WASHINGTON, D.C. — Tensions are flaring on Capitol Hill tonight with a looming health care deadline that Congress is unlikely to meet.
House Speaker Mike Johnson, R-La., and his conference pushed ahead this week with the “Lower Health Care Premiums for All Americans Act,” the GOP’s proposal to lower health care costs. The legislation passed the House Wednesday evening.
Republicans say the bill lowers premiums by letting more employers band together to buy insurance, increases transparency from pharmacy benefit managers and funds cost-sharing programs for some ACA enrollees.
However, the bill does not extend enhanced Affordable Care Act tax credits — set to expire in just two weeks — threatening premium spikes for millions next year.
“I am. And what people can’t afford, they make some very difficult decisions,” said Rep. Glenn “GT” Thompson, R-Pa., when asked if he was concerned about people dropping health insurance as a result of higher premiums. “That’s why I’m pretty pleased with the package just coming together. It’s estimated that’ll lower premium costs for about 11%.”
The majority of Republicans believe time is up for the COVID-era enhanced subsidies that drove ACA marketplace enrollment to over 24 million people in 2025 — a record high.
“They created this. But they also knew that it should be just for COVID, and that they’re the ones — it was actually the Democratic Party — that established the expiration deadline,” Thompson added.
Still, Democrats warn that doing nothing will have a devastating impact on millions of Americans.
“Once Jan. 1 occurs, as I’ve said over and over again, the toothpaste is out of the tube,” said Senate Minority Leader Chuck Schumer, D-N.Y. “Once that happens, millions will be without health care.”
Allowing the subsidies to lapse has infuriated not only Democrats, but also a handful of moderate House Republicans.
“You know what’s funny? Three-quarters of people on Obamacare are in states Donald Trump won. So maybe, just maybe, everybody should look at this and say, how do we actually fix the health care system,” Rep. Mike Lawler, R-N.Y., told reporters.
Lawler and other GOP moderates, including Rep. Brian Fitzpatrick, R-Pa., Rep. Rob Bresnahan, R-Pa., and Rep. Ryan Mackenzie, R-Pa., have teamed up with Democrats — signing onto a rare discharge petition to force a vote on a three-year subsidy extension in January — triggering a stunning and public revolt inside Johnson’s party Wednesday.
“I have not lost control,” Speaker Johnson told reporters Wednesday.
Even if the three-year subsidy extension passes the House next month, it faces steep opposition in the Senate — where a proposal by Democrats to do the same thing failed last Thursday.
“If that did happen, I wouldn’t support the straight three-year extension without the reforms,” said Sen. Dave McCormick, R-Pa. “I think there’ll be a Senate version that will have those reforms in it, which I would support.”
Among the reforms McCormick believes are necessary include income caps, which he says are needed to push back against billions in fraud.
“The question is whether we should extend those for three more years. It has people making five or $600,000 a year receiving subsidies. There’s huge fraud, billions of dollars of fraud in the system,” McCormick said. “I would be in favor of a shortened time frame, probably two years, where you put income caps significantly less than $500,000 a year.”
Additionally, McCormick believes minimum monthly payments and health savings accounts would crack down on insurance companies, which have seen record-breaking profits in recent years.
“There’s some proposals like that being kicked around on the Senate side. They also have something called health savings accounts, which gives the money back to the consumer. And that’s what President Trump’s been advocating, and I’d be supportive of that,” McCormick added.
Speaker Johnson’s health care package passed the House Wednesday evening and now heads to the Senate. But Democrats and the handful of moderate Republicans say it doesn’t address the real issue: soaring premiums in the new year. The discharge petition they signed to force a vote on a three-year extension of the enhanced subsidies now has the required 218 signatures — teeing up a House vote in early January, but after the subsidies expire.
