House Republicans, fresh off a win from passing their “big beautiful bill,” already have another debate looming: whether to save expanded tax credits for Obamacare health premiums that expire at the end of this year.
Reauthorizing the enhanced Affordable Care Act credits, created and then extended under the Biden administration, will make it difficult to attract GOP support.
Recommended Stories
- Congress passes spending cuts — but the small savings may make for bigger budgeting troubles
- Rob Bresnahan puts more guardrails on stock trades after scrutiny
- Republican ad campaign to slam vulnerable Democrats over 'big, beautiful bill'
Republicans spent years attempting to dismantle the healthcare law, and a Congressional Budget Office analysis requested by GOP committee chairmen found that a permanent extension of the enhanced subsidies would cost $383 billion.
House Republicans have said since they retook control of Washington, D.C. in January that they are looking to cut “waste, fraud, and abuse” in programs as part of President Donald Trump’s broader agenda to reduce federal spending.
However, a loose bloc of centrist Republicans, already wary of the projected loss of Medicaid benefits as part of their megabill, is interested in extending the tax credits. The CBO estimated that, if the subsidies expire, the number of uninsured people would rise by an average of 3.8 million annually from 2026 to 2034.
An extension could also become an enticement for Republicans looking to make progress on negotiations with Democrats over drug pricing reforms.
On Wednesday, the Ways and Means Committee held a bipartisan roundtable discussion with Dr. Mehmet Oz, the Centers for Medicare & Medicaid Services administrator. Ranking member Richard Neal (D-MA) told the Washington Examiner that he brought up the Obamacare subsidies to Oz.
“We seem to be in agreement about the problem, even though I pointed out that we are unlikely to be in agreement about the solutions,” Neal said, referring to the Democrats and Republicans on the committee.
Neal added that Oz did not agree nor disagree with extending the tax credits, but the congressman said the administrator “made the argument that access is important,” particularly when it comes to rural areas and telehealth opportunities.
“I don’t know how much of that happens unless you extend those tax credits,” Neal said.
The Washington Examiner reached out to Ways and Means Committee Chairman Jason Smith (R-MO) for comment, but he has previously suggested Republicans would be broadly opposed to Obamacare extensions, and in interviews, numerous GOP lawmakers expressed a similar sentiment.
“Well, we need less government in our lives,” Rep. Roger Williams (R-TX) said. “And so, anything Obama had that expires is good for America.”
House weighs healthcare reforms
There have not yet been earnest negotiations over what a healthcare compromise with the Democrats might look like, if one materializes. Republicans have passed legislation through a party-line budget process called reconciliation, while Democrats have dug in against the Trump administration on Capitol Hill and beyond.
Still, Republicans know the expiring enhanced tax credits could have knock-on effects. Created as part of the American Rescue Plan Act in 2021 and then extended into 2025 through the Inflation Reduction Act, the enhanced credits opened up the program to more middle-income earners. However, lawmakers are sensitive to how their extension could affect poorer households.
Rep. Mike Haridopolos (R-FL), a freshman GOP lawmaker, said if the ACA credits expire, “the last thing we want to do is have people fall back on Medicaid.”
“I’m not a big fan of Obamacare,” Haridopolos said. “I don’t think anyone on the Republican side is, but we need to understand how that impacts the lower middle class.”
“I think that’s one of the main issues we will be confronting in the fall, and try to right-size something so that folks who are working hard can get that insurance because if you fall back on the taxpayer, you’re going to have even more budget pressure,” Haridopolos said.
Rep. Tim Burchett (R-TN) wants to let the credits expire, but said that Republicans need an alternative.
“The problem we really have, though, is Republicans run against Obamacare, but they need to substitute for that,” Burchett said. “And that’s where we’re going to have to really get to work, I think. And something has to take its place, and it doesn’t need to be more government involvement.”
“I would submit to you more capitalist ideas and quit allowing the pharmaceuticals to dump everything on America, us having to foot the bill, pay exorbitant prices where other countries don’t,” he added.
Other Republicans see expiration of the expanded credits as a point of leverage in talks over related healthcare policies, especially those regulating pharmacy benefits managers. House members got close to passing a bipartisan deal as part of a December government funding bill, but the provisions were ultimately stripped out.
2026 looms over tax credit expiration
Republicans have attempted to insulate themselves from the loss of Medicaid coverage expected due to their megabill by setting new work requirements for the program that take effect after the 2026 elections.
But some Republicans are warning that the enhanced Obamacare credits pose another threat. Trump-aligned pollster Tony Fabrizio is commissioning polls that find the subsidies are politically popular.
A February survey found 78% of swing voters support extending healthcare premium tax credits for “working families,” while not billing it as “Obamacare” in the poll.
The tax credits are available to those earning up to 400% of the poverty line. Those earning under 150% of the poverty line pay minuscule premiums.
The subsidies are available to more than just working-class individuals, however. Those earning more than 800% of the federal poverty line (more than $120,400) can also qualify for the subsidies, in which the average enrollee saved an estimated $705 annually, or about 44%, in health insurance premium costs in 2024.
Another poll by Fabrizio released last week mirrored February’s findings. According to the survey, a generic Republican candidate is down 3 to 7 points, depending on whether registered or motivated voters are counted. If the ACA credits were to expire, the GOP would trail the Democratic candidate by 15 points. But Fabrizio conversely found that a GOP candidate who supported extending the tax credits would lead a Democrat by 6 points overall.
“Unlike recent changes to Medicaid which do not go into effect until after the midterm elections, voters on the individual insurance marketplace, who voted for Trump by 4-points, will begin getting notices of significant premium hikes this fall,” Fabrizio wrote in a memo. “The incentive is to act on extending the tax credit soon.”
“Republicans can position themselves ahead of Democrats in these districts by extending the premium tax credit and using the individual market as a landing spot for working-age adults on Medicaid,” the pollster added.
Democrats’ healthcare messaging
Obamacare has been a target of the GOP since its inception, with Trump pledging during his first administration that he would repeal the ACA. The late Sen. John McCain’s (R-AZ) famous “no” vote ultimately dealt a fatal blow to Trump and Republicans’ attempts to repeal Obamacare, and the GOP suffered more backlash in 2018 for trying to undo ACA provisions.
Democrats accused House Speaker Mike Johnson (R-LA) of wanting to repeal the ACA ahead of the 2024 elections, after the speaker said “No Obamacare” when asked whether the ACA would survive the GOP’s plan to “take a blowtorch to the regulatory state.”
Johnson later clarified his comments that the ACA is “so deeply ingrained” in current policy that it would take “massive reform.”
“House Republicans will always seek to reduce the costs and improve the quality and availability of healthcare for all Americans,” Johnson said in a statement to the Washington Examiner at the time. “Anyone who has been a patient or known a loved one who has struggled with health issues understands why this is so important.”
The Washington Examiner contacted Johnson for additional comment on the latest plans for ACA credits post-reconciliation.
Republicans are already bracing for Democratic messaging on Medicaid. The GOP is selling the more popular provisions of the megabill, including its permanent extension of Trump’s 2017 tax cuts and money for border security. In terms of Medicaid, Republicans emphasize the work requirements and changes to keep illegal immigrants off the program.
Still, Democrats plan to frame the bill as cuts to working families in exchange for handouts to the rich, with the expanded Obamacare credits providing another line of attack if they expire.
Rep. Nicole Malliotakis (R-NY), a blue-state Republican who went toe-to-toe with leadership on Medicaid and the state and local tax deduction, told the Washington Examiner that the ACA credits only affect about 1% of her district.
“So I really got to look into more, to see,” she said when asked if she’d be in favor of extending them. “I’m not sure what that would mean for costs for that 1%, so I gotta dig more into it. But I imagine there will be a bipartisan push to extend them.”
DEMOCRATS’ STRATEGY ON THE ‘BIG, BEAUTIFUL BILL’ MIRRORS GOP’S OBAMACARE PLAYBOOK
Malliotakis said she isn’t sure if there will be similar GOP pushback for the ACA credits as with Medicaid and SALT.
“It depends on how strongly the membership feels,” Malliotakis, a member of the Ways and Means Committee, said Tuesday. “I think there’s probably going to be some type of bipartisan tax package, and, you know, there’s already a push from some Republicans and Democrats on this issue. So whether that becomes a priority for the package, I don’t know just yet.”