There’s still a chance that the healthcare subsidies that 22 million Americans grew accustomed to during the COVID-19 era could be temporarily extended, but such a measure would require Republican senators to compromise, something they’ve already said they aren’t going to do.
A bipartisan coalition in the U.S. House voted last week, 230-196, to extend Affordable Care Act subsidies for three years. PBS reported that the House vote was a “remarkable rebuke of Republican leadership.”
The tax credits were never intended to be permanent, Republicans have argued, and they expired in December, leaving about 2 million Texans with premiums that doubled and tripled.
The extension measure stalled in Congress late last year and prompted a 43-day government shutdown, the longest in U.S. history.
Senators said at the time of the shutdown they would revisit the extension in January, but they’re under no obligation to do so. Political experts told the Houston Press earlier this month that stalling a vote could help Democrats in the midterm elections, because they’ll be able to say that their GOP opponents don’t care about affordable healthcare.
Rice University political science professor Mark Jones pointed out that U.S. Rep. Monica De La Cruz of Edinburg is one of more than a dozen Republicans facing a competitive race in the November 2026 midterms and likely doesn’t want the healthcare issue to be used against her. De La Cruz voted in favor of the subsidy extension last week.
The fact that 17 House Republicans voted with the Democrats and against their speaker doesn’t necessarily signal that the Senate will follow suit, University of Houston political science lecturer Nancy Sims said Monday.
“I don’t expect the Senate to pass it,” she said, noting that almost all of the House Republicans are up for re-election but just one-third of the Senate Republicans are in that position.
“In the House, those Republicans who crossed over have constituents who are screaming about the ACA,” she said. “I know so many people who were on the ACA and have had to drop it because they just can’t afford what’s happening. I think it was their constituents who drove them to cross the aisle and vote the way they did. In the Senate, you don’t have enough [who are running for re-election and being pressured to vote for an extension].”
U.S. Rep. Lizzie Fletcher, D-Houston, said the House vote was the result of a months-long effort to get the bill to the floor. House Democrats forced the measure to a vote by invoking a so-called “discharge petition” to unlock debate, bypassing objections from House Speaker Mike Johnson.
“The good news: it didn’t only make it to the floor, it passed,” Fletcher wrote in a newsletter to constituents. “The challenge: the Senate may or may not consider it. I am hopeful this effort will get the Senate to act to restore these credits. [About] 125,000 people in Texas’ Seventh Congressional District depended on the [extended premium tax credits] to access health care. Texas’ uninsured rate — which is already the highest in the country — is expected to increase from 16 to 20 percent because of the EPTCs’ expiration.”
The nonpartisan Congressional Budget Office estimated last week that the three-year subsidy extension would increase the nation’s deficit by about $80.6 billion over the decade. At the same time, it would increase the number of people with health insurance by 100,000 this year and 3 million in 2027, a spokesperson for the CBO said.
Johnson, a Republican from Louisiana, urged members of Congress to vote against the extension, saying that the federal health care funding program is rife with fraud.
A bipartisan deal emerging in the Senate would extend the enhanced subsidies for two years and impose an income cap and language requiring a minimum premium of $5 a month to eliminate the $0 premium plans Republicans say are fraudulent, The Hill reported on January 8. The amended proposal would also give patients the option of receiving funding in a health savings account.
Sims said healthcare has been in crisis since the late 1980s but ACA insurance, also referred to as Obamacare, gave millions who don’t have a plan through their employer an alternative for affordable healthcare.
House Democratic Leader Hakeem Jeffries said ahead of last week’s vote that the affordability crisis is not a hoax, as suggested by President Donald Trump.
“Democrats made clear before the government was shut down that we were in this affordability fight until we win this affordability fight,” he said during last week’s discussions. “Today we have an opportunity to take a meaningful step forward.”
This article appears in Private: Jan 1 – Dec 31, 2026.