WASHINGTON 

The US House of Representatives passed a Republican health care measure Wednesday that omits an extension of soon-to-expire tax credits relied on by millions of Americans to help them afford coverage under the Affordable Care Act (ACA), or Obamacare.

The Lower Health Care Premiums for All Americans Act was passed in a 216-211 vote. Rep. Thomas Massie was the sole Republican to vote against the bill.

Republican leaders rolled out the proposal less than a week ago amid growing pressure from party moderates to bring a vote on extending the enhanced premium tax credits in the ACA that are set to expire Dec. 31.

The legislation’s prospects remain uncertain in the Senate, where passage would require backing from multiple Democrats.

Before voting, House Speaker Mike Johnson told reporters that the bill delivers commonsense reforms to lower premiums, expand access, increase choice and flexibility, and bring transparency to health care. It would cut premium costs by at least 11% and save taxpayers nearly $30 billion.

He contrasted the Republican bill with a push by Democrats to extend enhanced ACA premium subsidies that were enacted during the coronavirus pandemic.

Johnson argued that extending subsidies is not an effective way to reduce health care costs and accused Democrats of prioritizing politics over policy.

"The Democrats broke America's health care system. When they gave us the ACA, the unaffordable care act 15 years ago, they promised that premiums would come down, that access would increase in quality of health care would increase. None of that happened because it's a flawed system," he said.

Earlier, the House approved a procedural motion in a 204 - 203 vote, blocking a late push by Democrats -- joined by four Republicans -- to force expedited votes on a three-year extension of ACA subsidies.

The move sparked loud protests from Democrats, who accused Republican leaders of ending the vote prematurely while some lawmakers were still attempting to cast their votes.

"That's outrageous," Democratic Rep. Jim McGovern yelled at Republican leadership.

House rules allow Democrats to demand a vote on their proposed three-year extension, but Johnson said he would delay scheduling a vote until Congress reconvenes the first week of January, after a recess that is expected to begin later this week.

Without congressional action, some of the roughly 24 million Americans who purchase coverage through the ACA could see their health insurance costs rise sharply starting Jan. 1.