- The House passed a Republican health care bill without renewing Affordable Care Act subsidies on Wednesday.
- Democrats protested the move, warning of higher insurance premium costs for 24 million Americans.
- The bill may reduce insured numbers by 100,000 annually through 2035, says the Congressional Budget Office.
WASHINGTON — An expanded federal health care subsidy that grew out of the pandemic is all but certain to expire at the year's end as the House of Representatives advanced a Republican health care bill on Wednesday that would not renew the tax credit.
The 216-211 vote, likely Congress's last vote on health care policy this year, came hours after Republican leaders faced a rebellion within their ranks in support of a Democratic-backed extension of the Obamacare benefit.
Earlier, the House voted 204-203 in a procedural move to stop the last-minute attempt 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 gaveling an end to the vote prematurely while some members were still trying to vote.
"That's outrageous," Democratic Rep. Jim McGovern of Massachusetts yelled at Republican leadership.
Under the rules of the House, Democrats can insist on a vote on their three-year extension. But House Speaker Mike Johnson told reporters late on Wednesday that he would not schedule that vote until the first week of January, when Congress returns from a recess that is set to begin by the end of this week.
Johnson is expected to work to defeat the measure, telling reporters that the enhanced subsidy "was not good policy."
Some of the 24 million Americans who buy their health insurance through the Affordable Care Act program, nicknamed Obamacare, could face sharply higher costs beginning on Jan. 1 without action by Congress.
"Millions will be without health care" if that happens, Senate Democratic Leader Chuck Schumer told reporters. "Tens of millions more will have since changed (to) policies that are much worse for them: higher deductibles, higher copays."
Republican plan
The Republican bill aims to lower premiums for some people while reducing overall subsidies and raising premiums for others, starting January 2027. It would also expand access to association health plans, which allow small businesses, freelancers and self-employed individuals to pool resources and purchase group health insurance at potentially lower costs.
Republicans largely attacked the Affordable Care Act subsidy over its provision that sends federal dollars to insurance companies to help reduce premium costs. "Throwing more money at the insurance companies is not the answer," Rep. Morgan Griffith of Virginia said during the House debate.
The nonpartisan Congressional Budget Office 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 $35.6 billion, the office said.
Republican Rep. Kevin Kiley of California said in a floor speech that he would support the Republicans' targeted health care bill despite reservations. "The bill does not address the immediate, urgent problem in front of us, which is that 22 million people are about to pay a lot more for health insurance," Kiley said.
The Senate, also controlled by President Donald Trump's Republicans, last week rejected dueling Republican and Democratic plans to address the subsidies.
Subsidies cause of record government shutdown
Tensions are high over the expiring health care subsidies under the Affordable Care Act, which were the cause of the record-breaking government shutdown earlier this fall. Democrats withheld their support of a temporary government funding bill unless the subsidy was extended. Republicans refused that demand.
The debate over health care — one that has pitted Republicans against Democrats for decades — is more than a policy matter. The November 2026 congressional elections hang heavy over lawmakers at a time when Republican President Donald Trump's public approval rating is weak.
The four Republicans who joined forces with House Democratic Leader Hakeem Jeffries in trying to advance a three-year Affordable Care Act subsidy extension represent districts that could see competitive reelection races next year. Three of them come from the swing state of Pennsylvania, with the fourth from New York.
Even though the Republican-controlled House passed the health care bill, 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 Jan. 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 Sen. 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."
Contributing: David Morgan
