Rep. Brian Fitzpatrick (R-Pa.), a key House Republican moderate, is drafting a new health care bill aimed at securing support from more-conservative GOP members and President Trump. His proposal would extend soon-to-expire Obamacare subsidies and introduce new flexibility for health savings accounts (HSAs), a policy favored by conservative Republicans. Fitzpatrick and allies are pushing for an extension of the Affordable Care Act (ACA) tax credits while also considering broader reforms, including a stalled bipartisan package to overhaul pharmaceutical benefit managers (PBMs). However, GOP leaders, including House Majority Leader Steve Scalise, have signaled they are unlikely to support an extension of the ACA subsidies, instead focusing on other conservative priorities such as HSA flexibility and PBM reforms.
Democrats have expressed opposition to replacing subsidies with individual accounts, warning that it could destabilize health insurance markets. The House GOP centrists feel sidelined by their leadership and frustrated by Democrats’ insistence on a larger negotiation framework. This situation underscores the deepening divisions within the Republican Party over the future of the ACA and health care reform.