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House Passes GOP Health Bill as 4 Republicans Trigger January Vote on ACA Subsidy Extension

The maneuver sets up a delayed decision as the enhanced tax credits expire Dec. 31, leaving millions bracing for higher 2026 premiums.

Overview

  • Speaker Mike Johnson declined to allow a vote on extending enhanced Affordable Care Act tax credits, and the House approved the GOP’s Lower Health Care Premiums for All Americans Act 216-211 without an extension.
  • Four centrist RepublicansBrian Fitzpatrick, Mike Lawler, Rob Bresnahan and Ryan Mackenzie — joined all Democrats on a discharge petition, reaching 218 signatures to force a floor vote on a three-year extension.
  • Under House rules the petition must ripen for seven legislative days, making a vote unlikely before January; Johnson said he would not block the vote once eligible.
  • Senators indicated any action will wait until after the holiday recess following failed votes last week, leaving the enhanced subsidies set to lapse at year’s end for roughly 24 million marketplace enrollees.
  • Nonpartisan CBO and JCT estimate the House GOP package would cut the deficit by $35.6 billion over a decade and increase the uninsured by about 100,000 people per year starting in 2027, as independent analyses warn of substantial premium hikes if the enhanced credits end.