With enhanced Affordable Care Act premium subsidies set to expire at the end of 2025, a change analysts say would trigger steep premium hikes for many marketplace enrollees, several House Republicans are pressing to extend the tax credits.
Why It Matters
Premium tax credits established by the ACA and expanded during the COVID-19 pandemic are set to expire at the end of the year without Congressional action. The subsidies have been at the heart of several political fights, including the government’s 43-day shutdown earlier this Fall.
About 24 million Americans rely on the tax credit for health care. If the credit expires, enrollees could lose the subsidy completely or only qualify for a smaller tax credit.
Health care is likely to be a major political issue in the 2026 midterm elections, when Democrats are hoping to reclaim a majority of seats in the House of Representatives and the Senate, while Republicans are working to retain them. Millions of Americans, both Democrats and Republicans, could see insurance premiums rise if these credits expire.
Some Republicans do not want to extend ACA credits at all, and others are seeking additional provisions to be tied in, such as abortion restrictions.
What To Know
Congress is expected to vote on the health care legislation early next week, with Republicans still wrapping up proposals. More than 9 million Republicans and Republican-leaning independents depend on Obamacare for their health insurance, the Kaiser Family Foundation (KFF) found.
Some Republicans are pushing for an extension of the subsidies, although many are still not on board. Representatives Jen Kiggans, a Virginia Republican, and Democrat Josh Gottheimer are pushing a bipartisan House proposal, “CommonGround 2025,” to extend enhanced Affordable Care Act premium tax credits while tightening eligibility for the subsidies, which is backed by over a dozen Republicans.
Republicans who have signed on include Representatives Juan Ciscomani, Maria Salazar, Mike Lawler, Jefferson Van Drew, Tom Kean Jr., Jeff Hurd, David Valadao, Ryan MacKenzie, Carlos Gimenez, Monica de la Cruz, Robert Bresnahan, Don Bacon, Kevin Kiley, and Nick LaLota.
Representative Brian Fitzpatrick of Pennsylvania is also working to extend the subsidies, as well as add a cap on some earners and access to a health savings account. The Republican is working with bipartisan members to strike a balance.
In another effort, Kiley has introduced the “Fix It Act” alongside Democratic Representative Sam Liccardo, seeking to extend ACA premium tax credits. As of December 2, Republican Representatives Don Bacon, Zach Nunn, and Mike Lawler have signed on as cosponsors.
What People Are Saying
Representative Kevin Kiley said in a December 2 press release: “With 22 million Americans facing a massive increase in healthcare costs, doing nothing is not an option.”
Representative Brian Fitzpatrick told CBS in December: “Can’t say they agree with everything we’re doing, but that’s kind of the whole point, right? This is supposed to be a compromise.” He continued, “As we say, we’d rather get 80% of something than 100% of nothing. We’re not going to allow the perfect to be the enemy of the good here.”
Senate Minority Leader Chuck Schumer said about Republicans: “They have no unity, they have no consensus. They don’t even have concepts. It’s amazing. They have nothing. It’s the most major issue facing the American people and they can’t get their act together.”
Representative Jen Kiggans said: “40,000 people in my district who rely on this health care. Doing nothing to prevent a spike in their premiums is wrong.”
A group of thirteen House Republicans wrote in an October letter to Speaker Johnson: “Let us be clear: significant reforms are needed to make these credits more fiscally responsible and ensure they are going to the Americans who need them most. Our Conference and President Trump have been clear that we will not take healthcare away from families who depend on it. This is our opportunity to demonstrate that commitment through action.”
What Happens Next
House Speaker Johnson has said Republicans are likely to vote on a health care proposal early next week.
Gottheimer said at a press conference on Thursday, “We’re calling for a vote by December 18 in both chambers of Congress to get something done before premiums rise in January.”
