The future has only gotten hazier for the Affordable Care Act (ACA) tax credits — also known as the enhanced subsidies — that make private health insurance more affordable for nearly 20 million Americans and 530,000 Ohioans.
The COVID-era subsidies are set to expire at the end of the year, and House Republicans have little time to come to a consensus on their fate.
In a show of party leadership, President Donald Trump was reportedly expected to unveil his preferred subsidy reforms on Monday. The policy framework was expected to include a two-year extension of the subsidies with an income cap, as well as federal savings account option. But Trump’s announcement never happened. House Speaker Mike Johnson reportedly told Trump that his proposal wouldn’t have the necessary support from House Republicans.
But Rep. Greg Landsman, a Democrat representing Ohio’s 1st Congressional District, told CityBeat he’s having positive conversations with Republican colleagues about extending the subsidies with changes down the line.
“I’m working with a group of folks on both sides of the aisle, and in the Senate, to try to get this done, because we can’t rely on leadership anymore,” Landsman said. “Based on my conversations, most people believe in a one to two-year extension, and that there be some cap and transition…The other thing that people have talked about is trying to get these subsidies to cover co-pays, premiums, that kind of stuff, and go directly to individuals and how you do that. All of that is probably best for a year two, but right now we just got to extend it for this year, because open enrollment starts Jan. 1; we may have to extend open enrollment.”
The rub with Republicans varies — some are caught up on the COVID connection, others are using their leverage to attack abortion providers — but Republicans have roundly opposed ACA funding since former President Barack Obama passed his namesake healthcare law in 2010. Gallup and PEW research polls have found only about 11% of Republicans approve of the ACA, while 52% of Americans overall approve. Another poll shows 69% of all Americans believe insurance companies have too much influence on public debates about health policy. But perhaps the most vivid polling this year came in the form of public reaction to the shooting death of United Healthcare CEO Brian Thompson.
“I think there’s people who understand, in ways that maybe wasn’t so clear to some folks, how bad the insurance companies have taken advantage of the system, and how much money they do put into their pockets and send to corporate investors when they’re denying claims and they’re jacking up premiums,” Landsman said. “I am a big believer that you have to have a public option, that people need to have the choice of buying into a system like Medicare and that will keep the private insurance companies honest.”
The “Horrors of Socialism”
Republicans have long equated public funding for healthcare with insidious “socialism.” Just last year, Senate Republican Mitch McConnell referred to efforts to lower prescription drug prices by the Biden-Harris administration as “prescription drug socialism” with the “eerie echoes of Marxist propaganda.”
It’s no surprise then that in the midst of the publicly funded healthcare fight (and on the very same day democratic socialist and NYC Mayor-Elect Zohran Mamdani was scheduled to meet Trump) that Republicans brought a resolution to the House floor titled, “Denounce the Horrors of Socialism.”
“Resolved by the House of Representatives (the Senate concurring), That Congress denounces socialism in all its forms, and opposes the implementation of socialist policies in the United States,” the resolution reads, listing death tolls under authoritarian regimes over the century while pulling quotes from James Madison and Thomas Jefferson. The bill appears to pull talking points from the Victims of Communism Memorial Foundation, which has ties to The Heritage Foundation, the think tank that produced Project 2025.
“This resolution selectively lists certain despotic leaders and the harms of totalitarian regimes self-labeled as ‘socialist,’” reads a statement from House Democratic Whip Katherine Clark. “Ranking Member Waters opposes this resolution as a blatant attempt to tie critical government programs like Social Security, Medicare, and Medicaid, as well as other policies that increase affordability for the American people, to these authoritarian regimes.”
The House voted 285-98 to approve the GOP-written resolution, with 86 Democrats voting in favor of the bill, including Landsman.
“To be clear the bill denounced the killing of 100,000,000 people, not free buses,” Landsman wrote on Facebook following the vote.
Speaking to CityBeat, Landsman reaffirmed he was condemning “deadly regimes” with his vote, but he also brushed off the bill as “absurd.”
“It’s a bill about the 100 million people who died of starvation and political executions in these ridiculously corrupt and deadly regimes,” he said. “But I think it has more to do with how dumb this speaker’s Congress has become in terms of the crap that he brings to the floor when there are a ton of bipartisan bills to address costs and safety and other things that people care about, and he won’t do it. He brings these absurd messaging bills.”
“If you thought it was an absurd messaging bill, then why did you vote for it?” CityBeat asked.
“What does it matter if I voted for it or didn’t vote for it?” Landsman responded. “It’s like, I’m not going to fall into his trap.”
“Honestly, I’m just trying to get people health care,” he continued. “I think it’s such a dumb argument and fight, and I think most Americans hate it.”
Olivia Merrill is a spokesperson for Cincinnati’s Democratic Socialists of America chapter. She told CityBeat that she wasn’t surprised by Landsman’s vote but found his reasoning frustrating.
“Landsman is a grown adult who’s capable of reading between the lines,” she told CityBeat. “He can recognize that this is not that the Republicans randomly decided it was important to recognize the deaths that were caused by the excesses of communism across the globe, but that this was specifically a reaction to Zohran Mamdani coming to the White House and an attempt to specifically intimidate him and intimidate Democratic Socialism across the country.”