H.R. 498 – Do No Harm in Medicaid Act; H.R. 3492 – Protect Children's Innocence Act; H.R. 6703 – Lower Health Care Premiums for All Americans Act

House Rules and Floor ProcedureHouse Rules · 2025-12-16 · 119th Congress
The House Rules Committee met to set the terms of floor debate for three bills: H.R. Begins at 0:38:46
Transcript
Highlights

Title

Rules Committee debate on GOP health premium bill and ACA tax credit expiration

Purpose

The House Rules Committee met to set the terms of floor debate for three bills: H.R. 6703 (Lower Health Care Premiums for All Americans Act), H.R. 498 (Do No Harm in Medicaid Act, restricting federal funds for gender-transition procedures), and H.R. 3492 (Protect Children's Innocence Act, criminalizing gender-affirming care for minors). The hearing occurred as enhanced ACA premium tax credits were set to expire at year's end, and much of the debate centered on whether Republicans would allow floor votes on Democratic amendments to extend those credits. Begins at0:38:46

Who spoke

Chair Virginia Foxx (R-NC)0:38:46: Opened by describing premiums as "skyrocketing" and introduced H.R. 6703 as a Republican alternative to the ACA0:39:38, H.R. 498's ban on federal funding for gender transition procedures for minors0:41:21, and H.R. 3492 criminalizing "gender affirming care" for children0:42:39.

Rep. Jim McGovern (D-MA), Ranking Member0:43:50: Said this would likely be the last Rules Committee meeting of the year and accused Republicans of doing "absolutely nothing" as premiums are set to double or quadruple0:44:19; cited enrollment rising to 24.3 million with 88% in states Trump won0:45:11; noted 214 Democrats have signed a discharge petition to extend the ACA tax credits0:49:29; argued the bills target transgender Americans while ignoring health costs0:50:10.

Rep. Brett Guthrie (R-KY), Chairman, Energy and Commerce0:51:54: Testified deductibles average around $9,000 with $6,000+ out-of-pocket maximums under the ACA0:52:51; said the enhanced credits were designed by Democrats to expire and criticized them as benefiting people who never file insurance claims1:31:291:32:01; sparred with McGovern over whether the bill funds HSAs (it does not)2:02:25.

Rep. Frank Pallone (D-NJ), Ranking Member, Energy and Commerce0:57:13: Argued the ACA was created because people couldn't get affordable insurance and that current GOP proposals don't address that need0:57:46; criticized "junk health plans" that don't cover essential services1:01:26.

Rep. Diana Harshbarger (R-TN)1:03:59 (Chairman Fox referenced but Harshbarger opening statement begins here): Described family premium increases and touted the bill's transparency provisions for pharmacy benefit managers (PBMs)1:08:37.

Rep. Kim Schrier (D-WA)1:09:34 (introduced as "Ms." on the health subcommittee): Argued the bill would strip health coverage from millions and accused Republicans of using this hearing as "another" attempt to weaken ACA protections, including allowing junk policies and discrimination against preexisting conditions1:15:22.

Rep. Erin Houchin (R-IN)1:16:14: Advocated for Association Health Plans (H.R. 2571/AHP Act) and the Self-Insurance Protection Act, framing them as ways for small businesses to gain bargaining power similar to large employers1:17:001:18:39.

Rep. Lori Trahan (D-MA)1:20:54: Called the bill a "recycled, futile attempt" that would let association plans medically underwrite premiums and cause a "death spiral" for ACA risk pools by drawing healthy enrollees away1:21:231:23:11; also criticized weakened stop-loss insurance oversight1:24:25.

Rep. Diana DeGette (D-CO)1:57:22 (referred to as "Miss Fischback" area but transcript shows a Colorado member; likely Rep. Neguse based on later reference): Pushed back on dismissive treatment of the "small portion" of Americans affected by subsidy expiration, citing hundreds of thousands of Coloradans1:57:46.

Rep. Michelle Fischbach (R-MN)1:47:31: Clarified that the credits at issue are "enhanced" COVID-era subsidies, not original ACA subsidies, and cited a GAO report finding fraud including subsidies paid to dead enrollees1:53:391:54:31.

Rep. Ralph Norman (R-SC)2:14:43: Asked about waste, fraud and abuse in subsidized enrollment, citing GAO findings that a test found 20 of 24 fictitious applications were approved for subsidies2:16:372:17:02; also referenced Social Security numbers of deceased people being used2:19:07.

Rep. Teresa Leger Fernández (D-NM)3:10:49 (second panel, abortion-related testimony continues into a member's remarks): Told personal constituent stories about denial of care during miscarriage/ectopic pregnancy risk under state abortion restrictions tied to insurance access3:10:493:14:43.

Rep. Jared Golden or unidentified Kentucky-area member (described only by role, "a committee member")3:19:02: Discussed a constituent whose association health coverage collapsed due to mismanagement3:19:02.

Rep. Suzan DelBene / Bonamici area — "Ms." introduced witness3:47:11: (Second panel opening) On H.R. 498/3492, argued Medicaid work requirements and related cuts are framed as targeting waste but harm vulnerable populations including children and people with disabilities3:47:58.

Rep. Jamie Raskin (D-MD)3:59:10: Testified the bill would criminalize doctors for prescribing puberty blockers, comparing the decision to his own family's private medical choice for his daughter's nose injury4:00:29; called the bill an example of scapegoating a "small minority" and warned some families are considering leaving the country4:03:194:03:47.

Rep. Chip Roy (R-TX)4:36:14: Read testimony from a constituent describing a mastectomy at 15 and resulting scarring, arguing minors shouldn't be told "what to do with their own skin"4:36:504:37:11; separately raised constitutional concerns about federal criminalization under the Commerce Clause4:38:10.

Rep. Brian Fitzpatrick (R-PA)4:44:38: Presented his own amendment for a two-year extension of enhanced premium tax credits with income caps at 700% of the poverty line and fraud-prevention reforms4:45:314:46:25.

Rep. Hillary Scholten or "Sparks" (identified in transcript as "Sparks")4:56:18: Withdrew her own amendments but criticized the overall bill as a messaging exercise rather than real reform, calling for bipartisan work in January4:57:024:58:27.

Rep. Mary Scanlon (D-PA)5:15:02: Questioned Fitzpatrick on whether Republican leadership would honor a "current policy baseline" for extending tax credits given precedent set on other tax bills5:15:17.

Rep. Emilia Sykes (D-OH)5:46:22: Offered an amendment to prohibit cost-sharing restrictions that would force ACA marketplace plans to drop abortion coverage, citing 3.7 million enrolled in ACA coverage with abortion benefits as of 20235:46:535:47:21.

Key moments

McGovern stated 214 Democrats have signed a discharge petition to force a vote extending ACA premium tax credits, and challenged Republicans to join0:49:29.

Guthrie and Pallone clashed over whether pre-ACA insurance was adequate, with Pallone arguing "junk" policies didn't cover basic hospitalization0:57:461:01:26.

Trahan argued the AHP bill would let association plans "medically underwrite" premiums, causing a "death spiral" as healthy people leave ACA risk pools for cheaper plans, raising costs for those with preexisting conditions1:21:501:23:11.

Fischbach and Norman cited GAO findings of subsidy fraud: 20 of 24 fictitious test applications were approved, and more than 58,000 (garbled to "59") people receiving subsidies were reportedly deceased1:53:392:16:37.

Guthrie confirmed the underlying bill contains no additional HSA or flexible spending account funding, under direct questioning from a Democratic member2:02:252:02:55.

CBO was cited as estimating roughly 100,000 people would lose insurance under the Republican plan; Guthrie disputed the interpretation of CBO's behavioral modeling2:05:492:06:17.

A member cited insurer stock price increases since ACA passage — Cigna up 916%, UnitedHealth up 540%, and Aetna up 458% — juxtaposed against rising premiums for regular Americans1:51:571:52:25.

Raskin recounted his daughter's own medical decision-making experience to argue against federal intrusion into family medical choices, warning some families may leave the U.S. over the legislation4:00:294:03:47.

Chip Roy read a constituent's testimony describing a mastectomy performed at age 15 and resulting scarring as justification for H.R. 34924:36:50.

Fitzpatrick presented a bipartisan two-year extension amendment for the enhanced premium tax credits with 700%-of-poverty income caps, which he said was "100% paid for," but the amendment was ultimately rejected on a roll call vote4:45:315:45:37.

Metadata

CommitteeHouse Rules
Chamber / CongressHouse · 119th Congress
Date2025-12-16
TypeMeeting
Witnesses
(none listed in event metadata)
Videoyoutube
Transcript604 caption blocks · 20,834 words · 5:50:34 runtime
EventCongress.gov 118783