Millions of Americans who rely on Affordable Care Act (ACA) subsidies to make their health insurance affordable are facing a daunting new year: sharply higher premiums and, for some, the prospect of losing coverage altogether. The cause? A political standoff in Washington, D.C., that has left Congress deadlocked and the enhanced ACA tax credits set to expire at the end of December 2025.
On December 16, 2025, House Speaker Mike Johnson, a Republican from Louisiana, made it official: there would be no vote this week on a bipartisan amendment to extend the enhanced ACA subsidies, despite mounting pressure from moderate Republicans and Democrats alike. According to States Newsroom, Johnson explained, “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. And many of them did want to vote on this Obamacare, COVID-era subsidy the Democrats created. We looked for a way to try to allow for that pressure release valve and it just was not to be.”
The enhanced tax credits, first introduced during the COVID-19 pandemic, have played a critical role in helping roughly 22 million Americans afford health coverage through the ACA’s marketplace system. But with their expiration looming at year’s end, premiums are expected to rise dramatically. As Larry Levitt, executive vice president for health policy at KFF, wrote on X, “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. Some will find a way to pay it, some have switched to higher deductibles, and some have dropped coverage.”
For many lawmakers, especially those representing competitive districts, the impending premium hikes are a political powder keg. Rep. Mike Lawler, a Republican from New York and one of the most vulnerable GOP lawmakers heading into the 2026 midterms, did not mince words. On the House floor, Lawler called the decision to let the enhanced ACA tax credits expire “idiotic and shameful,” adding, “Everybody wants the upper hand. Everybody wants the political advantage. They don’t actually want to do the damn work. This problem could be solved today if everybody who says they care about extending this signs the discharge.” Lawler’s frustration was echoed by Rep. Kevin Kiley of California, who labeled Johnson’s refusal to hold a vote on the extension “a failure of leadership.”
The Republican health care bill scheduled for a vote on December 17, 2025, does not include an extension of the ACA tax credits, a point that has left moderate Republicans feeling exposed. Johnson, however, remained confident that blocking the amendment would not lead centrist GOP lawmakers to oppose the broader Republican health care bill. “I certainly appreciate the views and the opinions of every member of this conference,” Johnson told reporters, according to NBC News. “But I will tell you: One thing they will all join in unity on is voting for this bill that we’ve been discussing this morning.”
The political battle over the ACA subsidies is not new. Republicans have long argued that the enhanced subsidies were a temporary fix for pandemic-era hardships, not a permanent entitlement. Johnson reiterated this stance, telling reporters that he would not support an extension without corresponding spending cuts to offset the estimated $35 billion annual cost. “We worked on it all the way through the weekend, in fact. And in the end there was not an agreement — it wasn’t made,” Johnson said.
Democrats, for their part, warn that letting the subsidies expire will have dire consequences for everyday Americans. House Minority Leader Hakeem Jeffries of New York has pushed for a clean three-year extension of the enhanced tax credits, arguing that “214 Democrats have signed a discharge petition that would force an up-or-down vote on extending the Affordable Care Act tax credits — to make sure that tens of millions of Americans don’t experience increased health insurance premiums that will prevent them from being able to go see a doctor when they need one.” All it would take, Jeffries noted, is for four House Republicans to join the effort.
Some moderate Republicans have signaled openness to this approach, with Lawler stating, “All options are on the table.” But with the holiday season approaching and the House set to adjourn, the likelihood of a discharge petition leading to a floor vote before the new year is slim. Even if the House were to pass an extension, its prospects in the Senate remain uncertain. As Rep. Andy Harris of Maryland, a member of the House Freedom Caucus, put it, “These will pass in the House, and then they’ll be killed over in the Senate. The Senate’s already taken a position on extending the Affordable Care Act to enhance subsidies, and they rejected it.”
The Senate’s own efforts have stalled. In early December, the chamber voted on two health care bills — one from Republicans and one from Democrats — but neither garnered the support needed to move forward. The Republican bill proposed direct payments of up to $1,500 annually for people enrolled in certain ACA marketplace plans, while the Democratic bill would have extended the enhanced tax credits for three years. Neither approach bridged the partisan divide.
President Donald Trump has weighed in as well, advocating for Republicans to eliminate the Senate filibuster to push through health care reforms. “Republicans should knock out the filibuster and we should approve a lot of things,” Trump said during an Oval Office event. He also reiterated his preference for direct payments to Americans to help them buy health insurance, declaring, “I want all money going to the people and let the people buy their own health care. It’ll be unbelievable. They’ll do a great job. They’ll get much better health care at a much lower cost.”
The stakes are high, not only for those who rely on ACA subsidies but also for lawmakers facing a restless electorate. A poll released on December 15, 2025, by the West Health-Gallup Center on Healthcare in America found that cost is the “most urgent” health issue facing the country. Only 57% of respondents said they were satisfied with their own health care costs, and a mere 16% expressed satisfaction with the total cost of healthcare. Nearly two-thirds (about 66%) believe it’s the federal government’s responsibility to ensure all Americans have health care coverage.
As the year draws to a close, millions of Americans are left in limbo—and lawmakers are left to reckon with the consequences of inaction. The political gridlock over ACA subsidies is a microcosm of the broader health care debate that has roiled Washington for more than a decade. With no compromise in sight, the new year promises uncertainty, higher costs, and renewed calls for reform.
