The House approved a three-year extension of enhanced Affordable Care Act subsidies on Thursday, with 17 Republicans joining all Democrats in a rebuke to GOP leaders. The bill, passed 230-196, would restore higher federal subsidies that lapsed at the end of last year to help lower premiums for millions of people buying coverage on the ACA marketplace. The measure may well not clear the Senate, the Washington Post reports; Senate Majority Leader John Thune wants changes that Democrats oppose. "Republicans and Democrats can agree," said Rep. Mike Lawler, a Republican who voted with Democrats, per the New York Times. "Our system is broken and we need to fix it, and we need to work in a bipartisan way."
Republican leaders had not advanced their own plan before the subsidies expired, despite warnings from members in competitive districts that rising costs could hurt them in the 2026 midterms. The measure reached the floor through a discharge petition pushed by Democrats and a small group of Republicans, bypassing House Speaker Mike Johnson, per the Post. The Senate blocked a comparable extension last month when Democrats could not attract enough Republican support to overcome a filibuster. The changes Republicans want include income caps, minimum out-of-pocket premiums, expanded health savings accounts, and abortion-related limits.
A bipartisan Senate group is instead discussing a shorter, two-year extension with income limits, a $5 minimum monthly premium, anti-fraud measures, and an option to direct some subsidy money into health savings accounts. Republican opponents in the House framed Thursday's bill as prolonging a flawed law. Ahead of voting, the nonpartisan Congressional Budget Office estimated that the three-year extension would increase the nation's deficit by about $80.6 billion over the decade, per the AP. 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.
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