WASHINGTON (AP) – Speaker Mike Johnson had a pointed back when asked why Republicans weren’t moving to extend federal health care subsidies: their party wanted to help 100% of Americans with their costs, not just the 7% of Americans enrolled in Affordable Care Act plans.
But not 100% of his conference agreed.
A rare revolt from the moderate wing of the party overturns Johnson’s plans. Four Republicans this week signed a Democratic discharge petition that guarantees the House will vote on extending the ACA subsidies sometime in January, with Republican leaders now powerless to stop it.
For Democrats, it was a vindication of a months-long strategy, beginning with the government shutdown in the fall, that pushed the expiration of ACA support to the forefront of politics. Republicans from competitive districts most at risk of losing their seats in next year’s midterms felt the political pressure as they heard from constituents about rising premiums.
“Nothing has changed with the Republican leadership of the House, but something has changed within their own ranks,” said Rep. Pete Aguilar, chairman of the House Democratic Caucus.
Addressing his caucus Thursday on the Capitol steps, House Democratic Leader Hakeem Jeffries demanded that Johnson allow a vote on the three-year extension of ACA subsidies before lawmakers leave for recess: “Not tomorrow. Not next week. Not next year. Today.”
Johnson refused, saying he would “be on the ground that first week of January when we return.”
Legislators prepare to leave in limbo
The impasse has left lawmakers in the dark as they head home for the holiday break. Republican leaders now face mounting pressure to appease centrist members who are threatening to side with Democrats to approve a three-year extension of Affordable Care Act subsidies.
Senate Majority Leader John Thune must also confront the issue. Any ACA bill that clears the House would simply push the fight to the Senate, which has already rejected a three-year extension.
A bipartisan group of senators has been meeting and discussing possible compromise bills that would extend the subsidies but place new limitations on them. But they don’t consider anything until January.
Thune told reporters Thursday that a three-year extension of “a failed program that is full of fraud, waste and abuse” is not happening.
Yet Republican leaders in both chambers have not offered a plan that fully addresses members’ concerns about the sharp increases in insurance costs that many Americans are expected to face in 2026 and potentially beyond.
The White House has been involved in discussions about the health care proposals but has largely allowed House Republicans to sort out their internal divisions and come together around a plan on their own, according to a senior administration official involved in the talks who spoke on condition of anonymity to discuss private discussions.
House Republicans on Wednesday passed a more than 100-page health care package centered on longtime GOP priorities, including expanding coverage options for small businesses and the self-employed. The bill would also crack down on pharmacy benefit managers – middlemen who manage drug costs and process insurance claims.
Johnson announced the measure as “a bigger, better and more important thing for 100% of Americans, not just 7% of Americans.” But some Republicans facing tough reelection bids remain fixated on the looming increase in ACA costs.
The holidays provide Johnson with a short window to try to persuade moderates to abandon the effort. The discharge petition froze once it reached the 218-signature threshold, meaning that while only four Republicans have publicly signed on, more may be willing to support the Democratic bill.
Representative Ryan Mackenzie, one of the four Republicans who signed the Democratic petition, said that it “generated more conversations” and that “we hope over the next three weeks, we will actually see some changes in some bipartisan efforts that can actually generate a significant vote that will get 218 in the House and 60 in the Senate.”
“I think allowing a vote is very important,” Mackenzie said. “I think everyone should be able to put their votes on the board, and should be able to let everyone in the American public see how they voted on these individual issues.”
Leader Jeffries’ waiting game pays off
For months, Jeffries refused to support a one-year extension of ACA subsidies that a bipartisan group of lawmakers was pursuing, dismissing it as a “non-starter” and a “laughable proposal.”
Instead, he held firm on a three-year extension with no income limits or cost compensation. That strategy paid off, as GOP moderates were forced to move in his direction when Johnson refused to allow any vote on an ACA extension.
Jeffries has faced criticism this year from progressive members of his caucus and grassroots groups who have urged him to push back harder against Trump and Republicans. But on Thursday, much of the party rallied behind him on the Capitol steps, with several lawmakers praising his approach.
“As Chief Jeffries has said all along, this is the only real plan on the table,” Aguilar said.
Still, while the Democrats got a vote, insurance costs for millions are expected to rise next year, and the passage of a three-year extension of ACA subsidies remains a long shot even if it passes the House. Senate Republicans have already rejected the three-year extension, but some GOP senators who are open to a subsidy deal said a House vote could provide momentum.
“We can have a vehicle — if we can get Republicans and Democrats behind it — then we can send it back,” said GOP Sen. Thom Tillis, adding that “it means there’s still a chance.”
For Democrats, the fight also allowed them to rally around a message they believe can be powerful on the campaign trail.
“The Republican health care crisis is unacceptable, senseless, and un-American,” Jeffries said.
A divided Republican House
The decision by four Republicans to break with the party leadership and join the Democrats is just the latest sign of discontent in the tightly divided House.
Johnson argued that criticism directed at his leadership — and lawmakers repeatedly seizing the leadership to force votes — is inevitable given the GOP’s slim majority. He said that he lacks the advantages of a large majority, where “the speaker had a long stick that administered the punishment.”
“I don’t have it, because we have a small margin,” he said. Of the ACA extensions, Johnson said the leadership had “talked about it at length” with GOP moderates, describing the conversations as “some intense fellowship.”
“Everyone is in good spirits now and everyone understands what is happening,” he added.
Some GOP members, however, don’t seem to share that assessment. There was continued discontent as lawmakers went home for the holidays.
“I don’t know how we didn’t vote on a good bipartisan extension,” said GOP Rep. Don Bacon, adding that Democrats will use the health care issue “like a sledgehammer” on the campaign trail.
House Majority Leader Steve Scalise, R-La., insisted that Republicans are ending the year “as united as we’ve ever been.”
“We set out on a course to do big things, not small things, and that means we’re going to have some differences along the way.”
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Associated Press reporter Mary Clare Jalonick and Kevin Freking contributed to this report.