Republicans promised health care negotiations after the shutdown, but Democrats are wary

WASHINGTON– Now that the government shutdown is over, House and Senate Republicans say they will negotiate with Democrats over whether to extend COVID-era tax credits that help tens of millions of Americans pay their health care premiums. But finding a bipartisan agreement could prove difficult, if not impossible, before the grants expire at the end of the year.

The shutdown ended this week after a small group of Democrats struck a deal with Republican senators who promised a vote by mid-December on expanding the Affordable Care Act subsidies. But there is no guaranteed outcome, and many Republicans have made clear they want the credits to expire.

House Speaker Mike Johnson, R-La., called the subsidies a “mess” immediately after the House voted Wednesday to end the shutdown, and President Donald Trump declared the Obama-era health care overhaul a “disaster” as he signed the reopening bill.

This is far from the result hoped for by Democrats who kept the government closed for 43 days, demanding that Republicans negotiate an extension with them before contributions rise sharply. But they say they will try again as the expiration date approaches.

“It remains to be seen whether they are serious,” said House Democratic Leader Hakeem Jeffries of New York. But he said Democrats are “just getting started.”

Republicans met privately to discuss the issue. Some want to extend the subsidies, with modifications, to avoid across-the-board premium increases. Others, like Johnson and Trump, want to start a new conversation about completely overhauling “Obamacare” — an overhaul after a similar effort failed in 2017.

Health care has long been one of the toughest issues on Capitol Hill, marked by deep ideological and political divisions. Partisan disagreement over the 2010 law has persisted for more than a decade, and relations are already strained following weeks of partisan tensions over the shutdown.

Connecticut Rep. Rosa DeLauro, the top Democrat on the House Appropriations Committee, said that although Republicans have promised negotiations and a vote in the Senate, Democrats are wary. She noted that Johnson hadn’t committed to anything in the House.

“Do I trust any of them? Hell no,” DeLauro said.

If the two sides fail to reach an agreement, as many as 24 million people who receive their health care through the exchanges created by the law could see their premiums increase on January 1. New Hampshire Sen. Jeanne Shaheen, one of the Democrats who struck a deal with Senate Majority Leader John Thune, R-S.D., to reopen the government, said she believes a deal on tax credits is possible.

During the discussions that led to the shutdown’s end, Shaheen said she and other moderate Democrats sat across from Thune and “looked him in the eye” as he pledged a serious effort.

“We’re going to have a chance to vote on a bill that we draft by mid-December, in a way that gives us a chance to build – we hope – bipartisan support to get it passed,” Shaheen said.

Although Democrats would like to see a permanent extension of the tax credits, most realize that is unlikely. Just before the shutdown ended, Senate Democratic leader Chuck Schumer of New York proposed a one-year extension and the creation of a bipartisan committee to address Republican demands for changes to the ACA. But Thune said it was a “failure” as the government remained paralyzed.

In the House, Democrats proposed a three-year extension.

While Republicans have long sought to repeal Obamacare, they have struggled over the years to find what could replace it. This problem plagued efforts in 2017, when then-Sen. John McCain, R-Ariz., voted decisively to reject a bill in the Senate that lacked detail.

Republican Sen. Bill Cassidy of Louisiana, chairman of the Senate Labor and Pensions Health Education Committee, and Sen. Rick Scott, R-Fla., have proposed revising the law to create accounts that would direct money to individuals rather than insurance companies. These are ideas that Trump echoed in signing the funding bill Wednesday night.

“I want the money to go directly to you, the people,” Trump said.

It’s unclear exactly how that would work, and scrapping the law in its current form would take months, if not years, to negotiate, even if Republicans were able to find the votes to do so.

Some moderate Republicans in the House have said they want to work with Democrats to extend the grants before the deadline, which is just weeks away. In a letter Wednesday to Thune and Schumer, Pennsylvania Rep. Brian Fitzpatrick, Republican co-chair of the Bipartisan Problem Solvers Caucus, encouraged negotiations.

“Our sense of urgency could not be greater,” Fitzpatrick wrote. “Our willingness to cooperate knows no bounds.”

So far, however, Senate Republicans have met alone to resolve their own differences.

“Right now, it’s just about getting consensus among us,” Sen. Thom Tillis, R-N.C., said Monday after GOP members of the Senate Finance Committee met to discuss possible solutions.

Tillis supports expanding tax credits, but said lawmakers also need to find a way to reduce costs. If the two sides can’t agree, Tillis said, Republicans may have to try to find a way to do it on their own, possibly using budgetary maneuvers that allowed them to pass Trump’s “Big Beautiful Bill” this summer without any Democratic votes.

“We should have this in our back pocket, too,” Tillis said.

Some House Democrats have raised the possibility of another shutdown if they fail to secure concessions on health care. The bill Trump signed will fully fund some parts of the government, but others will run out of money again at the end of January if Congress doesn’t act.

“I think it comes down to vulnerable House Republicans who won’t be able to go back to their constituents without telling them they did something on health care,” said Rep. Pramila Jayapal, D-Wash.

“We’ll just have to see” if there could be another shutdown, said Rep. Mark Takano, Democrat of California.

Rep. Jim McGovern, Democrat of Mass., said he was “not going to vote to endorse their cruelty” if Republicans don’t extend the subsidies.

DeLauro said Republicans have wanted to repeal the ACA since it was signed into law. “That’s where they’re trying to go,” she said.

“On January 30, we will see what progress has been made,” she said.