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4h ago

House Sets Vote on Narrow Health Bill as ACA Subsidy Extension Faces Final-Hour Headwinds

A narrow House GOP package is unlikely to avert a lapse in enhanced credits given a stalled Senate plus imminent enrollment cutoffs.

Speaker of the House Mike Johnson at the US Capitol, in Washington, DC, on Friday, December 12, 2025.
Speaker of the House Mike Johnson discusses affordability at a press conference on December 10, 2025 at the U.S. Capitol in Washington, DC. The Republican leaders discussed healthcare plans with a vote regarding an extension of the ACA subsidies looming.

Overview

  • The Senate last week failed to reach 60 votes on both a Democratic three-year extension of enhanced ACA premium tax credits and a Republican alternative centered on Health Savings Accounts and direct payments.
  • House leaders plan a vote on a GOP bill that does not renew the enhanced credits, with a potential amendment from Rep. Brian Fitzpatrick to extend them for two years still in flux and facing uncertain support.
  • Bipartisan discharge petitions to force votes are active, including Fitzpatrick’s two-year extension with changes (24 signers) and Rep. Josh Gottheimer’s one-year extension with targeted reforms (39 signers), both short of the 218 needed.
  • Key deadlines constrain any fix: Dec. 15 for coverage starting Jan. 1, Dec. 31 for credit expiration, and Jan. 15 for the close of open enrollment, limiting the ability of any late deal to blunt near-term premium impacts.
  • Analysts warn that more than 20 million marketplace enrollees could face sharp cost increases if the credits lapse, as Republicans cite GAO-identified fraud risks to press structural reforms favored by the White House such as HSAs and direct payments.