Illustration: Sarah Grillo/Axios
Republicans have officially kept their House majority, according to Associated Press projections, giving them a chance to advance their health care priorities next year with some new leadership.
Why it matters: The House GOP likely will keep an extension of enhanced Affordable Care Act market subsidies out of a tax deal — unless Democrats make a really enticing offer to tie them to expiring Trump tax cuts.
- Instead, they could resume efforts to crack down on PBMs, enact Medicare site-neutral hospital payment reforms and place new accountability requirements on public health agencies.
If the House GOP doesn't want to extend ACA subsidies, look for lawmakers to try to find new coverage arrangements that don't meet the ACA standards.
- Those could include options promoted during the first Trump administration such as association health plans, health reimbursement arrangements and short-term health plans.
Also don't discount that Speaker Mike Johnson said at a campaign event in October that he saw "massive reform" on the ACA as a target in the next Congress — although he later told Axios that "no one's talking" about ACA repeal.
