Stalled bills, looming shutdown: Why it matters that there's no House speaker

In late September, a rare bipartisan bill was nearing the finish line in the House.

The draft legislation, which had been in the works for months, would penalize hospitals, labs and surgical centers if they didn't publicly list their prices.

While a key part of the bill, introduced by Republican Rep. Cathy McMorris Rodgers, wouldn't take effect until 2026 -- the government would need time to work with hospitals on compliance -- lawmakers felt that they had found a concrete way of helping Americans to avoid landing in medical debt.

After months of staff negotiations, the bill emerged from three separate committees as a bipartisan triumph. Supporters believed they could easily push the legislation through the House with the right maneuvering.

Then, everything on the House floor stopped.

A revolt by a small group of far-right Republicans nearly shut down the government and led to the ouster of the top GOP leader. The unprecedented move to unseat House Speaker Kevin McCarthy turned half of Congress into a rudderless ship.

Now, Republican rivals are jockeying to replace him, and no one is empowered to set a legislative agenda or advance bills.

"We're determined to get this across the finish line this year. But we're in a holding pattern as we wait to resolve the Speaker's race," said CJ Young, a spokesperson for Rep. Frank Pallone of New Jersey, the top Democrat on the House Energy and Commerce Committee and co-sponsor of the bill.

What's at stake

As House Republicans scramble to find their next speaker, the implications of a paralyzed House are sweeping. The hospital pricing bill is one of several promising legislative efforts now stuck in limbo.

Among the biggest challenges for the next House speaker will be getting Republicans to agree on how to fund the government. If that doesn't happen by Nov. 17, an estimated 3.5 million federal workers would lose pay, including two million military service members. An unknown number of federal contractors, including janitors, cafeteria workers and security guards, could also be out of work.

Some 700,000 employees like border patrol agents and air traffic controllers would be asked to come to work during a period when they would forego pay.

Federal employees -- not contractors -- would eventually qualify for back pay. Still, union officials warn that many federal employees will struggle to put gas in their cars or pay for childcare. During the last shutdown, which stretched five weeks into January 2019, federal airport workers eventually stopped showing up for work. The staffing shortages triggered long lines and flight delays.

Aid to Ukraine also hangs in the balance. The Pentagon and State Department both back continued foreign aid as a means to deter Russian aggression in Europe. As a member of NATO, U.S. officials worry the nation could be dragged into war if Ukraine isn't successful.

While some House conservatives are balking at the idea of sending any aid to Ukraine, or want to attach conditions, not having a House speaker means that a debate on aid can't happen.

"It does worry me," President Joe Biden told reporters on Wednesday of a Ukraine bill sinking in the House. "But I know there are a majority of members of the House and Senate in both parties who have said that they support funding Ukraine."

What happens next

As for the hospital transparency bill, aides on Capitol Hill said they remain hopeful.

The idea behind the "Lower Costs, More Transparency Act" had been championed by the Trump administration and quickly found support among Democrats. Some hospitals were ignoring federal regulation on the matter, advocates argued, and lawmakers agreed the best path was to throw in "sticks" to ensure compliance.

Industry groups oppose the measure, insisting it will add unnecessary "regulatory burdens" on the health care system.

"More than 60% of Americans are living paycheck to paycheck. It means they are just one medical bill away from a financial emergency. One doctor visit away from not being able to pay their rent, for their groceries, or gas," said House Energy and Commerce Committee Chair Cathy McMorris Rodgers, a Washington Republican and co-sponsor of the bill.

Biden, who focused his remarks Wednesday on the looming government shutdown and Ukraine aid, said it was important for the House to return to business.

"We have a lot of work to do, and the American people expect us to get it done," he said.