After the Senate failed this week to pass bills aimed at lowering health care costs, House Republicans released a legislative proposal late Friday that would not extend the enhanced Affordable Care Act (ACA) tax credits that many Democrats sought. Leaders say the package contains other changes intended to expand access and reduce costs, but it stops short of continuing the subsidies that help lower marketplace premiums.
Lawmakers face a tight deadline. The enhanced ACA subsidies—first introduced in 2021—are set to expire at year’s end, and millions of people who buy plans on the marketplaces could see premiums rise sharply if the credits end. Democrats have pushed to extend those higher tax credits to avoid premium spikes.
The House GOP plan, which leadership said could be voted on next week, includes provisions to let small businesses combine buying power to purchase coverage for employees and new rules for pharmacy benefit managers aimed at lowering drug prices. It would also create federal cost‑sharing reduction payments beginning in 2027 to help lower premiums for some lower‑income enrollees, but would bar those payments for health plans that cover abortion.
House members have only four legislative days before their holiday recess begins Dec. 19; the Senate is scheduled to recess on Dec. 20.
Democratic House Minority Leader Hakeem Jeffries criticized the proposal for not extending the ACA tax credits, calling it “a deeply unserious proposal.” Earlier this week, a Democratic‑led Senate bill to extend the enhanced subsidies for three years, supported by a handful of Republicans, failed to pass, as did a separate Senate Republican plan; neither measure reached the 60‑vote threshold needed to advance in the chamber.
Former President Trump and other Republicans have proposed different approaches, arguing federal assistance should go directly to people rather than to insurers. A Senate GOP proposal had included up to $1,500 for health savings accounts for people earning under 700% of the federal poverty level, paired with high‑deductible plans; that language does not appear in the House Republican package. Democrats opposed the Senate GOP plan, saying it would not meaningfully help people pay premiums and objecting to its restrictions on abortion coverage and gender‑affirming care.
Some Republicans have warned that allowing the enhanced ACA subsidies to expire could hurt the party politically in next year’s elections, and a number of House Republicans are pursuing ways to extend the credits, including efforts to force a floor vote over leadership objections.