众议院在周三通过了一项法案共和党医疗保健一揽子计划，216-211，不延长即将到期的平价医疗法案(ACA)补贴。
四名温和派共和党人周三早些时候反对共和党领导人，签署了民主党支持的出院请愿书，投票赞成医疗保健一揽子计划。众议员托马斯·马西是唯一投反对票的共和党人。
这项措施现在提交到参议院，不太可能通过，这意味着国会将在假期休会，因为数百万美国人将看到他们的医疗保险费飙升。
周三早些时候，众议院议长·迈克·约翰逊否认他已经“失去了对众议院的控制”，此前共和党温和派反抗并加入了民主党人迫使对ACA补贴延期三年进行投票的努力。
“我们拥有美国历史上最小的多数，好吗?现在不是正常时期。约翰逊说:“在众议院，有一些[流程]和程序，在多数票占多数的情况下不太常用。“当你像我们一样，利润微薄时，人们认为书中的所有程序都摆在桌面上，这就是区别。”
约翰逊的声明是在四名共和党人打破常规，签署了众议院民主党领袖哈基姆·杰弗里斯的声明后做出的出院申请这使其获得了强制投票所需的218个签名，尽管这最早也要到2026年1月才会发生。
共和党控制的众议院规则委员会(House Rules Committee)周二晚上阻止了延长ACA补贴的修正案，此后，温和的共和党众议员布莱恩·菲茨帕特里克(Brian Fitzpatrick)、迈克·劳勒(Mike Lawler)、罗布·布雷斯纳汉(Rob Bresnahan)和瑞安·麦肯齐(Ryan Mackenzie)决定加入民主党。
约翰逊还拒绝允许就延长即将到期的补贴进行向上或向下的修正案投票，这是民主党人在今年秋天创纪录的43天政府关闭中的焦点。
当被问及他是否会允许在一月份就ACA延期进行投票时，约翰逊说，“大家保持关注。我们正在进行对话。”
在周三上午的投票中，这位被发现与温和派挤在一起的发言人说，“我们只是有一些强烈的友谊……我们正在解决非常复杂的问题，就像我们一直在这里做的那样，这很好。每个人都在为想法而努力。我们将保持富有成效的对话。事情就是这样。”
在请愿书上签名的温和派共和党人将目标对准了众议院领导层。
纽约的劳勒说，他不支持民主党的法案，但是“当领导层完全阻止行动时，国会有责任采取行动。劳勒在x上写道:“我的首要任务是确保哈德逊谷的家庭不会陷入僵局。”
宾夕法尼亚州的菲茨帕特里克再次敦促对延长ACA补贴进行投票，呼吁领导层“让众议院按照自己的意愿行事”
美国广播公司新闻国会山记者杰伊·奥布赖恩就签署民主党人的出院请愿书是否会迫使共和党领导层采取不同的方式向菲茨帕特里克施压。
“我当然希望如此，”他说。“但你必须让人民的声音在议会中被听到。你不能因为害怕法案会被通过而不把它们放在地板上。这个地方不应该这样运作。”
代表宾夕法尼亚州的Bresnahan表示，两党领导人未能就ACA补贴达成两党妥协。
“什么都不做不是一个选项，虽然这不是我曾经打算支持的法案，但它是唯一剩下的选项，”他说说在一份声明中。
接下来会发生什么?
共和党控制的众议院将就ACA补贴的三年延期举行投票;然而，鉴于出院申请何时可以提交的规定，投票预计最早要到2026年1月才会进行。
现在最大的问题是参议院将如何回应。参议院已经在一项议案中否决了将补贴延长三年的提议一对针锋相对的医保投票上周，尽管几名共和党参议员跨越通道，加入所有民主党人的支持。
House passes GOP health care bill that doesn't extend ACA subsidies
The House on Wednesday cleared aRepublican health care package, 216-211, that does not extend the expiring Affordable Care Act (ACA) subsidies.
Four moderate Republicans who had earlier Wednesday bucked GOP leaders and signed a Democratic-backed discharge petition voted in favor of the health care package. Rep. Thomas Massie was the only Republican no vote.
The measure now goes to the Senate, where it's unlikely to pass, meaning Congress is set to leave for the holiday recess as millions of Americans will see their health care premiums skyrocket.
Earlier Wednesday, House Speaker Mike Johnson denied he has "lost control of the House" after the GOP moderates revolted and joined Democrats' effort to force a vote on a three-year extension of the ACA subsidies.
"We have the smallest majority in U.S. history, OK? These are not normal times. There are [processes] and procedures in the House that are less frequently used when there are larger majorities," Johnson said. "When you have a razor-thin margin, as we do, then all the procedures in the book people think are on the table, and that's the difference."
Johnson's assertion came after the four Republicans broke ranks and signed onto House Democratic Leader Hakeem Jeffries'discharge petition, giving it the 218 signatures needed to force a vote, though that is not likely to occur until January 2026 at the earliest.
The decision by moderate Republican Reps. Brian Fitzpatrick, Mike Lawler, Rob Bresnahan and Ryan Mackenzie to join Democrats came after the Republican-controlled House Rules Committee on Tuesday night blocked amendments to extend the ACA subsidies from advancing.
Johnson has also resisted from allowing an up or down amendment vote on extending the expiring subsidies, which were Democrats' focal point of the record 43-day government shutdown this fall.
Asked if he will allow a vote on the ACA extension in January, Johnson said, "Everybody stay tuned. We are having conversations."
The speaker, who was spotted huddling with moderates on the floor during votes on Wednesday morning, said, "We just had some intense fellowship … We’re working through very complex issues, as we do here all the time, and it's good. Everybody's working towards ideas. We're keeping the productive conversation going. That's what happens."
Moderate Republicans who signed onto the petition took aim at House leadership.
Lawler, of New York, said he doesn't endorse the Democrats' bill as written,but "when leadership blocks action entirely, Congress has a responsibility to act. My priority is ensuring Hudson Valley families aren’t caught in the gridlock," Lawler wrote on X.
Pennsylvania's Fitzpatrick again urged for an up or down vote on extending the ACA subsidies -- calling on leadership to "let the House work its will."
ABC News Capitol Hill Correspondent Jay O'Brien pressed Fitzpatrick on if signing the Democrats’ discharge petition will force GOP leadership to take a different approach.
"I sure hope so,” he said. "But you have to let the people's voice be heard on the House floor. You cannot not put bills on the floor because you're afraid they're going to pass. That's not how this place should operate."
Bresnahan, who also represents Pennsylvania, said leadership on both sides of the aisle failed to reach a bipartisan compromise on the ACA subsidies.
"Doing nothing was not an option, and although this is not a bill I ever intended to support, it is the only option remaining," hesaidin a statement.
What happens next?
The Republican-controlled House will hold vote on a clean three-year extension of the ACA subsidies; however, the vote is not expected to occur until January 2026 at the earliest given the rules for when a discharge petition can hit the floor.
The big question now is how the Senate will respond. The Senate already rejected a clean three-year extension of the subsidies in apair of dueling health care voteslast week, though several Republican senators crossed the aisle to join all Democrats in supporting it.
