried to sell Johnson on this plan during a tense weekly lunch for the Republican Governance Group. At one point, the meeting got so heated that reporters outside the room could hear the members yelling at each other.

“We are never going to have a second reconciliation bill,” Rep. Mike Lawler, who has been pushing for the subsidy extension, exclaimed in the meeting.

“Take those words out of your mouth,” Johnson snapped back at him.

Afterward, moderates were quick to make their frustrations known.

“It’s a frustration from members who feel that we have a good compromise solution here to address a real problem and that leadership is shutting it down,” Rep. Nicole Malliotakis, a New York Republican, told reporters after the meeting.

Lawler told reporters he was “pissed off” and “it’s bullshit,” criticizing both Johnson and House Minority Leader Hakeem Jeffries.

Kiley, a Republican moderate from California who had his own proposal to extend the subsidies, also criticized leadership, saying after the meeting he was “very frustrated” with Republican leadership.

“He is willing to talk and to listen, so I’ll give him credit for that, but he has far too seldom been willing to act,” Kiley said of the speaker earlier Tuesday.

Despite their efforts, moderates would fall short of convincing Johnson to give them a floor vote on extending the subsidy. Leadership argued that the other amendment went against their agreement they had over the weekend, which was to offer the two-year extension with an offset.

The failure just adds to the high level of frustration and distrust in leadership as the year comes to a close.

“He’s getting pressure from all sides,” Rep. Don Bacon said of Johnson. “But in the end, you’ve got to show tangible stuff on the health care because everybody’s premium is going to go up.”