subsidies

WASHINGTON — In a remarkable rebuke of Republican leadership, the House passed legislation Thursday, in a 230-196 vote, that would extend expired healthcare subsidies for those who get coverage through the Affordable Care Act as renegade GOP lawmakers joined essentially all Democrats in voting for the measure.

Forcing the issue to a vote came about after a handful of Republicans signed on to a so-called “discharge petition” to unlock debate, bypassing objections from House Speaker Mike Johnson. The bill now goes to the Senate, where pressure is building for a similar bipartisan compromise.

Together, the rare political coalitions are rushing to resolve the standoff over the enhanced tax credits that were put in place during the COVID-19 crisis but expired late last year after no agreement was reached during the government shutdown.

“The affordability crisis is not a ‘hoax,’ it is very real — despite what Donald Trump has had to say,” said House Democratic Leader Hakeem Jeffries, invoking the president’s remarks.

“Democrats made clear before the government was shut down that we were in this affordability fight until we win this affordability fight,” he said. “Today we have an opportunity to take a meaningful step forward.”

Ahead of voting, the nonpartisan Congressional Budget Office estimated that the bill, which would provide a three-year extension of the subsidy, would increase the nation’s deficit by about $80.6 billion over the decade. It would increase the number of people with health insurance by 100,000 this year, 3 million in 2027, 4 million in 2028 and 1.1 million in 2029, the CBO said.

Growing support for extending ACA subsidies

Johnson (R-La.) worked for months to prevent this situation. His office argued Thursday that federal healthcare funding from the COVID-19 era is ripe with fraud, pointing to an investigation in Minnesota, and urged a no vote.

On the floor, Republicans argued that the subsidies as structured have contributed to fraud and that the chamber should be focused on lowering health insurance costs for the broader population.

“Only 7% of the population relies on Obamacare marketplace plans. This chamber should be about helping 100% of Americans,” said Rep. Jason Smith (R-Mo.), chair of the House Ways and Means Committee.

While the momentum from the vote shows the growing support for the tax breaks that have helped some 22 million Americans have access to health insurance, the Senate would be under no requirement to take up the House bill.

Instead, a small group of senators from both parties has been working on an alternative plan that could find support in both chambers and become law. Senate Majority Leader John Thune (R-S.D.) said that for any plan to find support in his chamber, it will need to have income limits to ensure that the financial aid is focused on those who most need the help. He and other Republicans also want to ensure that beneficiaries would have to at least pay a nominal amount for their coverage.

Finally, Thune said there would need to be some expansion of health savings accounts, which allow people to save money and withdraw it tax-free as long as the money is spent on qualified medical expenses.

Sen. Jeanne Shaheen (D-N.H.), who is part of the negotiations on reforms and subsidies for the Affordable Care Act, said there is agreement on addressing fraud in healthcare.

“We recognize that we have millions of people in this country who are going to lose — are losing, have lost — their health insurance because they can’t afford the premiums,” Shaheen said. “And so we’re trying to see if we can’t get to some agreement that’s going to help, and the sooner we can do that, the better.”

Trump has pushed Republicans to send money directly to Americans for health savings accounts so they can bypass the federal government and handle insurance on their own. Democrats largely reject this idea as insufficient for covering the high costs of healthcare.

Republicans bypass their leaders

The action by Republicans to force a vote has been an affront to Johnson and his leadership team, who essentially lost control of what comes to the House floor as the Republican lawmakers joined Democrats for the workaround.

After last year’s government shutdown failed to resolve the issue, Johnson had discussed allowing more politically vulnerable GOP lawmakers a chance to vote on another healthcare bill that would temporarily extend the subsidies while also adding changes.

But after days of discussions, Johnson and the GOP leadership sided with the more conservative wing, which has assailed the subsidies as propping up ACA, which they consider a failed government program. He offered a modest proposal of healthcare reforms that was approved, but has stalled.

It was then that rank-and-file lawmakers took matters into their own hands, as many of their constituents faced soaring health insurance premiums beginning this month.

Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan Mackenzie, all from Pennsylvania, and Mike Lawler of New York, signed the Democrats’ petition, pushing it to the magic number of 218 needed to force a House vote. All four represent key swing districts whose races will help determine which party takes charge of the House next year.

Trump encourages GOP to take on healthcare issue

What started as a long shot effort by Democrats to offer a discharge petition has become a political vindication of the Democrats’ government shutdown strategy as they fought to preserve the healthcare funds.

Democrats are making clear that the higher health insurance costs many Americans are facing will be a political centerpiece of their efforts to retake the majority in the House and Senate in the fall elections.

Trump, during a lengthy speech this week to House GOP lawmakers, encouraged his party to take control of the healthcare debate — an issue that has stymied Republicans since he tried, and failed, to repeal Obamacare during his first term.

Mascaro and Freking write for the Associated Press. AP writer Matt Brown contributed to this report.

Jan. 1 (UPI) — Insurance premiums are set to rise exponentially for Americans who have bought their health care policies through an Affordable Care Act exchange because Congress failed to extend subsidies for them.

Without the extension of the subsidies, people who have bought their health insurance through an ACA exchange will see their premiums increase by roughly 26% on average, with the increases expected to be higher in states that use the federal Healthcare.gov exchange while states that run their own exchanges may see lower increases, The Hill reported.

In 2025, about 24 million Americans bought health insurance through an ACA exchange, which are often referred to as Obamacare, which is the highest number of people who bought policies through the program since it debuted in 2010.

The government shutdown in the fall — which, at 43 days, was the longest in history — was centered around Democrats in the U.S. Senate pushing for an extension of enhanced ACA subsidies that were introduced during the COVID-19 pandemic to help Americans obtain insurance and care.

In recent weeks, bipartisan plans to extend the subsidies have emerged, including one in the Senate that calls for a three-year extension of the subsidies.

Among the Republicans who support the bipartisan bill are Missouri Sen. Josh Hawley, who has not specifically commented on extending the subsidies but has said that he is concerned about people whose health insurance costs may increase in the ongoing absence of Congressional action, Fox News reported.

“I think who it’s most disappointing for are the people whose premiums are going to go up by two, three times,” Hawley told reporters this week. “So, it’s not good.”

During the shutdown, Democrat members of Congress pushed for an extension — it was their stated reason for voting against several bills to fund the federal government, causing and extending the shutdown — which Senate Majority Leader John Thune, R-S.D., promised a vote on in mid-December.

Once the government reopened, the Senate voted on two health care related bills, one from Democrats and the other from Republicans, and both failed on party line votes.

1 of 3 | House Minority Leader Hakeem Jeffries, D-NY, said Sunday that he expects the House to pass a three-year extension of tax credits for people buy health insurance through Affordable Care Act exchanges. Photo by Bonnie Cash/UPI | License Photo

Dec. 21 (UPI) — House Minority Leader Rep. Hakeem Jeffries, R-N.Y., said Sunday that he expects lawmakers to pass a bipartisan compromise on extending Affordable Care Act tax credits.

Jeffries said on ABC News’ “This Week” that lawmakers will pass a bi-partisan compromise to extend ACA tax credits extension in the House, potentially forcing Senate Republicans hand on health insurance subsidies for at least 22 million Americans who will face higher premiums in the new year.

Congress adjourned for Christmas without reaching a deal on extending on the tax credits, which Jeffries promised that House lawmakers will address in early January.

“That will put pressure on John Thune and Senate Republicans to actually do the right thing by the American people, pass a straightforward extension of the Affordable Care Act tax credits, so we can keep health care affordable for tens of millions of Americans who deserve to be able to go see a doctor when they need one,” Jeffries said.

Democrats have said if the two sides are unable to reach a deal on an extension, they will wield it against Republicans in next year’s midterm elections.

Rep. Pat Ryan, D-N.Y., has said access to affordable health care remains among the most pressing issues among voters.

“It’s just pathetic,” Ryan said. “The last time there was a major national Republican effort to repeal the ACA, we had an overwhelming wave where they got absolutely wiped out, and I think that’s likely what will happen here again.”

A handful of centrist Republicans in vulnerable congressional districts bypassed the authority of House Speaker Mike Johnson to team up with key Democrats to authorize a vote on a three-year tax credit extension when the House returns to Washington the week of Jan. 5.

Some Republican leaders have said they favor allowing Covid-era tax credits that made health care more affordable for millions of Americans to expire or be phased out over several years. Other members of the GOP, however, have said they favor extending the credits for longer.

By a vote of 51-48 Thursday, the Senate rejected a three year ACA extension with four Democrats joining the GOP to vote it down.

An expanded federal healthcare subsidy that grew out of the pandemic looks all but certain to expire on December 31, as Republican leaders in the United States faced a rebellion from within their own ranks.

On Wednesday, four centrist Republicans in the House of Representatives broke with their party’s leadership to support a Democratic-backed extension for the healthcare subsidies under the Affordable Care Act (ACA), sometimes called “Obamacare”.

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By a vote of 204 to 203, the House voted to stop the last-minute move by Democrats, aided by four Republicans, to force quick votes on a three-year extension of the Affordable Care Act subsidy.

Democrats loudly protested, accusing Republican leadership of gavelling an end to the vote prematurely while some members were still trying to vote.

“That’s outrageous,” Democratic Representative Jim McGovern of Massachusetts yelled at Republican leadership.

Some of the 24 million Americans who buy their health insurance through the ACA programme could face sharply higher costs beginning on January 1 without action by Congress.

Twenty-six House members had not yet voted – and some were actively trying to do so – when the House Republican leadership gavelled the vote closed on Wednesday. It is rare but not unprecedented for House leadership to cut a contested vote short.

Democratic Representative Rosa DeLauro of Connecticut said the decision prevented some Democrats from voting.

“Listen, it’s playing games when people’s lives are at stake,” DeLauro said. “They jettisoned it.”

It was the latest episode of congressional discord over the subsidies, which are slated to expire at the end of the year.

The vote also offered another key test to the Republican leadership of House Speaker Mike Johnson. Normally, Johnson determines which bills to bring to a House vote, but recently, his power has been circumvented by a series of “discharge petitions”, wherein a majority of representatives sign a petition to force a vote.

In a series of quickfire manoeuvres on Wednesday, Democrats resorted to one such discharge petition to force a vote on the healthcare subsidies in the new year.

They were joined by the four centrist Republicans: Mike Lawler of New York and Brian Fitzpatrick, Robert Bresnahan and Ryan MacKenzie of Pennsylvania.

The Democratic proposal would see the subsidies extended for three years.

But Republicans have largely rallied around their own proposal, a bill called the Lower Health Care Premiums for All Americans Act. It would reduce some insurance premiums, though critics argue it would raise others, and it would also reduce healthcare subsidies overall.

The nonpartisan Congressional Budget Office (CBO) on Tuesday said the legislation would decrease the number of people with health insurance by an average of 100,000 per year through 2035.

Its money-saving provisions would reduce federal deficits by $35.6bn, the CBO said.

Republicans have a narrow 220-seat majority in the 435-seat House of Representatives, and Democrats are hoping to flip the chamber to their control in the 2026 midterm elections.

Three of the four Republicans who sided with the Democrats over the discharge petition are from the swing state of Pennsylvania, where voters could lean right or left.

Affordability has emerged as a central question ahead of the 2026 midterms.

Even if the Republican-controlled House manages to pass a healthcare bill this week, it is unlikely to be taken up by the Senate before Congress begins a looming end-of-year recess that would stop legislative action until January 5.

By then, millions of Americans will be looking at significantly more expensive health insurance premiums that could prompt some to go without coverage.

Wednesday’s House floor battle could embolden Democrats and some Republicans to revisit the issue in January, even though higher premiums will already be in the pipeline.

Referring to the House debate, moderate Republican Senator Lisa Murkowski told reporters: “I think that that will help prompt a response here in the Senate after the first of the new year, and I’m looking forward to that.”

The ACA subsidies were a major point of friction earlier this year as well, during the historic 43-day government shutdown.

Democrats had hoped to extend the subsidies during the debate over government spending, but Republican leaders refused to take up the issue until a continuing budget resolution was passed first.

WASHINGTON — Four centrist Republicans broke with Speaker Mike Johnson on Wednesday and signed onto a Democratic-led petition that will force a House vote on extending for three years an enhanced pandemic-era subsidy that lowers health insurance costs for millions of Americans.

The stunning move comes after House Republican leaders pushed ahead with a health care bill that does not address the soaring monthly premiums that millions of people will soon endure when the tax credits for those who buy insurance through the Affordable Care Act expire at year’s end.

Democrats led by Minority Leader Hakeem Jeffries of New York needed 218 signatures to force a floor vote on their bill, which would extend the subsides for three years.

Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan Mackenzie, all from Pennsylvania, and Mike Lawler of New York signed on Wednesday morning, pushing it to the magic number of 218. A vote on the subsidy bill could come as soon as January under House rules.

“Unfortunately, it is House leadership themselves that have forced this outcome.” Fitzpatrick said in a statement.

Origins of a Republican revolt

The revolt against GOP leadership came after days of talks centered on the health care subsidies.

Johnson, R-La., had discussed allowing more politically vulnerable GOP lawmakers a chance to vote on bills that would temporarily extend the subsidies while also adding changes such as income caps for beneficiaries. But after days of discussions, the leadership sided with the more conservative wing of the party’s conference, which has assailed the subsidies as propping up a failed marketplace through the ACA, which is widely known as “Obamacare.”

House Republicans pushed ahead Wednesday a 100-plus-page health care package without the subsidies, instead focusing on long-sought GOP proposals designed to expand insurance coverage options for small businesses and the self-employed.

Fitzpatrick and Lawler tried to add a temporary extension of the subsidies to the bill, but were denied.

“Our only request was a floor vote on this compromise, so that the American People’s voice could be heard on this issue. That request was rejected. Then, at the request of House leadership I, along with my colleagues, filed multiple amendments, and testified at length to those amendments,” Fitzpatrick said. “House leadership then decided to reject every single one of these amendments.

“As I’ve stated many times before, the only policy that is worse than a clean three-year extension without any reforms, is a policy of complete expiration without any bridge,” Fitzpatrick said.

Lawler, in a social media post, similarly said that “the failure of leadership” to permit a vote had left him with “no choice” but to sign the petition. He urged Johnson to bring the plan up for an immediate floor vote.

Path ahead is uncertain

Even if the subsidy bill were to pass the House, which is far from assured, it would face an arduous climb in the Republican-led Senate.

Republicans last week voted down a three-year extension of the subsidies and proposed an alternative that also failed. But in an encouraging sign for Democrats, four Republican senators crossed party lines to support their proposal.

Senate Majority Leader John Thune, R-S.D., argued against the Democratic extension as “an attempt to disguise the real impact of Obamacare’s spiraling health care costs.”

Freking writes for the Associated Press.