Mike Carey

WASHINGTON — The House of Representatives on Thursday voted 230-196 to extend enhanced Affordable Care Act tax credits for three years, with Reps. Max Miller of Bay Village, Dave Joyce of South Russell and Mike Carey of Columbus among 17 Republicans who joined all Democrats to approve the measure over Speaker Mike Johnson’s objections.

Miller, who represents Ohio’s 7th Congressional District, was also among nine GOP defectors who voted Wednesday to advance the Democratic-led discharge petition that forced the vote against the speaker’s wishes.

“Obamacare has failed, but pulling the rug out from under Ohio families without an alternative would be irresponsible,” said a statement Miller issued after the vote. “That’s why I supported a short-term extension of ACA credits as a bridge, not a destination, while Congress works toward affordable, sustainable healthcare solutions.”

A statement from Carey said he voted to continue the subsidies because nearly 45,000 people in his district have the affected plans “and I want to make sure that they do not lose access to a plan that they have relied on as Congress continues addressing the high cost of health care.”

A statement from Joyce said the tax credit won’t cure a “deeply flawed system that was created without any off-ramp.”

“However, as President Trump said earlier this week, it is time for our party to take control of the issues surrounding healthcare and affordability,” Joyce’s statement continued. “I supported this legislation to make clear that Congress cannot ignore the consequences of the credits’ expiration and to force a real conversation about responsible, short-term relief paired with meaningful reforms.”

The legislation stands little chance of passing the Senate, where it lacks the 60 votes needed to overcome a filibuster. However, a bipartisan group of senators whose leaders include Westlake Republican Bernie Moreno continues working to broker a compromise that could pair a shorter extension with policy reforms.

The temporary subsidies that expired Dec. 31 were established as a pandemic-era relief measure. They helped millions of Americans afford health insurance through the ACA marketplace. Their lapse has triggered premium increases for enrollees across the country, including an estimated 500,000 Ohioans.

House Republicans framed their opposition around cost, fraud, and priorities. Rep. Jason Smith of Missouri, who chairs the House Ways and Means Committee, argued the legislation amounts to “$100 billion worth of bailouts for a broken system,” claiming it subsidizes insurance plans for wealthy families earning up to $600,000 annually.

He contended that only 7% of Americans rely on Obamacare marketplace plans, questioning why Congress should prioritize them over the 93% who get coverage elsewhere. Smith highlighted what he called rampant fraud in the system, citing Government Accountability Office findings that fictitious applicants were approved for care and more than 58,000 deceased individuals received subsidies. Republicans also argued that Democrats deliberately made the enhanced subsidies temporary to fund other priorities like green energy tax credits, and should now live with that decision.

Democrats said the debate was about ensuring health care access for millions of Americans. The Ways and Means Committee’s top Democrat, Rep. Richard Neal of Massachusetts, emphasized that national uninsured rates have dropped to 6% thanks to the ACA. He warned that without extending the credits, a family of four earning $130,000 would see premiums jump from $921 to $1,992 monthly.

The vote represents a significant procedural defeat for Speaker Mike Johnson, a Louisiana Republican who tried to block the measure from reaching the floor. Democrats, joined by several GOP defectors used a rare discharge petition to force the vote over Johnson’s objections. The maneuver requires 218 signatures to bypass leadership and bring legislation directly to the floor—a tool typically reserved for issues where members believe leadership is blocking popular measures.

Ohio Republicans split

Miller had signaled his support for addressing the issue in December House floor remarks, though he emphasized the need for broader reforms.

“Ohio, families and small businesses continue to face unprecedented health care costs, making it increasingly difficult for my constituents to access affordable, high quality care,” Miller said. “Since the enactment of the so called Affordable Care Act in 2010 health care costs have risen dramatically, with premiums increasing by more than 25% over the last five years.”

House Judiciary Committee Chairman Jim Jordan, a Champaign County Republican, has taken a more cautious stance, saying he would only support a subsidy extension if it is paired with substantial reforms that increase choice and competition.

“If we do real reform, reform that increases choice and competition, everyone knows, subsidies drive up price,” Jordan said in a Jan. 6 NewsNation interview. “Choice and competition bring down price.”

Democrats press for action

Ohio Democrats have criticized Republicans for allowing the subsidies to lapse.

Warrensville Heights Democratic Rep. Shontel Brown warned that the expiration would mean “half a million Ohioans seeing their premiums skyrocket.”

“These subsidies worked, lowering costs and lowering the uninsured rate - and they’re supported by Ohioans across the political spectrum,” said a December statement from Brown. “My constituents can’t afford these Republican cuts. And if Congress doesn’t act, Northeast Ohio will face a health care crisis.”

Akron Democrat Emilia Sykes called the delay in addressing the issue “political malpractice” in House floor remarks.

“Access to health care should be a right, not a gamble,” Sykes said. “Republicans, failure to act is literally going to kill people across this country.”

Senate negotiations continue

Moreno is working with a bipartisan group of roughly a dozen senators on a compromise that would restore the subsidies for two years while implementing reforms including income caps and minimum premium payments.

The Ohio Republican said Wednesday that negotiators could release draft legislation as early as Monday. On Tuesday, he told reporters that he hoped to amend the House-passed measure with the bipartisan compromise he’s working on, and have it signed into law.

The talks have also explored allowing Americans to direct their subsidies into health savings accounts in the second year of an extension, and penalizing insurance companies that deliberately enroll people into Obamacare without their knowledge, Moreno has said.

A major sticking point remains language ensuring federal funds don’t subsidize abortion coverage. Senate Republicans are demanding strengthened Hyde Amendment protections, while Democrats warn such restrictions would kill any bipartisan deal.

“There’s no Republican that I know of in this building that’s saying, hey, there should be federal tax dollars” for abortion, Moreno told reporters on Tuesday.

President Trump urged House Republicans Tuesday to “own health care” and be “flexible” on the Hyde Amendment, though Senate Republicans have given his comments a cold reception.