12.02.25 - Where riders can show up and why it matters

Reporting suggests that Republicans in Congress are facing serious pressure to attach harmful policy riders to any proposal targeting soaring health care costs. Here’s a brief backgrounder on riders, their implications, and why it’s important to keep an eye out for them even when they aren’t bound for the President’s desk—yet.

Members of Congress routinely work to insert pet provisions into bills they believe are likely to become law. This is especially true for appropriations bills—bills that have to become law to avoid a government shutdown. Members can use appropriations bills to restrict federal funding and make sure it doesn’t pay for specific things, or to prohibit federal agencies from taking certain actions.

Provisions like these are often called “riders” because they advance by hitching a “ride” on a moving legislative vehicle. 

On their own, these provisions might be unlikely to become law, either because they’re not a high priority for other Members or because they lack sufficient support—but if they’re folded into another vehicle that has legs, they might just make it into law. 

And once riders become law, they might stay that way.

Riders then 

I’ll give one example of a long-standing policy rider: the Hyde Amendment, first passed in 1976 and named for its author, the late Congressman Henry J. Hyde. 

The Hyde Amendment prohibited coverage of abortion care under Medicaid. For decades, it’s been attached to the annual appropriations bill that funds the Department of Health and Human Services. This prevents insurance programs run by HHS—like Medicaid, Medicare, CHIP, and the Indian Health Service—from covering abortion care. Over time, Congress attached the Hyde Amendment to other appropriations bills, too, subjecting even more Americans to bans on abortion care. 

The fact that this rider is still blocking access to health care nearly 50 years after it first passed speaks to the long-lasting implications riders can have. 

Riders Now

As we come up on the end of the year and Congress scrambles to finish the big items on its agenda, we’re likely to see votes in both the House and Senate to finalize the annual National Defense Authorization Act (NDAA) and a Senate vote on Democratic legislation to avoid massive spikes in health insurance premiums next year, per last month’s agreement to reopen the government. We may also see votes on more appropriations bills to fund the government through September.

Members will undoubtedly attempt to attach policy riders to these bills—namely, the NDAA and appropriations bills, given that they’re more likely to become law. But even health care proposals that aren’t poised to become law imminently could be fodder for harmful riders. 

It’s true that the agreement to reopen the government only requires the Senate to hold a vote on a Democratic health care bill. It doesn’t guarantee enough GOP votes for the bill to pass, a vote in the House, or the President’s signature. In other words, this vote is largely symbolic.

But even a symbolic measure matters. It will show, on the record, what senators are willing—or unwilling—to support. That helps clarify which policies or riders might eventually make it into a real health care deal down the road to address the premium spikes expected in 2026.

That’s why riders matter even when a bill has no clear path to becoming law—and advocates are acting accordingly. Anti-abortion groups, for instance, are pressuring Republicans to support even more abortion bans as part of any health care proposal. Republicans could also use health care legislation as a vehicle to further attack the trans community and immigrant families.

The upshot

There’s been a flood of reporting on how Congress might address skyrocketing health care premiums, and it’s tough to track risks in proposals that may or may not ever materialize. But this is where things stand.

By the end of the month, we could see a symbolic Senate vote on a Democratic health care bill, a House discharge petition on health care, and possibly even a House GOP proposal on premium relief. It’s not clear that any of these options will actually produce a solution in time to bring down Americans’ health care costs next year.

What is clear is that how Members vote on these proposals—and the riders attached to them—will reveal what they are and aren’t willing to accept in a future deal. Even backing a dead-on-arrival proposal that includes a harmful rider can legitimize that rider and make it more likely to appear in a viable proposal later.

And as the 50-year-old Hyde Amendment shows us, once the door to a harmful rider opens, it can be very hard to close it again. So, keep your eyes peeled—and we’ll keep you posted. 

If you’d like a live update for your group or coalition, reach out to catherine@webuildprogress.org. Thanks!