By Siobhan Hughes and Olivia Beavers
WASHINGTON -- A growing chunk of Republicans in both the House and Senate are breaking with party leaders and saying the GOP should extend expiring Affordable Care Act subsidies, seeing that as the only way to avert big cost increases for 20 million households next year and buy time for a bigger overhaul.
Republicans have fought for years to stop or curtail the 2010 health law, casting it as a failed program that props up big health insurers and fuels cost increases. But with enhanced ACA subsidies set to lapse next year, some Republicans across the political spectrum say they are willing to back a short-term extension.
"I'd be open to doing it in the short-term until we fix the overall problem," said Rep. Ronny Jackson (R., Texas), President Trump's former White House physician. "I'd be willing to do it to bridge a gap."
Already, some GOP lawmakers have sponsored or signed onto bills that would extend the tax credits for one or more years, while including changes designed to crack down on fraud and limit eligibility to exclude higher-income households. They include Sens. Susan Collins (R., Maine), Jon Husted (R., Ohio) and Roger Marshall (R., Kan.) -- all of whom are up for election next year -- and vulnerable House Republicans like Reps. Rob Bresnahan (R., Pa.) and Mike Lawler (R., N.Y.).
The Senate plans two healthcare votes Thursday: one on a GOP bill that would put as much as $1,500 a year into health savings accounts in lieu of providing subsidies to cover premiums, and the second on a Democratic plan that extends ACA subsidies for three years. Neither is expected to reach the 60 votes needed to advance, but the willingness of some Republicans to consider any form of ACA extensions has opened the door to possible talks if the partisan measures fail.
In the House, Speaker Mike Johnson (R., La.) said Republicans plan to put on the floor next week a package of healthcare proposals that doesn't include extending subsidies. But other lawmakers see an ACA extension as the only way to prevent widespread pain ahead of the 2026 midterms and get a GOP-led Congress in position to make more sweeping changes.
Rep. Jim Jordan (R., Ohio) -- a onetime leader of the hard-line House Freedom Caucus -- argued in a closed-door House Republican meeting that the party needed its own plan to temporarily extend the subsidies in tandem with more sweeping changes. If they didn't, he warned, conservatives could be sidelined by centrists' push to bring their own ACA extension to the floor.
"There's a whole list of good things that we need to put in the legislation," Jordan said in an interview. "But we also need to recognize reality, which is the cliff is coming in 21 days, and we have members who are very concerned about that. I think we all are."
Trump has heavily criticized the ACA and said he would favor direct payments to Americans, but he hasn't put forward his own plan. Johnson had earlier warned Trump against endorsing a renewal of the subsidies, arguing that they didn't have support in the House and aligning with hard-line conservatives who oppose the tax credits.
In the effort to break the logjam, Republican and Democratic centrists on Thursday lined up to sign onto a petition designed to circumvent Johnson and bring directly to the floor legislation to generally extend the subsidies for two years. The plan, led by Rep. Brian Fitzpatrick (R., Pa.), would require enrollees to pay at least $5 a month in premiums and would phase out the subsidies for higher-income households. It would also allow at least some of the federal subsidy to be directed to tax-advantaged health savings accounts, an idea favored by President Trump, and extend the open enrollment period.
Rep. Pete Aguilar (D., Calif.), a member of party leadership, signaled Wednesday that Democrats could be flexible if their three-year extension fails. "We're willing to have conversations and members are having conversations," he said. In his own remarks a day earlier, Senate Majority Leader John Thune (R., S.D.) said that if neither the Democratic nor Republican proposal advances in the Senate, "then we'll see where it goes from there."
The pandemic-era ACA subsidies at issue were enacted to enlarge existing tax credits and extend them to a broader population. The expansion proved so popular that it more than doubled the number of people buying insurance through the ACA marketplaces, to about 24 million, many of them in red states. During the 2025 open-enrollment period, about 42% of enrollees chose plans that cost $10 or less a month after the subsidy was applied, according to the Centers for Medicare and Medicaid Services.
A recent Government Accountability Office probe found cases in which fake enrollees obtained insurance, with companies pocketing the government subsidies for nonexistent people. The overall program of tax credits -- including the enhanced credits -- cost $124 billion in 2024 for about 19.5 million enrollees, according to the GAO report, meaning even a small share of fraud could be costly.
Write to Siobhan Hughes at Siobhan.hughes@wsj.com and Olivia Beavers at Olivia.Beavers@wsj.com
(END) Dow Jones Newswires
House Republican and Democratic centrists on Wednesday lined up to sign onto a discharge petition to extend ACA subsidies. "Some Republicans Break With Leaders in Healthcare Fight," at 5:01pm ET incorrectly said they lined up Thursday.
(END) Dow Jones Newswires
December 10, 2025 17:49 ET (22:49 GMT)
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