Speaker Johnson was ready to move on from ACA subsidies. But his members had other plans

House Republicans Face Revolt as Moderates Force Vote on Health Care Subsidies

In a stunning break with party leadership, four moderate Republicans have signed onto a Democratic discharge petition, guaranteeing a House vote on extending Affordable Care Act subsidies in January. The rare revolt has upended Speaker Mike Johnson’s strategy and highlighted growing divisions within the GOP caucus over health care policy.

Johnson had repeatedly dismissed calls to extend the ACA subsidies, insisting Republicans wanted to “help 100% of Americans with their costs, not just the 7% of Americans enrolled in Affordable Care Act plans.” That position has now crumbled under pressure from vulnerable members in competitive districts who have heard directly from constituents worried about 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, who celebrated the development as a victory for his party’s months-long strategy.

The impasse sends lawmakers home for the holiday break with significant uncertainty. House Democratic Leader Hakeem Jeffries demanded Johnson allow an immediate vote on a three-year extension of ACA subsidies before the recess, but Johnson refused, insisting it will “be on the floor that first week of January when we return.”

Senate Majority Leader John Thune faces similar challenges. Any ACA bill passing the House would move the fight to the Senate, which has already rejected a three-year extension of what Thune called “a failed program that’s rife with fraud, waste and abuse.” A bipartisan group of senators has been discussing potential compromises that would extend subsidies with new limitations, but those talks won’t resume until January.

Meanwhile, millions of Americans face potential insurance cost increases in 2026 if the subsidies expire. Republican leaders in both chambers have struggled to offer alternatives that fully address these concerns.

On Wednesday, House Republicans passed a comprehensive health care package focused on GOP priorities, including expanding coverage options for small businesses and self-employed individuals, while adding regulations for pharmacy benefit managers. Johnson promoted the legislation as “a bigger and better and more important thing for 100% of Americans, not just 7%.”

But that hasn’t satisfied moderates concerned about ACA subsidy expirations. Rep. Ryan Mackenzie, one of the four Republicans who signed the Democratic petition, said the move has “generated more conversations” and expressed hope for bipartisan solutions. “I think allowing a vote is critically important,” Mackenzie said. “Everybody should be able to put up their votes on the board.”

For Democrats, the development represents vindication of Leader Jeffries’ strategy. For months, he refused to support a one-year extension that bipartisan lawmakers had proposed, dismissing it as “a non-starter” and “a laughable proposition.” Instead, he held firm on demanding a three-year extension without income caps or cost offsets.

“As Leader Jeffries has said all along, this is the only real plan on the table,” Aguilar noted as Democrats rallied behind their leader on the Capitol steps Thursday.

Still, while Democrats have secured a vote, passage of a three-year extension remains uncertain. Senate Republicans have already rejected such a proposal, though some GOP senators believe House action could create momentum for a compromise.

The health care fight has given Democrats a unified message they believe will resonate in upcoming elections. “The Republican health care crisis is unacceptable, unconscionable, and un-American,” Jeffries declared.

For Johnson, this revolt is just the latest challenge in managing a deeply divided Republican conference with a razor-thin majority. He acknowledged the difficulties, noting he lacks “a long stick” to enforce party discipline. “I don’t have that, because we have a small margin,” Johnson explained.

Some Republicans remained frustrated as they departed Washington. Rep. Don Bacon warned that Democrats will use the health care issue “like a sledgehammer” in campaigns. House Majority Leader Steve Scalise attempted to project unity, claiming 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,” Scalise said, “and that means we’re going to have some differences along the way.”