House Republicans passed a conservative health-care bill that does not extend enhanced Affordable Care Act tax credits set to expire at the end of the month, following a discharge petition by four moderate Republicans that forced the issue.The Lower Health Care Premiums for All Americans Act cleared the House 216-211 amid opposition from Democrats and Rep. Thomas Massie, and the CBO said it would lower benchmark premiums by about 11% and cut the deficit by $35.6 billion through 2035 while reducing enrollment by roughly 100,000 people per year.The vote exposed a rift in the Republican conference after talks between GOP leaders and centrists broke down; moderates Brian Fitzpatrick, Mike Lawler, Rob Bresnahan and Ryan Mackenzie signed the petition while Democrats pressed a three-year clean extension that still faces an uphill path in the Senate and a final House vote is expected after members return Jan 6.