Congress Might Vote on Health Care Subsidies, But First: Vacation

In a rebuke to House Speaker Mike Johnson, four Republicans broke ranks to force a floor vote. Next year.

Mike Johnson, dressed in a suit with a blue tie, stands in the foreground to address reporters at a press conference. Two other officials stand in the background.

House Speaker Mike Johnson addresses reporters at the Capitol.J. Scott Applewhite/AP

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There may be hope for millions of Americans whose health insurance premiums are set to skyrocket in the new year, but not before Congress gets back from its two-week holiday vacation. Four moderate Republicans signed on to a Democratic petition to extend Affordable Care Act subsidies for three years on Wednesday, effectively giving Democrats the numbers they needed to force a floor vote in Congress.

Minority Leader Hakeem Jeffries (D-NY) led the petition, which allows a majority of House members (218 votes) to force a bill to a floor vote. The petition received support from all 214 Democrats and four Republicans who defied GOP leadership in signing —Reps. Brian Fitzpatrick (R-Pa.), Mike Lawler (R-NY), Rob Bresnahan (R-Pa.), and Ryan Mackenzie (R-Pa.).

The subsidies date back to 2010, when Congress passed the Affordable Care Act. The effort was a signature achievement of President Barack Obama’s first term, and became colloquially known as “Obamacare.” The law effectively created marketplaces where people could buy health insurance if they weren’t covered by their employers, Medicare, or Medicaid. Buyers were incentivized with tax credits, a type of subsidy. Those subsidies got a big boost in government funding under President Joe Biden in 2021 as part of the Inflation Reduction Act, and many more people became eligible for them. But the credit extended only through 2025.

ACA marketplace enrollment was 24.3 million people in 2025, hitting a record-high for the fourth consecutive year.

Now, unless Congress extends them again, many enrollees will experience dramatic spikes in their premium costs. According to Kaiser Family Foundation, a nonpartisan healthcare policy group, subsidized enrollees are estimated to pay more than double for premiums. They found that the average cost of $888 in 2025 would increase to $1,904 in 2026. 

Even though House Speaker Mike Johnson (R-La.) acknowledged at a Tuesday press conference that around a dozen Republicans were working to reduce health care costs for their constituents, “many of them did not want to vote on this ObamaCare COVID-era subsidy the Democrats created.” 

Rep. Fitzpatrick said he voted with Democrats because GOP leadership rejected compromise after he spent months offering ideas and amendments. 

“The only policy that is worse than a clean three-year extension without any reforms, is a policy of complete expiration without any bridge,” Fitzpatrick said in a statement on Wednesday. “Unfortunately, it is House leadership themselves that have forced this outcome.”

Fitzpatrick is one of several Republicans who face competitive challenges in their electoral districts in 2026.

But all of this may be too little, too late. The ACA funding bill is not expected to go to the floor before the end-of-the-year deadline unless Johnson decides to speed up the vote, which doesn’t seem likely. House rules state a bill can only go to a floor vote at least seven legislative days after a discharge petition. The House will only be in session until Friday before a two-week holiday. House members come back on January 6, so a floor vote will most likely take place in the second week of January.

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