Johnson Blocks Vote on Health Subsidies; Was 'Not to Be'

House Speaker Mike Johnson has shut down a push for a vote to keep expanded Affordable Care Act subsidies in place, leaving millions facing higher premiums when the aid ends on Dec. 31. After days of mixed signals, Johnson told Republicans in a closed-door meeting on Tuesday that the House wouldn't vote on an extension, despite lobbying from moderates in battleground districts worried about voter backlash, per the New York Times. "We looked for a way to try to allow for that pressure release valve, and it just was not to be," he told reporters. He adds that leadership tried to reach an agreement with party centrists "all the way through the weekend," per NBC News.

The AP notes the decision "all but guarantees that many Americans will see substantially higher insurance costs in 2026." The move angered some vulnerable Republicans, including New York Rep. Mike Lawler, who called the move "idiotic" and "political malpractice," per the Times. "I am pissed for the American people," he adds, per NBC. The House instead plans to take up a narrower GOP health bill that assumes the pandemic-era subsidy boost will lapse and focuses on longer-term cost measures, the Times notes. The package would expand small-business insurance arrangements, tighten rules on pharmacy benefit managers, and restore insurer payments cut during President Trump's first term.

The nonpartisan Congressional Budget Office estimates that plan would reduce the deficit by $35.6 billion but leave 100,000 more people uninsured by 2035. The CBO separately projects about 2 million more Americans would lose coverage next year if the current ACA subsidies are allowed to expire, and 3.8 million over 10 years. With time running out before Congress leaves Washington for the holidays, both parties are testing long-shot procedural maneuvers to force votes on competing subsidy plans, but none could take effect before the year-end deadline.

In the Senate, meanwhile, where efforts also stalled last week, a bipartisan group of about 20 senators is now working on a framework to extend the tax credits for two years, tapering them off in the second. Sen. Susan Collins of Maine, a lead organizer, said the group is focused on avoiding premium spikes that could make coverage out of reach for lower- and middle-income consumers.