WASHINGTN — On Thursday several moderate House Republicans joined House Democrats to pass a clean extension of ACA subsidies that expired at the end of the 2025. The expired subsidies mean increased health care premiums for millions of Americans and around 4 million people will likely lose insurance.
The vote was 230-196, with 17 Republicans joining a unanimous Democratic caucus to pass the legislation. Most of the breakaway GOP lawmakers represent swing districts and are wary of health care becoming a political vulnerability in the 2026 midterms.
The bill would resurrect Affordable Care Act premium tax credits for about 22 million Americans after Republicans rejected bills last year to extend the money past the Dec. 31 deadline. Insurance premiums are estimated to double, on average, for those enrollees this year unless the funding is restored.
Sen. Bernie Moreno, R‑Ohio, is advocating for a proposal that would extend Affordable Care Act funding for two additional years while introducing several revisions. These include capping eligibility at 700% of the federal poverty level and requiring all enrollees — including the lowest‑income participants — to pay at least a $5 monthly premium.
Moreno also wants to allow enrollees, beginning in the second year, to redirect their enhanced tax credits into a health savings account (HSA). That provision is expected to face resistance from Democrats. In addition, he is still exploring ways to incorporate abortion‑related restrictions sought by many Republicans, an issue that has been a major hurdle for months.
If the Senate manages to assemble the 60 votes needed, the measure will return to the House, where Speaker Mike Johnson has not committed to bringing it to the floor.
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