Speaker Johnson unveils health care plan as divided Republicans scramble
for alternative
[December 13, 2025]
By KEVIN FREKING and LISA MASCARO
WASHINGTON (AP) — The Senate failed to get anywhere on the health care
issue this week. Now it's the House's turn to show what it can do.
Speaker Mike Johnson unveiled a Republican alternative late Friday, a
last-minute sprint as his party refuses to extend the enhanced tax
subsidies for those who buy policies through the Affordable Care Act,
also called Obamacare, which are expiring at the end of the year. Those
subsidies help lower the cost of coverage.
Johnson, R-La., huddled behind closed doors in the morning — as he did
days earlier this week — working to assemble the package for
consideration as the House focuses the final days of its 2025 work on
health care.
“House Republicans are tackling the real drivers of health care costs to
provide affordable care,” Johnson said in a statement announcing the
package. He said it would be voted on next week.
Later Friday, though, House Democratic Leader Hakeem Jeffries said:
“House Republicans have introduced toxic legislation that is completely
unserious, hurts hardworking America taxpayers and is not designed to
secure bipartisan support. If the bill reaches the House floor, I will
strongly oppose it.”
Time is running out for Congress to act. Democrats engineered the
longest federal government shutdown ever this fall in a failed effort to
force Republicans to the negotiating table on health care. But after
promising votes, the Senate failed this week to advance both a
Republican health care plan and the Democratic-offered bill to extend
the tax credits for three years.
Now, with just days to go, Congress is about to wrap up its work with no
consensus solution in sight.
What Republicans are proposing
The House Republicans offered a 100-plus-page package that focuses on
long-sought GOP proposals to enhance access to employer-sponsored health
insurance plans and clamp down on so-called pharmacy benefit managers.
Republicans propose expanding access to what's referred to as
association health plans, which would allow more small businesses and
self-employed individuals to band together and purchase health coverage.
Proponents say such plans increase the leverage businesses have to
negotiate a lower rate. But critics say the plans provide skimpier
coverage than what is required under the Affordable Care Act.
The Republicans’ proposal would also require more data from pharmacy
benefit managers, or PBMs, as a way to help control drug costs. Critics
say PBMs have padded their bottom line and made it more difficult for
independent pharmacists to survive.
Additionally, the GOP plan includes mention of cost-sharing reductions
for some lower-income people who rely on Obamacare, but those do not
take effect until January 2027.
The emerging package from the House Republicans does not include an
extension of an enhanced tax credit for millions of Americans who get
insurance coverage through the Affordable Care Act. Put in place during
the COVID-19 crisis, that enhanced subsidy expires Dec. 31, leaving most
families in the program facing more than double their current
out-of-pocket premiums, and in some cases, much more.
What Trump wants
President Donald Trump has said he believes Republicans are going to
figure out a better plan than Obamacare — something he has promised for
years — but offered few details beyond his idea for providing Americans
with stipends to help buy insurance.
[to top of second column]
|
Speaker of the House Mike Johnson, R-La., prepares to speak to
reporters following a strategy session with House Republicans, at
the Capitol in Washington, Wednesday, Dec. 10, 2025. (AP Photo/J.
Scott Applewhite)
“I want to see the billions of dollars go to people, not to the
insurance companies," Trump said late Friday during an event at the
White House. “And I want to see the people go out and buy themselves
great healthcare.”
The president did not comment directly on the House's new plan. He
has repeatedly touted his idea of sending money directly to
Americans to help offset the costs of health care policies, rather
than extending the tax credits for those buying policies through
Obamacare. It’s unclear how much money Trump envisions. The Senate
GOP proposal that failed to advance would have provided payments to
new health savings accounts of $1,000 a year for adult enrollees, or
$1,500 for those ages 50 to 64.
It appeared there were no such health savings accounts in the new
House GOP plan.
Political pressure is building for many
Going Johnson's route has left vulnerable House Republicans
representing key battleground districts in a tough spot.
Frustrated with the delays, a group of more centrist GOP lawmakers
is aligning with Democrats to push their own proposals for
continuing the tax credits, for now, so that Americans don't face
rising health care costs.
They are pursuing several paths for passing a temporary ACA subsidy
extension, co-sponsoring a handful of bills. They are also signing
onto so-called discharge petitions that could force a floor vote if
a majority of the House signs on.
Such petitions are designed to get around the majority's control and
are rarely successful, but this year has proven to be an exception.
Lawmakers, for example, were able to use a discharge petition to
force a vote on the release of the Jeffrey Epstein files held by the
Department of Justice.
One petition, filed by Rep. Brian Fitzpatrick, R-Pa., had signatures
from 12 Republicans and 12 Democrats as of Friday afternoon. It
would force a vote on a bill that includes a two-year subsidy
extension and contains provisions designed to combat fraud in the
ACA marketplace. There are also restrictions for PBMs, among other
things.
Another petition from Rep. Josh Gottheimer, D-N.J., has 39
signatures and is broadly bipartisan. It's a simpler proposal that
would force a vote on a one-year ACA enhanced subsidy extension and
would include new income caps limiting who qualifies for the
enhanced credit.
Both discharge petitions have enough Republicans’ support that they
would likely succeed if Jeffries encouraged his caucus to jump on
board. So far, he's not tipping his hand.
“We’re actively reviewing those two discharge petitions and we’ll
have more to say about it early next week,” Jeffries said.
Meanwhile, Jeffries is pushing Democrats' own discharge petition,
which has 214 signatures and would provide for a clean three-year
subsidy extension. No Republicans have signed onto that one.
And as Republicans made clear in the Senate this week, a three-year
extension without changes to the program has no chance of passing
their chamber.
All contents © copyright 2025 Associated Press. All rights reserved |
