Healthcare Overhaul: New Speaker’s Ambitious Plans

The House welcomes its new speaker, Mike Johnson (R-La.), who inherits the challenge of securing Republican votes for legislative approval, much like Rep. Kevin McCarthy (R-Calif.). His immediate focus is the FY 2024 appropriations, with a looming deadline of Nov. 17.

In addition, he faces the task of navigating the revival of several “extenders” that lapsed at the end of September, now in a state of inertia. These include vital initiatives like the Pandemic and All-Hazards Preparedness Act (PAHPA), funding for community health centers, efforts to combat opioid abuse, and the PEPFAR program dedicated to fighting AIDS and HIV.

While Johnson’s congressional tenure spans only four terms, his legislative history underscores his unwavering support for anti-abortion and anti-LGBTQ measures. He has sponsored three bills aimed at national abortion restrictions: the Pain-Capable Unborn Child Protection Act, the Protecting Pain-Capable Unborn Children From Late-Term Abortions Act, and the Heartbeat Protection Act of 2021. Furthermore, he voted against legislation seeking to codify same-sex marriage into law.

As the chairman of the Republican Study Commission, Johnson played a pivotal role in crafting the group’s healthcare plan in 2019 and the fiscal year 2020 budget. The 2019 healthcare plan revisited several Republican proposals for repealing and replacing the Affordable Care Act. It advocated for capping federal Medicaid funds and expanding health savings accounts, while also proposing high-risk pools as an alternative to guaranteed coverage for individuals with pre-existing conditions.

The 2020 budget proposed raising the eligibility age for Medicare and transitioning it into a premium support program, where private plans would compete with traditional Medicare. Instead of a guaranteed benefit, beneficiaries would use vouchers to purchase coverage through private plans or Medicare. These ideas, despite the reduced focus on replacing the Affordable Care Act in recent years, continue to align with conservative ideals. If Republicans regain control of Congress and the White House post the 2024 election, these policies may shape their healthcare priorities.