The House on Thursday approved a bill that would provide a three-year extension of enhanced subsidies for healthcare plans sold under the Affordable Care Act, overcoming resistance from Republican leaders who sought to avoid taking up the measure.
The final vote was 230 to 196, with all Democrats and 17 Republicans supporting the legislation. Many of the Republicans backing the bill are from closely divided districts, and their votes come amid worries that soaring insurance costs could contribute to major GOP losses in the midterm elections this fall.
The enhanced subsidies, which expired at the end of 2025, helped spark the longest government shutdown ever late last year, as Democrats pushed to renew the tax credits and prevent a spike in out-of-pocket costs for millions of Americans.
Thursday’s vote came after nine Republican representatives joined with Democrats on Wednesday to advance the legislation onto the House floor. In December, four swing-district Republicans helped the discharge petition secure the 218 signatures needed to sidestep House Speaker Mike Johnson and set up the floor action this week.
According to an analysis by the Congressional Budget Office, the three-year extension of the ACA subsidies would increase the number of people with health insurance by 4 million in 2028, at a budgetary cost of about $80.6 billion over 10 years.
Senate eyes a fix: The Senate rejected a three-year extension of the ACA subsidies last month, and the House bill is not expected to be treated any differently, but a bipartisan group of senators has been discussing a plan that could conceivably pass the upper chamber.
The bipartisan deal would reportedly include a two-year extension of the ACA subsidies, with assistance capped for households with incomes above 700% of the federal poverty level. All participants would be required to pay a minimum of $5 per month for their coverage, and the legislation could create an option for participants to receive subsidies directly in health savings accounts in the second year.
One issue that remains unresolved revolves around the Hyde Amendment, which bans the use of federal funds for abortions, and its applicability to direct federal subsidies for healthcare.
Republican Sen. Bernie Moreno said Wednesday that the bipartisan group is in the “red zone,” using a football term to indicate that they were getting close to reaching a deal. “But that does not mean a touchdown,” he added. “It could mean a 95-yard fumble.”