House speaker says no to Affordable Care Act subsidies vote

Modern Healthcare – Tuesday, December 16, 2025
By Michael McAuliff and Bridget Early

A last minute push by swing-district Republicans to secure a vote to extend enhanced tax credits for federal marketplace health insurance came up short Tuesday.

More than a dozen Republicans had been lobbying for an amendment to a House GOP health plan expected to get a vote Wednesday, but House Speaker Mike Johnson (R-La.) told reporters it will not happen.

The boosted Affordable Care Act subsidies, which Democrats first passed in 2021, are set to expire Jan. 1.

“Many [Republicans] did want to vote on this Obamacare COVID-era subsidy the Democrats created,” Johnson said after a meeting with his conference. “We looked for a way to try to allow for that pressure release valve, and it just was not to be.”

Open enrollment is over for 2026 plans that start at the beginning of the year. The final deadline to sign up for the rest of the year is Jan. 15.

Without any sort of subsidy extension, marketplace enrollees face average premium hikes of 114%, according to analysis by the health research, polling and news organization KFF.

Moderate Republicans were harshly critical of the speaker and of Democratic leaders who have declined to support a handful of bipartisan proposals to keep tax credits for a year or two with modifications and income caps.

“To not have a vote on the extension with reforms, with conservative reforms — income limits, elimination of zero premium plans, [pharmacy benefit manager] reform, HSA expansion — to not do that is idiotic. It is political malpractice,” said Rep. Mike Lawler (R-N.Y.).

“Congress has what, a 15% approval rating? I think it’s going to go down if we don’t get something done here,” said Rep. Kevin Kiley (R-Calif.).

Lawler and more than a dozen other Republicans have signed onto two bills that could get a vote if 218 lawmakers sign what is known as a discharge petition.

While some Democrats have embraced the bills, with more than 40 signatories from both parties, Democratic leadership has not.

House Democratic leaders said Tuesday their bill to extend expiring subsidies for three years is the only path remaining. They are also using a discharge petition that 214 Democrats have signed.

“This is the closest path that we have in front of us. Other discharge petitions, 40, 50 signatures — that’s fine, but this one is meaningful,” House Democratic Conference Chair Pete Aguilar (D-Calif.) told reporters.

“If Republicans are serious about this, then they can sign our discharge petition and work with us in good faith,” Aguilar added. “It seems like a reasonable place to land, given that their own leadership won’t give them the time of day.”

The bill that Republicans plan to put on the floor centers around expanding association health plans and requiring greater transparency from PBMs. It also funds cost-sharing reductions for marketplace benchmark plans, which has the effect of lowering those premiums, but also reducing subsidies pegged to the benchmark premiums. The Congressional Budget Office estimated Tuesday the GOP bill would save about $36 billion over 10 years, largely due to the cost-sharing provision.

The Senate failed to advance healthcare bills last week, and intends to leave town after this week until next year. Even if the House changes course, it would be too late for the start of 2026.

The House Rules Committee planned to meet Tuesday afternoon to finalize which amendments would be allowed on the GOP bill.

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