The House has a new speaker, Mike Johnson (R-La.), who now grapples with the challenges facing Rep. Kevin McCarthy (R-Calif.) in securing ample Republican votes for legislative approval. In the immediate future, he must address the FY 2024 appropriations before the looming Nov. 17 deadline.
Furthermore, he must navigate a path forward for several “extenders” that lapsed at the end of September and have been in a state of inertia. These include the Pandemic and All-Hazards Preparedness Act (PAHPA), funding for community health centers, initiatives against opioid abuse, and the PEPFAR program dedicated to combatting AIDS and HIV.
Although Johnson has only served four terms in Congress, his legislative history underscores his staunch support for anti-abortion and anti-LGBTQ measures. He has sponsored no fewer than three bills aimed at restricting abortion at the national level: 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. Additionally, he voted against legislation aimed at codifying same-sex marriage into law.
As chairman of the Republican Study Commission, he was the architect of the group’s healthcare plan in 2019 and its fiscal year 2020 budget. The 2019 healthcare plan revisited many 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 the establishment of high-risk pools instead of guaranteed coverage for individuals with pre-existing conditions.
The 2020 budget called for raising the eligibility age for Medicare and transforming Medicare into a premium support program where private plans compete with traditional Medicare. Rather than a guaranteed benefit, beneficiaries would use a voucher to purchase coverage through either a private plan or Medicare.
Despite a decreased focus on replacing the Affordable Care Act in recent years, the ideas presented in the 2020 budget and 2019 healthcare plan continue to resonate with conservative ideals. If Republicans gain control of Congress and the White House after the 2024 election, these policies could offer insight into their healthcare priorities.