After failure in the Senate, House GOP has its own health care proposal : NPR
Speaker Mike Johnson, R-La., speaks with reporters outside his office at the Capitol, Thursday, Dec. 4, 2025, in Washington.
Kevin Wolf/AP/FR33460 AP
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Kevin Wolf/AP/FR33460 AP
After the Senate failed to advance bills to reduce health care costs this week, House Republicans released a bill Friday night that would not expand the Affordable Care Act’s enhanced tax subsidies but would make other changes that party leaders are pushing for to improve Americans’ access to health care.
Time is running out for Congress to act. Once subsidies for Americans purchasing health care plans through the Affordable Care Act (ACA) expire at the end of the year, premiums for millions of Americans will skyrocket.
Democrats have pushed to extend these enhanced tax credits to prevent premiums from doubling or more.
The enhanced subsidies began in 2021 to make ACA Marketplace plans more affordable for more Americans. The market grew out of the health care reform that President Barack Obama signed into law in 2010 and that Republicans have long criticized.
House members have just four days left before their holiday break begins on December 19. The Senate recess begins on December 20.
Friday’s proposal from House Republicans includes measures that would allow small businesses to band together to purchase insurance plans for their employees and establish new requirements for pharmacy benefit managers in an effort to reduce drug costs.
Starting in 2027, federal payments, called cost-sharing reduction payments, would aim to reduce premiums for some low-income Americans. Health plans that offer abortion coverage would be excluded.
A vote on the package is expected next week, House Speaker Mike Johnson said.
“House Republicans are addressing the real drivers of health care costs to provide affordable care, increase access and choice, and restore the integrity of our nation’s health care system for all Americans,” Johnson said in a statement.
Democratic House Minority Leader Hakeem Jeffries blasted the proposal Saturday.
“Mike Johnson just released a toxic Republican health care plan that hurts ordinary Americans,” Jeffries wrote on X. “He fails to extend the ACA tax credits that expire this month. And it’s a deeply unserious proposal.”
A Democratic-led proposal in the Senate to extend subsidies for ACA plans for three years was joined by a handful of Republicans but failed to pass this week, as did a separate plan backed by Senate Republicans. Both bills failed to attract enough support to clear the de facto 60-vote threshold set by the House.
President Trump has advocated giving people money to pay for health care costs rather than tax credits for ACA plans.
“I want the billions of dollars to go to the people, not to the insurance companies,” Trump said Friday evening at a White House event. “And I want to see people go out and get good health care.”
The Senate Republicans’ plan included a proposal to allow Americans to get up to $1,500 health savings accounts for Americans earning less than 700 percent of the federal poverty level, but the House Republican proposal does not include that language.
In the Senate Republican proposal, savings accounts, which cannot be used to pay premiums, would have been combined with high-deductible insurance plans. These health plans have an average deductible cost of about $7,000, according to an analysis by KFF, a health policy organization.
Democrats opposed the Republican Senate bill, arguing it would not help Americans pay health care premiums. They also opposed language that would have placed restrictions on abortion and gender-affirming care.
Meanwhile, some Republicans have warned that ending ACA subsidies could cost their party the midterm elections, citing worried communications from their constituents. A number of Republicans in the House are seeking ways to expand the subsidies, including working to force a vote in the House over objections from party leaders.
