House Republican leaders have declined to allow a vote on extending enhanced Affordable Care Act tax credits before the end of the year, a decision that all but guarantees the expiration of subsidies relied on by millions of Americans and sets the stage for sharp premium increases in 2026. Speaker of the House Mike Johnson confirmed Tuesday that no vote would be held, citing unresolved disagreements within the Republican conference over how to proceed.
The decision comes as a critical deadline approaches. The enhanced ACA tax credits are set to expire at the end of the month, and the open enrollment period for coverage beginning January 1, 2026 has already closed. Without congressional action, health insurance premiums for people who receive coverage through the ACA marketplaces are expected to rise dramatically, on average by about 114 percent, according to figures cited in the reporting. Around 22 million Americans currently participate in the program.
Johnson told reporters that internal opposition prevented leadership from moving forward, despite pressure from some Republicans representing politically competitive districts. “There’s about a dozen members in the conference that are in these swing districts who are fighting hard to make sure they reduce costs for all of their constituents. … We looked for a way to try to allow for that pressure release valve, and it just was not to be,” Johnson said. In a separate exchange, he added, “We looked for a way to try to allow for that pressure release valve, and it just was not to be. We worked on it all the way through the weekend, in fact. And in the end there was not an agreement.”
At the center of the stalemate was how to pay for the extension. According to the reporting, centrist Republicans were told that no vote could take place unless they identified roughly $35 billion in federal spending cuts to offset the cost of the tax credits. That demand effectively halted the effort, even as lawmakers acknowledged that premiums would rise sharply for constituents if the subsidies lapse.
Rep. Mike Lawler of New York, a Republican representing a swing district, reacted angrily to Johnson’s announcement. “I am pissed for the American people. This is absolute bullshit, and it’s absurd,” Lawler said in remarks to NBC News. In separate comments reported elsewhere, Lawler called Johnson’s obstruction of a vote “bullshit” and “political malpractice.” While Lawler placed blame on both Republican and Democratic leaders for the impasse, he also said it would be “idiotic” to withhold a vote on renewing the credits.
The enhanced ACA subsidies were first put in place in 2021 amid the Covid-19 pandemic and have helped lower premiums for marketplace enrollees across income levels. Their expiration is expected to have immediate financial consequences. For many enrollees, costs will rise by around $1,000 per year. For others, the increase could be even higher. The reporting cited the example of an individual earning $28,000 annually who could see premiums rise by $1,562 if the credits expire.
Survey data included in the articles underscore the scale of the potential impact. A survey conducted by KFF earlier this month found that 58 percent of people currently enrolled in ACA marketplace plans said they could not afford even a $300 increase in yearly health costs. Another 20 percent said they could not afford a $1,000 increase. In a separate KFF survey, 25 percent of marketplace enrollees said they would be “very likely” to go without insurance if their monthly premiums doubled.
Despite these figures, House Republican leaders have pointed to alternative approaches rather than a straightforward extension of the tax credits. Johnson suggested that a reconciliation bill could be taken up early next year, a process that would allow legislation to pass the Senate without being blocked by a filibuster. However, the reporting noted that such a plan would likely not extend the ACA tax credits and would instead provide qualified applicants with direct health savings account payments.
Johnson has also promised a broader health package that would “reduce premiums for 100 percent of Americans who are on health insurance,” though he did not offer details. Critics cited in the articles argue that proposals along these lines would simply push people into lower premium plans with much higher deductibles, shifting costs rather than reducing them. Senate Minority Leader Chuck Schumer described a similar approach discussed earlier in the month as “little more than junk insurance,” adding, “It is no real plan at all.”
Democrats and outside advocates have sharply criticized the decision to let the subsidies expire. Rep. Pramila Jayapal of Washington said Republican lawmakers were knowingly leaving town without addressing the looming cost increases. “They are actively choosing to go into the holiday break, knowing healthcare premiums are doubling and tripling for millions of Americans in 2026, and doing nothing about it,” Jayapal said.
Some lawmakers have turned to procedural tools in a last-ditch effort to force action. Two discharge petitions are circulating in the House, either of which could bring a vote to the floor if they secure 218 signatures. One, sponsored by Democrats, would extend the tax credits for qualifying ACA marketplace recipients for two years. The other would also extend the credits but impose stricter income eligibility rules. Both petitions have received signatures from about a dozen Republican lawmakers, though the Democratic-led petition has more Democrats signed on.
Even if one of the petitions ultimately gathers enough support, timing remains a major obstacle. Reporting cited by NBC News noted that reaching the House floor would take time, likely pushing any vote into next year. In the Senate, any extension would still face the threat of a filibuster, and it remains unclear whether President Donald Trump would sign such a bill into law.
Health policy analysts have warned that the expiration of the credits will lead to a range of outcomes, from higher out of pocket costs to loss of coverage altogether. “With no extension of enhanced tax credits, ACA enrollees are going to start the year with premium payments increasing by an average of 114%, or over $1,000 a year per person,” Larry Levitt, KFF’s executive vice president for health policy, noted Tuesday. “Some will find a way to pay it, some have switched to higher deductibles, and some have dropped coverage.”
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