House GOP Unveils Health Bill That Lets Obamacare Subsidies Expire
House Republicans on Friday unveiled a sweeping health care package they plan to bring to a floor vote next week that would overhaul parts of the U.S. health system but leave expiring Affordable Care Act subsidies untouched, setting up a major policy clash heading into 2026.
The proposal, advanced by the House Energy and Commerce Committee and the Ways and Means Committee, does not extend the enhanced ACA premium tax credits that were first enacted in 2021 and later extended through the end of 2025. Without congressional action, those subsidies are scheduled to expire on Dec. 31.
According to estimates cited by lawmakers and insurers, the lapse could lead to sharp premium increases for millions of marketplace enrollees beginning in 2026 and result in several million people losing health coverage.
Instead of addressing the subsidy expiration, the House Republican package focuses on other priorities, including reforms to pharmacy benefit managers, changes to Medicaid financing, new work requirements for some Medicaid recipients, and restrictions on federal funding for Planned Parenthood. The bill also includes a series of cost-containment measures aimed at reducing federal health spending.
Republican leaders argue the enhanced ACA subsidies were always intended to be temporary and say extending them permanently would add hundreds of billions of dollars to the federal deficit over the next decade. Speaker Mike Johnson has said the issue of expiring subsidies could be revisited in separate legislation next year.
The decision has drawn criticism from Democrats and concern from some moderate Republicans, particularly those representing swing districts. Several GOP senators have already signaled they would not support legislation that allows the subsidies to expire without a replacement, raising questions about the bill’s prospects in the Senate.
The health care provisions are expected to be folded into a broader budget reconciliation package that includes tax, energy, and border policy measures. A full House vote is anticipated during the week of Dec. 15.
With the subsidy deadline looming, the issue is shaping up to be one of the most consequential domestic policy fights as Republicans begin 2026 with control of Congress and the White House.
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