After Democrats tried for months to renew enhanced Affordable Care Act subsidies ahead of a Jan. 1 expiration date, lawmakers took a major step Thursday toward breaking the impasse.
Following a successful discharge petition to force a vote, the House passed a bill, 230-196, that would extend the subsidies for three years. Seventeen Republicans joined all Democrats to support the measure.
While the bill itself faces little chance of becoming law — the Senate already rejected this same proposal — Democrats and Republicans expect the measure to serve as the legislative vehicle for an eventual Senate deal.
For weeks now, a bipartisan group of senators has been working on a compromise. Those talks gained momentum in late December, continued through the holiday recess and are only expected to intensify in the coming days.
While no agreement has been finalized, sources told MS NOW that the emerging framework would include a two-year extension of the subsidies paired with a number of Republican proposals, such as expanded Health Savings Accounts, new income caps on the subsidies around 700% of the poverty level and a $5 minimum monthly premium payment. In exchange for those new changes, Democrats would be able to reopen the marketplace for plans under the ACA (also known as Obamacare).
The enhanced subsidies expired at the start of 2026, leading premiums to skyrocket for millions of those enrolled in the ACA marketplace. Many saw their premiums more than double, according to KFF.
The HSA option included in the framework would align with President Donald Trump’s repeated demand that money go straight to Americans rather than to insurance companies. With the subsidies already expired, Democrats appear more willing to take a less-than-perfect deal to restore coverage and stabilize premiums.
Still, major obstacles remain — chief among them abortion.
Some Republicans are pushing for stricter abortion restrictions, particularly targeting marketplace plans in states that allow or require abortion coverage. Democrats say any additional abortion restrictions would be a deal-breaker.
“Most of the Republicans in the House and Senate want to put poison pill riders about abortion on it,” Senate Minority Leader Chuck Schumer, D-N.Y., told reporters Thursday.
“They are standing in the way. They should get out of the way,” Schumer said.
At the same time, some Democrats see an opening with comments Trump made about abortion earlier this week.
On Tuesday, the president advised GOP lawmakers to be “flexible” on the Hyde Amendment, which prohibits federal funds from being used for abortions except in the cases of rape, incest or when the life of the mother is at risk.
Although several Republicans pushed back against Trump’s comments, others saw an opening.
“The debate is ‘do we really need to do more?’ It’s already in the ACA bill,” Rep. Don Bacon, a moderate Republican from Nebraska, said.
Ahead of Thursday’s health care vote, House and Senate moderates huddled behind closed doors to talk through the latest negotiations. Exiting the meeting, several lawmakers touted what they believe is progress toward a Senate deal.
“The Senate is very far along,” Rep. Tom Suozzi, D-N.Y., said.
Rep. Brian Fitzpatrick, R-Pa., echoed that sentiment, saying lawmakers are “very close.”
Still, the momentum could reverse itself quickly.
Earlier this week, Sen. Thom Tillis, R-N.C., told reporters that “the half-life of an opportunity for an agreement is about every week, you lose about 50%.” Tillis’ warning was particularly apt on Thursday — a day that only underscored the political fickleness of Congress. In the morning, senators surprised Trump by advancing a war powers resolution that would constrain the president’s ability to conduct military operations in Venezuela. Minutes after the vote, Trump posted on Truth Social that the five Republican senators who broke with him — Sens. Susan Collins of Maine, Josh Hawley of Missouri, Lisa Murkowski of Alaska, Rand Paul of Kentucky and Todd Young of Indiana — “should never be elected to office again.” By the afternoon, however, Trump demonstrated his continued sway over the GOP, persuading enough Republicans to sustain vetoes on two bills that had previously passed unanimously. That influence was again tested later Thursday with the health care vote. Ultimately, 17 Republicans broke ranks, joining with all Democrats to pass the three-year extension — a symbolic victory that nevertheless puts pressure on the Senate to act. Trump’s role looms large over the next phase of negotiations. During the recent government shutdown, Democrats repeatedly insisted that the president engage in the subsidy talks, even as he largely stayed on the sidelines. At one point, the White House prepared to offer a proposal to extend the subsidies temporarily while lawmakers worked on a larger deal. But GOP leaders resisted the idea, and Trump eventually scrapped the proposal. The impasse opened the door for four Republican members of the House to eventually join Democrats in signing on to the discharge petition, which effectively sidestepped GOP leadership and Trump to secure a vote on the subsidies on the House floor. Now, Republicans — particularly those in competitive districts — are eager for the president’s help. But whether Trump chooses to facilitate a deal or derail it remains an open question. Asked whether Trump should get involved, Fitzpatrick — one of the moderates central to the effort to find a compromise — told reporters, “It certainly wouldn’t hurt.” “It would help,” he said. Syedah Asghar and Jack Fitzpatrick contributed to this report.
Kevin Frey is a congressional reporter for MS NOW. Recommended
