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

WASHINGTON (AP) — Asked why Republicans aren’t moving to expand federal health care subsidies, Speaker Mike Johnson asked to be prepared: His party wants to help 100% of Americans with their costs, not just the 7% of Americans enrolled in Affordable Care Act plans.

But his conference was not 100 percent agreed.

A rare rebellion by the party’s moderate wing has backfired on Johnson’s plans. Four Republicans this week signed a Democratic discharge petition that guarantees the House will vote to extend ACA subsidies in January, leaving Republican leaders powerless to stop it.

For Democrats, it was a vindication of a months-long strategy, beginning with the government shutdown in the fall, that has pushed the expiration of ACA support to the forefront of politics. Republicans in competitive districts feel the political pressure to risk losing their seats in next year’s midterms as they hear from constituents about their skyrocketing premiums.

“Nothing has changed in the House Republican leadership, but something has changed in their own ranks,” House Democratic Caucus Chairman Rep. Pete Aguilar said.

With his caucus on the Capitol steps Thursday, House Democratic Leader Hakeem Jeffrey demanded that Johnson be allowed to vote on a three-year extension of ACA subsidies: “Not tomorrow, not next week, not next year. Today.”

“The first week of January when we come back will be on the floor,” Johnson declined.

Lawmakers are set to be left in the lurch

The impasse rocked MPs heading home for the holidays. Republican leaders now face increasing pressure to appease centrist members who are threatening to approve an extension of Affordable Care Act subsidies for three years with Democrats.

Senate Majority Leader John Thune will also face the issue. Any ACA bill that clears the House would push the fight to the Senate, which has already rejected a three-year extension.

A bipartisan group of senators is meeting and discussing possible compromise bills that would expand the subsidies but place new limits on them. But they didn’t consider anything until January.

Thune told reporters Thursday that “three years of a failed program riddled with fraud, waste and abuse is not being extended.”

Yet Republican leaders in both chambers have not offered a plan that fully addresses members’ concerns about the sharp insurance cost increases that many Americans are expected to face in 2026 and potentially beyond.

The White House has engaged in discussions about health care proposals but has largely allowed House Republicans to reconcile their internal divisions and unite around their own plan, according to a senior administration official involved in the negotiations who was briefed on the discussions.

House Republicans passed a 100-plus-page health care package Wednesday that focuses on longstanding GOP priorities, including expanding coverage options for small businesses and the self-employed. The bill would also rein in pharmacy benefit managers — middlemen who manage drug costs and process insurance claims.

Johnson touted the measure as “great and good and important for 100% of Americans, not just 7% of Americans.” But some Republicans who face tough re-election bids remain fixated on the growing spike in ACA costs.

The holidays provide a brief window for Johnson to try to persuade moderates to abandon the effort. The discharge petition froze after it reached the 218-signature threshold, meaning only four Republicans have publicly signed it, with many more Democrats likely willing to support the bill.

Rep. one of the four Republicans who signed the Democratic petition. Ryan McKenzie said that this has “generated more conversations” and “hopefully in the next three weeks, we’ll actually see some changes in some bipartisan efforts that actually get 218 in the House and 60 in the Senate.”

“I think it’s important to vote,” McKenzie said. “I think everyone should be able to put their vote across the board, and they should be able to see everyone in the American public see how they voted on these individual issues.”

Leader Geoffrey’s waiting game pays off

For months, Jeffrey refused to support a one-year extension of ACA subsidies that was being pursued by a bipartisan group of lawmakers, dismissing it as a “non-starter” and “a ridiculous proposal.”

Instead, he insisted on a three-year extension with no income cap or cost offset. That strategy paid off, as GOP moderates were forced to move in his direction after Johnson refused to allow any vote on the ACA extension.

Jeffrey has faced criticism this year from progressive members of his caucus and grassroots groups who have urged him to push back more forcefully against Trump and Republicans. But on Thursday, much of the party rallied behind him on the Capitol steps, with many lawmakers praising his approach.

“Leader Jeffries has said all together, this is the only real plan on the table,” Aguilar said.

Still, while Democrats have secured the vote, insurance costs for millions will rise next year, and a three-year ACA subsidy extension remains a long shot even if the House passes it. Senate Republicans have already rejected a three-year extension, but a House vote could provide momentum if some GOP senators are open to compromising on subsidies.

“We can have a vehicle — if we can get Republicans and Democrats behind it — then we can send it back,” said GOP Sen. Thom Tillis, “which means there’s still a chance.”

For Democrats, the fight has allowed them to coalesce around a message they believe can prove powerful on the campaign trail.

“The Republican health care crisis is unacceptable, unfair and un-American,” Jeffrey said.

The Republican House was divided

The decision by four Republicans to break the party leadership and join Democrats is just the latest sign of discontent in the narrowly divided House.

Johnson has argued that criticism directed at his leadership — and lawmakers repeatedly bypassing leadership to force votes — is inevitable given the thin GOP majority. He said he did not have the advantages of a large majority, where “the speaker had a long stick that he would punish.”

“I don’t have that, because we have a small margin,” he said. Among ACA extensions, Johnson said leadership had “talked about it at length” with GOP moderates, describing the conversation as “some intense fellowship.”

“Everyone is in good spirits now and everyone understands what’s going on,” he added.

Some GOP members, however, don’t seem to share that assessment. When the MPs were about to go home to celebrate the holiday, the dissatisfaction was high.

“I don’t know how we didn’t vote on a good bipartisan extension,” said GOP Rep. Don Bacon, adding that Democrats will use the health care issue “like a sledgehammer” on the campaign trail.

House Majority Leader Steve Scalise, R-La., insisted that Republicans are ending the year “as united as we’ve ever been.”

“We’re on a course to do big things, not small things, and that means we’re going to have some differences along the way.”

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Associated Press reporters Mary Claire Jalonik and Kevin Freking contributed to this report.