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House Republicans Pass Health Insurance Bill Without Support From Colorado Democrats
A closely contested health insurance bill backed by House Republicans has passed the U.S. House of Representatives by a narrow 216-211 vote, setting the stage for a political showdown in the Senate. The bill, which emphasizes long-standing conservative priorities in healthcare reform, has drawn sharp criticism from Democrats and offers no extension to federal premium tax credits that many Coloradans depend on for affordable insurance coverage.
The legislation reflects broader national tension between market-based health strategies and government-supported affordability measures — a divide that is especially relevant as millions brace for potential premium increases once enhanced Affordable Care Act subsidies expire.
Colorado Delegation Splits Down Party Lines
Colorado’s representatives voted along partisan lines. Republicans Lauren Boebert, Jeff Crank, Gabe Evans, and Jeff Hurd supported the bill, praising its emphasis on cost-sharing reforms and association plans. Democrats Jason Crow, Diana DeGette, Joe Neguse, and Brittany Pettersen opposed the measure, arguing that it fails to protect consumers and leaves vulnerable populations behind.
This vote underscores a deeper ideological conflict about how to achieve affordable healthcare: through increased marketplace flexibility, as Republicans advocate, or through federal assistance and coverage mandates, as Democrats promote.
What the Republican Bill Includes
The legislation focuses on several conservative policy goals:
- Reforms to pharmacy benefit managers (PBMs)
- Expanded access to association health plans
- Restoration of cost-sharing subsidies to reduce upfront coverage expenses
Supporters argue that PBM reforms could lower drug costs and that cost-sharing subsidies would reduce benchmark premiums — with Congressional Budget Office (CBO) projections estimating up to an 11% drop over the long term.
What’s Missing: ACA Subsidy Extensions
Noticeably absent from the bill are two measures with significant implications for Colorado:
- an extension of enhanced ACA premium subsidies
- expanded access to health savings accounts
Roughly 225,000 Coloradans rely on enhanced ACA tax credits to purchase insurance — credits set to expire at the end of the year. Without renewal, many residents could see their premiums double, and thousands may lose coverage entirely.
Competing Visions for Healthcare Affordability
GOP lawmakers argue the bill promotes affordability by loosening restrictions and fostering market competition. Rep. Gabe Evans cited CBO data supporting lower premiums under the bill’s cost-sharing provisions and said these changes are aimed at improving affordability for families and employers.
Democratic lawmakers, however, contend the proposal undercuts consumer protections. Rep. Joe Neguse criticized the bill as a step backward, warning it encourages “junk” plans lacking essential coverage — and risks leaving hundreds of thousands uninsured over the next decade.
An Uncertain Future for ACA Subsidies
Congress adjourned for the year without passing an extension to the enhanced tax credits. Lawmakers are expected to return on January 6, with a potential vote on a three-year extension taking place mid-January. While negotiations continue, the delay could already disrupt coverage decisions, as open enrollment for plans beginning January 1 has ended.
A discharge petition signed by four Republicans — Mike Lawler, Brian Fitzpatrick, Rob Bresnahan, and Ryan Mackenzie — reflects growing pressure within swing districts to act on tax credits.
What’s Next for Coloradans
With the subsidy expiration deadline looming and the bill unlikely to pass the Senate, many Coloradans face uncertain coverage and rising costs:
- 225,000 residents rely on premium subsidies to afford insurance
- open enrollment pressures may lead to coverage gaps
- rural and lower-income families are especially vulnerable
Coloradans still have until mid-January to secure coverage beginning February 1, but financial uncertainty may push some households to delay or forgo health insurance altogether.
Frequently Asked Questions
What does the Republican bill change?
It focuses on PBM reforms, association plans, and restoring cost-sharing subsidies — but does not extend ACA tax credits.
How many Coloradans use enhanced ACA subsidies?
About 225,000 residents rely on enhanced tax credits for marketplace coverage.
Why are Democrats opposed?
They argue the bill weakens coverage standards and fails to address affordability for millions of families.
Is the bill likely to become law?
It faces significant opposition in the Senate and is not expected to pass in its current form.
Are there efforts to extend subsidies?
Yes. A bipartisan group is pursuing a clean three-year extension, though timing remains uncertain.
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