Time has run out for lawmakers to extend the enhanced Obamacare subsidies before they expire at year’s end, putting Republicans on the hot seat with health care policy as they gear up for the midterms.
Due to the lack of action, 22 million Americans — or 92% of enrollees in the Obamacare exchanges — are expected to face out-of-pocket increases, including ones as high as thousands of dollars in some cases.
“Democrats do not have a feasible plan to lower health care costs. They would rather continue to use the same broken policies that have made health care unaffordable,” Sen. Mike Rounds (R-SD) chided on X.
“I look forward to continued discussions with my colleagues on how to address the high cost of health care.”
Health care premiums were generally expected to increase regardless of whether Congress acted on the expiring enhanced Obamacare subsidies.
But the stalled negotiations made the problem more acute.
The enhanced Obamacare tax credit — which costs about $30 billion annually — was nestled in the Inflation Reduction Act that passed in 2022, but it was only in effect for three years.
Total spending on Obamacare clocked in at around $138 billion in fiscal year 2025, per the Committee for a Responsible Federal Budget.
Standard Obamacare subsidies will remain in effect while the enhanced ones expire.
Democrats elevated the issue by tying it to government funding, resulting in a record-breaking 43-day government shutdown back in November, before caving.
Republicans have tossed around different ideas on how to address the matter, with President Trump favoring an approach that would take the enhanced Obamacare subsidies that go to insurance companies and send them directly to consumers.
But the GOP has splintered over the details of how to do that, and Democrats have resisted that approach, which would be subject to the 60-vote filibuster in the Senate.
Negotiations on some form of an extension had stalled earlier this month, prompting four House Republicans to defect and support a Democrat-backed discharge petition to force a vote on a flat extension of the enhanced subsidies.
A discharge petition bypasses the traditional committee process and forces a vote on a piece of legislation without leadership’s blessing.
A vote on the flat extension is expected to happen sometime in January.
Similar legislation failed in the Senate.
Democrats have seized on health care concerns as a core part of their messaging against Republicans heading into the 2026 midterm elections.
“I spoke to a NYCHA leader in her 60s who told me that her ACA premium is more than doubling because Republicans refused to extend the tax subsidies for low income Americans,” Rep. Dan Goldman (D-NY) posted on X.
“As of tomorrow, she will not be able to afford health care anymore. This is the GOP health care crisis.”
Trump and Republicans have been brainstorming ways to counter Democrats’ attacks on health care policy, with polls generally showing the GOP underwater on the hot-button issue.
