House Republicans Rush To Draft Health Plan As ACA Tax Credits Near Expiration

Washington — House Republican leaders say they will schedule votes next week on bills intended to blunt rising health insurance costs as more than 20 million Americans could face sharp premium increases when Affordable Care Act (ACA) tax credits lapse at the end of the year.

Republican leadership has released few specifics about the proposals they plan to advance or whether they will pursue a short-term extension of the expiring tax credits before the House's last scheduled session day on Dec. 18. Lawmakers and analysts warn that letting the credits expire could cause steep premium increases for many enrollees.

House Majority Leader Steve Scalise (R-La.) said the conference will place "a number" of bills on the floor that reflect areas of agreement, while acknowledging key differences remain.

"There's still some areas that we don't have full agreement upon, and we're going to keep working on those, and we've committed to work on those early in the next year," Scalise told reporters. "But starting next week, voting in the House on bills that will focus on lowering premiums for 100% of Americans."

Democrats have pushed for a clean, three-year extension of the ACA tax credits. House Minority Leader Hakeem Jeffries (D-N.Y.) has tried to force a vote via a discharge petition that would bypass Republican leadership, but that effort needs at least four House Republicans to succeed.

The Senate is expected to vote on a three-year extension this week, though the measure appears unlikely to pick up the 13 Republican votes required to advance. The upper chamber will also consider a Republican alternative that does not include an extension of the subsidies.

Republicans in both chambers contend a straight extension is unacceptable without reforms. GOP lawmakers have emphasized the need to curb fraud, set income eligibility limits and reevaluate policies that allow $0 premiums for many enrollees.

"There is no way that members of the House Republican conference are going to do a clean extension," Rep. Mike Flood (R-Neb.) told reporters last week.

Nonpartisan analysts warn that ending the tax credits would sharply raise consumer costs. The Center on Budget and Policy Priorities projects premiums could increase by more than $1,000 on average per year. The Kaiser Family Foundation estimates average annual premiums would rise from $888 in 2025 to $1,904 in 2026 if the subsidies expire.

Bipartisan Compromises And Discharge Petitions

Moderates in both parties have proposed bipartisan frameworks to break the stalemate. One plan from Rep. Josh Gottheimer (D-N.J.) and Rep. Jen Kiggans (R-Va.) would extend tax credits for one year with income limits and follow with a second year that implements deeper reforms, including eliminating most $0-premium plans with narrow, need-based exceptions. Supporters say eliminating broadly available $0-premium options reduces incentives for improper enrollments that can allow insurers to collect credits without active consumer participation.

Another bipartisan proposal led by Rep. Brian Fitzpatrick (R-Pa.) would extend credits through 2027 with an income cap, expand access to health savings accounts, and introduce a modest monthly premium for the lowest-income enrollees. Fitzpatrick says his plan reflects bipartisan input from both chambers and consultation with the White House.

"So that's going to be our best product we can put together," Fitzpatrick said last week.

Gottheimer and Fitzpatrick have filed discharge petitions to try to force floor votes on their measures — a tactic increasingly used by rank-and-file members to bypass leadership if they can marshal a majority. That path likely requires significant Democratic support and at least some GOP defections to succeed.

As lawmakers negotiate, millions of enrollees and health policy observers are watching closely. The coming votes and any short-term fixes will determine whether premium spikes are avoided, reduced, or delayed — and what conditions Congress attaches to continued federal support for marketplace coverage.