House passes bill to extend health care subsidies in defiance of GOP
leaders
[January 09, 2026]
By LISA MASCARO and KEVIN FREKING
WASHINGTON (AP) — In a remarkable rebuke of Republican leadership, the
House passed legislation Thursday that would extend expired health care
subsidies for those who get coverage through the Affordable Care Act as
17 renegade GOP lawmakers joined every Democrat in support.
The tally, 230-196, signified growing political concern over Americans'
health care costs. Forcing the issue to a vote came about after a
handful of Republicans signed on to a so-called “discharge petition” to
unlock debate, bypassing objections from House Speaker Mike Johnson. The
bill now goes to the Senate, where pressure is building for a bipartisan
compromise.
Together, the rare political coalitions are rushing to resolve the
standoff over the enhanced tax credits that were put in place during the
COVID-19 crisis but expired late last year after no agreement was
reached during the government shutdown.
“The affordability crisis is not a ‘hoax,’ it is very real — despite
what Donald Trump has had to say,” said House Democratic Leader Hakeem
Jeffries, invoking the president's remarks.
“Democrats made clear before the government was shut down that we were
in this affordability fight until we win this affordability fight,” he
said. “Today we have an opportunity to take a meaningful step forward.”
Ahead of voting, the nonpartisan Congressional Budget Office estimated
that the bill, which would provide a three-year extension of the
subsidy, would increase the nation's deficit by about $80.6 billion over
the decade. At the same time, it would increase the number of people
with health insurance by 100,000 this year, 3 million in 2027, 4 million
in 2028 and 1.1 million in 2029, the CBO said.
Growing support for extending ACA subsidies
Johnson, R-La., worked for months to prevent this situation. His office
argued Thursday that the federal health care funding from the COVID-19
era is rife with fraud and urged a no vote.
On the floor, Republicans also argued that the lawmakers should be
focused on lowering health insurance costs for the broader population,
not just those enrolled in ACA plans.
“Only 7% of the population relies on Obamacare marketplace plans. This
chamber should be about helping 100% of Americans,” said Rep. Jason
Smith, the Republican chairman of the House Ways and Means Committee.
While the momentum from the vote shows the growing support for the tax
breaks that have helped some 22 million Americans have access to health
insurance, the Senate would be under no requirement to take up the House
bill and has already rejected it once before.
Instead, a small group of senators from both parties has been working on
an alternative plan that could find support in both chambers and become
law. Senate Majority Leader John Thune, R-S.D., said that for any plan
to find support in his chamber, it will need to have income limits to
ensure that the financial aid is focused on those who most need the
help. He and other Republicans also want to ensure that beneficiaries
would have to at least pay a nominal amount for their coverage.
Finally, Thune said there would need to be some expansion of health
savings accounts, which allow people to save money and withdraw it
tax-free as long as the money is spent on qualified medical expenses.
GOP Sen. Bernie Moreno of Ohio, a leader in the group of about a dozen
senators, said they hope to deliver a framework next week. He and others
met with House colleagues on options.
Sen. Jeanne Shaheen, D-N.H., who is part of the negotiations, said there
is agreement on addressing fraud in health care.
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Speaker of the House Mike Johnson, R-La., speaks during a news
conference at the Capitol, Wednesday, Jan. 7, 2026, in Washington.
(AP Photo/Rod Lamkey, Jr.)
“We recognize that we have millions of people in this country who
are going to lose — are losing, have lost — their health insurance
because they can’t afford the premiums,” Shaheen said. “And so we’re
trying to see if we can’t get to some agreement that’s going to
help, and the sooner we can do that, the better.”
Trump has pushed Republicans to send money directly to Americans for
health savings accounts so they can bypass the federal government
and handle insurance on their own. Democrats largely reject this
idea as insufficient for covering the high costs of health care.
Republicans go around their leaders
The action by Republicans to force a vote has been an affront to
Johnson and his leadership team, who essentially lost control of
what comes to the House floor as the Republican lawmakers joined
Democrats for the workaround.
After last year’s government shutdown failed to resolve the issue,
Johnson had discussed allowing more politically vulnerable GOP
lawmakers a chance to vote on another health care bill that would
temporarily extend the subsidies while also adding changes.
But after days of discussions, Johnson and the GOP leadership sided
with the more conservative wing, which has assailed the subsidies as
propping up ACA, which they consider a failed government program. He
offered a modest proposal of health care reforms that was approved,
but has stalled.
It was then that rank-and-file lawmakers took matters into their own
hands, as many of their constituents faced soaring health insurance
premiums beginning this month.
Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan
Mackenzie, all from Pennsylvania, and Mike Lawler of New York,
signed the Democrats’ petition, pushing it to the magic number of
218 needed to force a House vote. All four represent key swing
districts whose races will help determine which party takes charge
of the House next year.
Jeffries said in a celebratory press conference afterward that Thune
should bring the Democratic bill to the Senate floor for an
immediate vote.
Trump encourages GOP to take on health care issue
What started as a long shot effort by Democrats to offer a discharge
petition has become a political vindication of the Democrats’
government shutdown strategy as they fought to preserve the health
care funds.
Democrats are making clear that the higher health insurance costs
many Americans are facing will be a political centerpiece of their
efforts to retake the majority in the House and Senate in the fall
elections.
Trump, during a lengthy speech this week to House GOP lawmakers,
encouraged his party to take control of the health care debate — an
issue that has stymied Republicans since he tried, and failed, to
repeal Obamacare during his first term.
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Associated Press writers Matt Brown and Steven Sloan contributed to
this report.
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