Congress is closing out the year focused on healthcare. Maybe.

Four GOP members of the House of Representatives joined with House Democrats to force a vote on extending tax credits that are part of the Affordable Care Act (ACA). The vote will play a major role over healthcare costs in the coming year, which are expected to significantly rise.

Who broke with Republicans to force the vote on extending ACA subsidies?

The debate over the ACA tax credits has been a major talking point in both the House and Senate for much of the year. With the tax credits set to expire, congress would have to vote to extend them. However, doing so would not fit with the legislative agenda set forth by the current administration.

House Speaker Mike Johnson, a Republican representing Louisiana’s fourth district, had initially planned to close out the year without a vote to extend the tax credits. However, four House Republicans joined with Democrats to force a vote on legislation to extend the credits, The Guardian reports.¹

Those Republicans are:

• Brian Fitzpatrick, Pennsylvania
• Robert Bresnahan, Pennsylvania
• Ryan Mackenzie, Pennsylvania
• Mike Lawler, New York

According to The Guardian, minority leader Hakeem Jefferies (D, NY) called for the vote to be had before the end of the current week. However, it’s possible that the vote may not occur until January, or even later.

The ACA tax credits have been at the front and center in the House for most of the year. The Government faced a 43-day-long shutdown in October and November over a disagreement to extend the tax credits. While Democrats in the Senate eventually relented, they only did so after being promised that there would be a vote on the tax credits in December.

That vote occurred in early December, with Republicans successfully voting it down in the Senate.

According to a report from CNN,² Democrats hope to extend the tax credits for another three years. However, Fitzpatrick says he wants to compromise on only extending them another two years.

While healthcare costs may be at the center of a political firestorm, they’re also a major issue for Americans. Even with insurance, healthcare is already prohibitively expensive for many people.

While the administration has taken steps to bring down drug prices, it’s unclear how much of an impact these efforts will have. President Trump announced TrumpRx, a DTC government-run website that will sell discounted medication. Details still remain unknown, however, and early reporting suggests that the medications may still be expensive for many Americans, even with the discounts (which appear to based on the list price).

According to a report from AP,³ House Republicans had planned to vote on their own healthcare bill instead of one that would extend the ACA credits. The GOP plan would focus on reducing the role of PBMs, extending access to association health plans, and cost-sharing reductions for some low-income patients.

Meanwhile, the same report says that President Trump suggested creating government sponsored health-savings accounts for Americans. It’s unclear how money would be provided in these accounts, but it’s unlikely that the government would be able to provide the American population with enough money on an individual basis to cover their healthcare costs.

Sources

1. Four Republicans join Democrats to force vote on bill that would extend Obamacare subsidies. The Guardian. December 17, 2025. https://www.theguardian.com/us-news/2025/dec/17/republicans-healthcare-subsidies-vote-petition
2. GOP centrists choose nuclear option in fight with Mike Johnson over Obamacare. CNN. December 17, 2025. https://www.cnn.com/2025/12/17/politics/obamacare-subsidies-discharge-petition-johnson-healthcare
3. Speaker Johnson unveils health care plan as divided Republicans scramble for alternative. AP. December 17, 2025. https://apnews.com/article/republican-house-health-care-plan-obamacare-subsidies-208b30670d0486c8d27ceb59c59003e0