Speaker Johnson was ready to move on from ACA subsidies. But his members
had other plans
[December 19, 2025]
By JOEY CAPPELLETTI
WASHINGTON (AP) — Speaker Mike Johnson had a ready-made refrain 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 has upended Johnson's
plans. Four Republicans this week signed onto a Democratic discharge
petition that guarantees that the House will vote on extending the ACA
subsidies sometime in January, with Republican leaders now powerless to
stop it.
For Democrats, it was vindication of a months-long strategy, starting
with the government shutdown in the fall, that pushed the expiration of
the 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 their skyrocketing premiums.
“Nothing has changed with House Republican leadership, but something has
changed within their own ranks,” said Rep. Pete Aguilar, chair of the
House Democratic Caucus.
Flanked by 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 the
holidays: “Not tomorrow. Not next week. Not next year. Today.”
Johnson refused, saying it will “be on the floor that first week of
January when we return.”
Lawmakers prepare to leave in limbo
The impasse left lawmakers with a cliffhanger as they headed home for
the holiday break. Republican leaders now face growing pressure to
appease centrist members who are threatening to side with Democrats to
approve an extension of Affordable Care Act subsidies for three years.
Senate Majority Leader John Thune has to confront the issue as well. Any
ACA bill clearing 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 put new limitations
on them. But they would not consider anything until January.
Thune told reporters Thursday that a three-year extension of “a failed
program that’s rife with 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 insurance cost
increases many Americans are expected to face in 2026 and potentially
beyond.
The White House has been engaged in discussions about the healthcare
proposals but has largely allowed House Republicans to sort out their
internal divisions and coalesce around a plan on their own, according to
a senior administration official involved in the talks who was granted
anonymity to discuss private discussions.
House Republicans on Wednesday passed a 100-plus-page health care
package centered on long-standing GOP priorities, including expanding
coverage options for small businesses and the self-employed. The bill
would also rein in pharmacy benefit managers — middlemen that manage
drug costs and process insurance claims.
Johnson touted the measure as “a bigger and better and more important
thing for 100% of Americans, not just 7% of Americans.” But some
Republicans who face tough reelection bids remain fixated on the looming
spike in ACA costs.
The holidays provide Johnson with a brief 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.
Rep. Ryan Mackenzie, one of the four Republicans who signed the
Democratic petition, said it has “generated more conversations” and that
“hopefully over the next three weeks, we will actually see some changes
in some bipartisan efforts that actually can generate a meaningful vote
that gets 218 in the House and 60 in the Senate.”
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Speaker of the House Mike Johnson, R-La., meets with reporters as
Republicans struggle with a plan to address growing health care
costs, at the Capitol in Washington, Tuesday, Dec. 16, 2025. (AP
Photo/J. Scott Applewhite)
“I think allowing a vote is critically important,” Mackenzie said. “I
think everybody should be able to put up their votes on the board, and
they should be able to let everybody 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 had been pursuing,
dismissing it as a “non-starter” and “a laughable proposition.”
Instead, he held firm on a three-year extension with no income caps or
cost offsets. 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 more
forcefully 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 Leader Jeffries has said all along, this is the only real plan on
the table,” said Aguilar.
Still, while Democrats have secured a vote, insurance costs for millions
are set to rise next year, and passage of a three-year ACA subsidies
extension remains a long shot even if it does pass the House. Senate
Republicans have already rejected the three-year extension, but some GOP
senators who are open to a deal on the subsidies said a House vote could
provide momentum.
“We could have a vehicle — if we could get Republicans and Democrats
behind it — then we could send it back,” said GOP Sen. Thom Tillis,
adding that it “means that there’s still a chance.”
For Democrats, the fight has also allowed them to unify around a message
they believe could prove potent on the campaign trail.
“The Republican health care crisis is unacceptable, unconscionable, and
un-American,” Jeffries said.
A Republican House divided
The decision by four Republicans to break with party leadership and join
Democrats is only the latest sign of discontent in the narrowly divided
House.
Johnson has argued that the criticism directed at his leadership — and
lawmakers repeatedly bypassing leadership to force votes — is inevitable
given the slim GOP majority. He said he lacks the advantages of a large
majority, where “the speaker had a long stick that he would administer
punishment.”
“I don’t have that, because we have a small margin,” he said. Of the ACA
extensions, Johnson said leadership had “talked about it at length” with
GOP moderates, describing the conversations as “some intense
fellowship.”
“Everybody’s in good spirits now and everybody understands what’s
happening,” he added.
Some GOP members, however, don’t appear to share that assessment. There
was lingering discontent as lawmakers headed home for the holidays.
“I don't know how we did not 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 finishing the year “as united as we've ever been.”
“We set out on a course to do big things, not little things, and that
means we’re going to have some differences along the way.”
___
Associated Press reporter Mary Clare Jalonick and Kevin Freking
contributed to this report.
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