It should be a relatively easy problem to solve.

Twenty-four million Americans face whopping increases in their health insurance premiums starting next month, increases of hundreds if not thousands of dollars a year. These are the self-employed or employees of small businesses and their families who, because they don’t get health insurance from employers, buy insurance on the exchanges created by the Affordable Care Act, or Obamacare, as it is most commonly called.

Although these policies have always been government-subsidized to a degree, depending on income, the level of government support was temporarily increased during the COVID-19 pandemic by adding new tax credits. Those tax credits are now set to expire just as ACA premiums, and everywhere else, are about to take a sharp jump because of rapidly rising medical costs. 

Democrats, looking for an issue on which to take a stand against President Donald Trump and the Republican majorities in the House and Senate that have cut them out of the legislative process, insisted the tax credits be extended. When Republicans refused, Democrats shut down the government for more than a month. It ended when eight of their more moderate senators voted to end the shutdown in return for a promise that there would be a vote on the premium subsidies question by the middle of December. 

The question is, a vote on what?

The outlines of a bipartisan deal were obvious from the start.

To win Democratic votes, extend most of the subsidies for most households for at least two years. 

For Republicans, phase out subsidies once household income reaches 400 percent of poverty, require all households to pay a token amount toward their premiums and make sure those who chose less expensive, high-deductible bronze plans that Republicans favor get as much subsidy as those choosing the comprehensive plans that Democrats like. 

And to give both parties political cover on the all-important “affordability” issue, commission a blue-ribbon panel to come up with recommendations on how to significantly reduce and restrain health care spending. 

Such a plan would give both parties the opportunity to declare a political win and be welcomed by a majority of Americans. Yet the betting is that such a bipartisan compromise won’t be enacted — indeed, it may not get a vote in either chamber. And the reasons tell you almost everything you need to know about why Congress has lost its power and relevancy. 

The first excuse you hear is that “there isn’t enough time” to resolve the issue. 

For months now, industry experts have been warning about the coming sticker shock. But such warnings are routinely ignored by a Congress that is addicted to last-minute brinkmanship, with any looming deadline treated as an opportunity to gain negotiating leverage over the other.

Democrats hoped to use the threat of a government funding shutdown to force Republicans to extend the credits. Now Republicans see the huge premium increases as a chance to extract changes to the Affordable Care Act itself. 

What should have happened is that the committees that have jurisdiction and expertise in this area should have held serious hearings over the summer and offered up various fixes until a bipartisan consensus emerged. But that didn’t happen because committees no longer take up any issue without the say-so of party leaders.

Unfortunately, party leaders are almost always uninterested in taking on tough issues, knowing that it risks causing division and dissension within their caucuses while alienating key interest groups and campaign contributors. In this case, for example, several dozen moderate Republicans or those in competitive reelection campaigns are eager to spare constituents the health care sticker shock. But an even greater number of hard-core conservatives and partisans oppose doing anything that might fix or enhance the popularity of Obamacare, a program they are determined to repeal — if only they could figure out something credible to replace it.

Meanwhile, anti-abortion activists, seeing a golden opportunity, have vowed to unleash a Christian conservative jihad against any Republican who votes to extend the tax credits without a new provision declaring that no insurance policies sold on or off the exchanges provide any coverage for abortions — a poison pill that everyone knows no Democrat could swallow. 

Eager to avoid an intraparty fight and derail the push for a bipartisan compromise, Republican leaders and committee chairs in both the House and Senate are now scrambling to cobble together an all-Republican proposal that they know can’t be enacted or, indeed, wouldn’t do much about the coming premium increases. (One Republican pollster suggested a “pivot” to drug prices.) But at least it would allow Republicans to claim they tried to do something about health care affordability.  

It’s not much different across the aisle.

Most Democrats in the House and Senate are still steaming about what they view as the treasonous defection of their eight colleagues who snatched defeat from the jaws of victory by ending the shutdown. And, as they see it, any bipartisan compromise would allow vulnerable Republicans the chance to vote for an extension and deny Democrats a potent political issue to use against them in the next election.

Their strategy is to offer up a “clean” three-year extension of the existing tax credits, knowing it will fail. Never mind that the tax credits were enacted as a temporary measure to deal with an economic and medical emergency that has passed that add $35 billion a year to an already out-of-control budget deficit. Never mind that the way the subsidies are structured, insurance companies have little incentive to hold down premium increases. And never mind that the compromises being talked about would extend most of the subsidies for most of those 24 million who now benefit from them.

The prevailing view within the Democratic caucuses is that they have Republicans on the run and that any bipartisan compromise would amount to a spineless acquiescence that lets the GOP off the hook.

So with only weeks before the higher premiums kick in, the task of actually solving the problem has fallen, as it often does, to a handful of bipartisan “gangs” whose members aren’t on the relevant committees, who don’t have the support of their party leaders or the majority of their caucuses, who would struggle to hammer out a reasonable compromise that might attract the 60 votes needed to overcome an inevitable Senate filibuster — with no guarantee that it would be taken up in the Republican House, where a badly weakened speaker more accustomed to taking his marching orders from Trump is unlikely to allow a vote on anything billed as a bipartisan compromise. 

Good luck with that.

One of the problems with having a Congress that accomplishes so little is that any issue that does manage to bubble to the surface is invested with so much imagined significance that anything less than total victory is viewed by both parties as a crushing defeat from which they, and the country, will never recover.  

In truth, the country will survive no matter what happens to tax credits that affect only 6 percent of the population. What it won’t survive is having a Congress that is so caught up in partisan gamesmanship that it cannot allow itself to resolve that and scores of other urgent and easily resolved issues in the most straightforward and democratic manner — by opening up the process to allow members to debate and vote on a variety of ideas until one emerges that a majority can accept. 

Steven Pearlstein is the director of the Fixing Congress Initiative at the University of Pennsylvania. He was a longtime writer and columnist for The Washington Post. He is also Robinson Professor of Public Affairs at George Mason University. The views expressed here are his own.