A Healthcare Concern Broken Promise
It is not even New Year’s Day and I have already broken a promise to myself for the New Year. I had promised not to write another column about healthinsurance, Obamacare, subsidies, and the Marketplace before the end of this year and the beginning of the next. Still the story continued and the debate did not end after my last column and I could not help myself.
Congress has packed up their bags now and gone home for the Christmas/Holiday recess. There may or may not be another vote in the House of Representatives in January on healthcare although a discharge petition supporting a three year extension of Obamacare subsidies with the support of all Democrats and four Republicans (three of the Republicans from Pennsylvania) has received the necessary votes to bring the vote to the floor. House Speaker Johnson refused an immediate vote before recess and implied it would be considered in January and that there would be more discussion. More of that later.
By now many if not most Americans understand that with the passage of the One Big Beautiful Bill in Congress there was created a massive budgetary. hole. The OBBB, among other things, continued and extended massive tax cuts for very affluent Americans. One of the largest alternative sources of revenue/income could be resourced by reducing the cost of health care not necessarily through greater efficiency but by cutting some health care provisions from the budget. Americans have come to rely on Medicare and Medicaid as originally passed and now also the additions through the Affordable Care Act (Obamacare) and by Medicaid Expansion. It is not surprising that reference was made back to those programs or some parts of them to try to help make up the difference.
Some of my involvement and motivation in following health care issues undoubtedly comes from my work as an elder law attorney dealing for twenty years plus with the U.S. healthcare system mostly but not exclusively with elderly clients and disabled and also throughout that time dealing with Medicaid and Medicare and regulations both federal and state. I also became a lawyer who had majored in political science and briefly was a former high school social studies teacher.
All of this pales before the most important issue. Some of my most serious involvement in this field also involves the concerns of a mother. My own daughter suffers from a serious chronic autoimmune disorder that attacks her eyes causing her to rely on weekly regular injections to prevent her from going blind. We often ignore the many steps that average people follow to find the right treatments to maintain their health and self determination. Once a right treatment or protocol is determined it can make all the difference. Considering this in light of the many Americans who rely on regular medications and treatments, access to the right treatments and protoculs, once found, is nothing to be dismissed lightly and it cannot be replaced by offering short term alternatives merely in terms of money. Suggesting new kinds of Health Savings Accounts or arbitrarily sending one time checks for health insurance premiums can miss the point. Money is one part of the issue but not the only one.
Returning to the issue of health care subsidies, what was needed to bring a vote to the floor of the House of Representatives is known as a discharge petition. It is a vote with enough supporters to require the Speaker to bring it to a vote to the entire House. This is what the legislators previously mentioned did and the resolution or another is now left to the reopening of the House in January.
This is not the end of the story. If a vote to extend the current healthcare subsidies for three years or two or one passes the House it would also still need to go to the Senate for approval.
One Senator, Senator Mike Rounds (R-SD) who sits on the banking, Housing, and Urban Affairs Committee was reported as saying “It’s just strange…There could have been a one-year extension. …<W>e need 60 votes here <to end debate and bring most votes to a final vote on a measure in the Senate>…. I want to vote on something that can actually pass, and I don’t know why that’s not our plan.” Raw Story, December 19, 2025. My daughter has an apt expression “We shall see.”
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.