House passes ACA extension as Senate also considers competing GOP-backed act
The U.S. House of Representatives passed a bill to extend now-expired subsidies to medical plans sold through government-run Affordable Care Act (ACA) exchanges. Seventeen Republicans joined Democrats in passing what could be a three-year extension of tax credits that make healthcare coverage more affordable.
The act passed on Thursday with 230 yea votes, with 196 members of the House voting against the measure. Every voting Democrat approved of the extension. Despite bipartisan cooperation in the House, the proposal now faces a divided Senate where a simple majority vote won’t be enough to clear the 60-vote threshold necessary to bring legislation to the floor for a vote.
The 17 members of the GOP who voted with Democrats are: Reps. Rob Bresnahan (R-PA), Mike Carey (R-OH), Monica De La Cruz (R-TX), Brian Fitzpatrick (R-PA), Andrew Garbarino (R-NY), Jeff Hurd (R-CO), Dave Joyce (R-OH), Tom Kean Jr. (R-NJ), Nick LaLota (R-NY), Mike Lawler (R-NY), Ryan Mackenzie (R-PA), Max Miller (R-OH), Zach Nunn (R-IA), Maria Elvira Salazar (R-FL), David Valadao (R-CA), Derrick Van Orden (R-WI) and Robert Wittman (R-VA).
In particular, Fitzpatrick was vocal about his support, saying to reporters outside of Congress that he hopes this bipartisan coalition was able to “breathe life back into this issue and really force the Senate to take this up.”
In early December, only 15 House Republicans were willing to cross party lines. The additional two supporters of ACA tax credits could signal that Republicans are worried they will be blamed for the spike in healthcare premiums.
The enhanced subsidies were put in place to contain healthcare prices during the COVID-19 pandemic. They were passed as part of the American Rescue Plan Act in 2021 with the goal of getting more Americans health coverage. They have now officially lapsed heading into 2026.
The longest government shutdown in history was a result of a deadlock between the two parties over the single issue of extending them. After 43 days, Democrats caved on the issue and the federal government was reopened without any agreement on healthcare in place.
Republicans said they wanted to ensure illegal immigrants were not taking advantage of the subsidies, which apparently necessitated putting an outright end to them.
As a solution, President Donald Trump had floated sending money directly to Americans to buy health insurance. But that idea failed to gain traction in Congress, the body of government responsible for funding government initiatives.
Senate considers competing ‘Lower Health Care Premiums Act’
In mid-December while fights over ACA subsidies were still raging, the U.S. House of Representatives passed its own GOP-led healthcare bill to address skyrocketing prices.
The “Lower Health Care Premiums for All Americans Act” passed by a narrow 216–211 vote, falling largely on party lines; all Democrats voted against the bill, and only two Republicans—Reps. Thomas Massie and Warren Davidson—opposed it.
There are no direct medical coverage subsidies present in the bill—but there are some reforms, such as new reporting requirements for pharmacy benefit managers and a cost-sharing program to reduce insurance premiums. The core of the act, however, is support for association health plans—a term for when small businesses and individual buyers band together to negotiate group rates.
The bill is officially in the hands of the Senate, but much like the ACA credit extension, it will require bipartisan support to make it to the floor to vote, which is unlikely to happen. Trump may never get a chance to sign or veto either act.
It’s not clear what other solutions, if any, will come down the pike.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.