Ten Democratic-leaning states are using their own money to help people buy Obamacare health plans, at least partially replacing the federal tax credits that expired at the end of last year.

The state assistance, some of it offered through programs that existed before the federal subsidies expired, is helping hundreds of thousands of people lower their monthly premium payments, which otherwise would have surged to double or even triple what they were before the expiration of the federal aid. The savings can total hundreds of dollars per month.

But only New Mexico is completely filling the gap left by the expiration of the federal help by offering it to people of all incomes; for most Americans buying Obamacare plans, the end of the federal aid means much higher prices. And New Mexico and the other states that are trying to cushion the blow for their residents will face increasing budget pressures as health care costs continue their inexorable rise.

In addition to the expiration of the federal subsidies, the cost of Obamacare coverage has increased because of other factors, including labor shortages and the rising cost of prescription drugs, driven in part by the growing demand for GLP-1 drugs such as Ozempic and Wegovy.

The enhanced federal subsidies were made available by the American Rescue Plan Act in 2021 and later extended through the end of 2025 by the Inflation Reduction Act. Designed as a temporary pandemic-era measure, they helped boost the number of people buying health coverage from the insurance marketplaces created under the Affordable Care Act — Obamacare’s formal name — from 11.4 million people in 2020 to 24.3 million last year.

The enhanced subsidies were available to everyone, regardless of income. Additional federal aid provided to some of the lowest-income households entirely eliminated premium payments for some people.

Congressional leaders let the subsidies expire on Dec. 31. As of the end of last month, the number of people enrolled in marketplace coverage was down by about 1.2 million compared with last year, according to federal data.

Last year, the Congressional Budget Office estimated that the expiration of the federal subsidies would increase the number of people without insurance by 4.2 million by 2034.

Under the Affordable Care Act, each state can either use the federal government’s online insurance marketplace, HealthCare.gov, or operate its own state-run exchange. Only the 21 states plus the District of Columbia with state-run marketplaces can offer state-funded tax credits or subsidies, and at least 10 of them (California, Colorado, Connecticut, Maryland, Massachusetts, New Jersey, New Mexico, New York, Vermont and Washington) are doing so.

Matt McGough, a policy analyst at health care research group KFF, said many of the people who buy Obamacare plans “have fallen between the cracks of the health care system.”

“They might not work a job or work enough hours at a job to be eligible for health benefits. They are too young for Medicare. They make too much to be eligible for Medicaid, and they really have no other option but to go to the marketplace,” McGough said.

He warned that relatively healthy people are the ones most likely to forgo marketplace coverage rather than pay more for it. That will leave the exchanges with the people who have the greatest health needs, raising costs and premiums for everyone. To avoid that scenario, he said, states “want to be able to keep as many people in the marketplace as possible.”

A big commitment in New Mexico

In New Mexico, Democratic Gov. Michelle Lujan Grisham and state lawmakers earlier this year tapped the state’s 5-year-old Health Care Affordability Fund for an additional $17.3 million so they could entirely replace the expired federal subsidies through June 30 for all enrollees, regardless of income.

The vast majority of the 82,400 New Mexicans who buy coverage from the state marketplace are eligible for state help. Perhaps as a result, New Mexico is one of only a handful of states where the number of people buying Obamacare plans has increased this year: Enrollment is up 18% in New Mexico, while there have been single-digit increases in the District of Columbia, Maryland and Texas.

“We feel really great about having come together to really focus on these affordability challenges for New Mexicans, and really proud of the gains that we’ve made in coverage while we’re seeing losses elsewhere,” said Kari Armijo, cabinet secretary for the New Mexico Health Care Authority. She noted that a handful of Republican state lawmakers have joined Democrats in supporting the aid.

The money in New Mexico’s Health Care Affordability Fund comes from a 3.75% surtax levied on insurance companies. When the fund was created, the surtax was expected to generate about $165 million in new revenue annually.

Currently, the state uses nearly half of the revenue from the surtax to fund other parts of its budget. But the New Mexico House earlier this month approved a bill that would gradually increase the portion of the surtax allocated to the Health Care Affordability Fund, from the current 55% to 100% in 2028.

Legislative financial analysts recently questioned the long-term sustainability of that approach. Armijo acknowledged that continuing to replace the expired federal subsidies “will deplete the fund over time.”

“It is a pretty substantial amount of money, and it is going to strain the programs that we can provide with that funding,” Armijo said.

Paul Gessing, president of the Rio Grande Foundation, a conservative-leaning think tank in New Mexico, said the state is “flush with oil and gas money” now, enabling it to “spend money in ways that don’t make a great deal of sense for the population as a whole and instead benefits a small sliver of relatively well-off New Mexicans.”

Gessing said the state should focus on reducing health care spending by recruiting and retaining more doctors and nurses to lessen its shortage of providers and by overhauling medical malpractice laws.

“I don’t think the state should make it a practice to use state funds to fill in the gap when federal funding is shifted or eliminated,” Gessing said.

Other states

In California, where 1.9 million people were enrolled on the state’s exchange in 2025, enrollment is already down by 32% from last year, according to state figures.

The state has opted this year to spend $190 million to fully replace the lost federal subsidies for people earning up to 150% of the federal poverty level ($23,940 for an individual), and partially replace them for people making between 150% and 165% of the federal poverty level — just above eligibility for Medicaid in the state. About 390,000 enrollees are receiving the state-based subsidies this year.

Like New Mexico, California in 2021 created a Health Care Affordability Reserve Fund, funded through general revenue and penalties some people have to pay when they file their taxes.

The state budget Democratic Gov. Gavin Newsom proposed last month envisions a “modest projected deficit” of $2.9 billion for fiscal year 2026-2027, but that could grow to $22 billion the next year. California has a total annual budget of about $350 billion.

“Any amount of money that you can put into affordability is meaningful,” said Jessica Altman, executive director of California’s marketplace. “Thinking about those trade-offs is a challenging conversation, but an important one at the state level.”

In Colorado, the state is offering financial help through a new program called the Colorado Premium Assistance program. It came together during an August 2025 special session, when Colorado lawmakers approved up to $110 million this year to partially replace the federal subsidies. Help will be available to anyone making between 133% and 400% of the federal poverty level, or between $43,890 and $132,000 for a family of four.

“It is clear that this is a value for Coloradans. And having a state based marketplace like we do in Colorado, it really allows us to develop state-specific solutions and have our policies and changes driven by the needs of the people who live here,” said Nina Schwartz, chief policy and external affairs officer for Colorado’s marketplace.

Schwartz emphasized, however, that the state help won’t entirely replace the expired federal aid, and that as a result, the number of people buying coverage on the exchange is declining. Cancellations are up 83% compared with last year.

“We’re seeing an increase in the number of cancellations, with the number of people nearly doubling who canceled their plans during open enrollment compared to last year,” she said.

Other states also are opting for limited assistance. Connecticut, for example, is offering aid to households with incomes up to 200% of the federal poverty level, and the state announced it would spend $115 million in 2026 to partially offset the expiration of the federal subsidies.

Massachusetts has set aside $250 million to enhance its existing state subsidy program, helping to keep around 270,000 enrollees with incomes below 400% of the federal poverty level enrolled with stable premiums. As of early January, around 25,000 people in Massachusetts had already canceled their marketplace plans.

Maryland has a new premium assistance program that fully replaces the federal aid for enrollees earning below 200% of the federal poverty level and partly replaces it for those earning between 200% and 400% of the federal poverty level. Since last year, New York has offered help to marketplace enrollees with incomes up to 400% of the federal poverty level. And since 2023, Washington has offered state subsidies to anyone earning below 250% of the federal poverty level.

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org. 

Photo by Gregory Conniff for Wisconsin Examiner

On July 4th, in the towns and counties of rural western Wisconsin, there were celebrations like on any other Independence Day: grilling bratwurst, drinking Leinenkugel’s, fireworks showering high in the summer night. 

That very same day, a thousand miles away in Washington, DC, HR1— also known as the “One Big Beautiful Bill Act” (OBBBA) — was signed into law. Yet for people here, the passage of the bill was a mere blip in the national headlines. It was not apparent that it would become an economic earthquake, triggering a tsunami of devastating after-effects soon to crash down on our rural communities.

The massive tax cut and spending bill is the most dramatic restructuring of federal budget priorities in six decades. The president called the OBBBA his “greatest victory” and the “most popular bill ever signed.” The White House issued only a scant 237-word press release summarizing the 900-page law; the substance of the law itself was barely mentioned. When it was enacted, nearly two-thirds of Americans said they knew “little or nothing” about what was in the bill.

When asked about his support of the bill, my own representative from Wisconsin’s 3rd Congressional District, Derrick Van Orden, dismissed any suggestion that the White House had influenced his vote. “The president of the United States didn’t give us an assignment. We’re not a bunch of little bitches around here, OK? I’m a member of Congress, I represent almost 800,000 Wisconsinites.” 

The OBBBA permanently extends the 2017 tax cuts and locks in a historic upward transfer of wealth. The top 1% of households receive an average tax cut of $66,000. Working families earning $53,000 or less get a tax cut of just $325. Roughly $1 trillion dollars will flow to the richest households over the next decade, while Medicaid, nutrition assistance, and health coverage are drastically scaled back, pushing 15 million people off insurance. 

‘I want to be part of a strategy, something that’s actually effective’

Last August, 70 of us gathered on a Saturday in Woodville, Wisconsin, population 1,400, with the understanding that something consequential was happening in our nation, yet struggling to figure out how we can respond. We filled a community center on Main Street for six hours: teachers, farmers, retirees, retail workers, students, small business owners. People brought notebooks and coffee. The windows were open. Ceiling fans spun slowly overhead. 

“I’m tired of complaining, feeling like a victim, worried about what’s going to happen next,” one of our members put it plainly. “I want to be part of a strategy, something that’s actually effective.”

I organize with Grassroots Organizing Western Wisconsin (GROWW). Our work has always started from a simple question: How does power move in the places we live? Since the organization began, our focus has been on local issues like housing, agriculture and rural broadband. But, at that meeting in Woodville, we were trying to name what was happening: how the political chaos in our federal government was flowing down to our families, counties, schools, cities, hospitals, town boards. And, most importantly, what we could actually do about it. 

That day in Woodville we made a plan. It did not involve protest or messaging. Our organizing has never been about reacting the fastest or shouting the loudest. Power is built methodically: identifying who makes decisions, who feels the consequences, and where solidarity can be established and strengthened before a harm is normalized and written off as inevitable. That is why we started with listening.

During the following three months we sat down face to face with nearly 100 local leaders across four counties. We met in offices, conference rooms and coffee shops. We spoke with school superintendents, sheriffs, county administrators, hospital executives, clergy, elected officials, business owners. We asked the same questions over and over: what were people experiencing in their jobs, what pressures were they under, what was keeping them up at night?

Many people we spoke with were overwhelmed by the effort required to stay focused on their jobs: the to-do lists, budgets, hiring, planning. One program director told us her job was mostly “putting out fires.” When we asked how they were reacting to federal policy changes, most people didn’t have much to say. Unless it was affecting them today, they didn’t have the luxury to worry about it. 

Each conversation made clear how county governments in rural Wisconsin are lifelines, not faceless bureaucracies. They plow snow, run elections, maintain roads, administer BadgerCare and SNAP, respond to mental health crises, operate nursing homes, and answer 911 calls. And they are already stretched thin.

Funding was the issue mentioned the most. A county administrator walked us through the elaborate gymnastics required to balance a county budget under state-imposed levy limits that make raising revenue nearly impossible: wheel taxes, bond sales, consolidating services. One-time fixes layered on top of structural gaps. Again, it came back to resources. Not culture wars, not ideology. Money.

Delaying the pain

What surprised us most was what we did not hear. Despite anxiety about shrinking budgets, very few people mentioned the One Big Beautiful Bill. It had not yet made a mark on their daily work. That is not accidental. The new law is designed to delay the pain, disperse responsibility, and conceal the damage out of public view until it feels inevitable.

We decided to look into the law’s ramifications. We did our own research, and what we learned is that rural and small-town communities in western Wisconsin are in for a slow-motion fiscal disaster, and that regular people will be the ones who pay the price. 

Starting in 2027, the federal government is scheduled to cut its share of SNAP administrative costs in half. In counties like Dunn, that shift could mean hundreds of thousands of dollars in new local costs. A smaller administrative budget means fewer staff, which means slower processing, higher error rates, and federal penalties that reduce funding even further. The OBBBA seems designed to trigger countless downward spirals that degrade programs until they can be declared broken.

The repercussions for Medicaid follow the same pattern. At Golden Age Manor, the beloved county-run nursing home in Amery, where most of the services are Medicaid funded, even modest reimbursement cuts will translate into tens or hundreds of thousands of dollars lost each year. At the same time, more uninsured residents will still need care.

Across our counties, more than 10,000 people rely on ACA Marketplace coverage for their health insurance. Since federal tax credits expired at the end of 2025, families face premium increases averaging around $1,600 a year. Some will pay far more. Many will drop coverage altogether. When they do, costs will shift to county-funded behavioral health systems and other services already operating at the limits of their resources.

One sheriff described what that will look like in practice: “When someone is in a mental health crisis, our deputies already spend hours driving them across the state because there are no beds here,” he said. “If people lose coverage, those crises do not go away. They show up as 911 calls.”

We must act before the tsunami arrives

A tsunami is set in motion by a distant earthquake that no one feels. Life happens on shore while energy gathers fiercely far out at sea. Only a seismograph sounds the alarm. Once the wave arrives, entire cities are engulfed, communities washed out to sea. Trump’s massive tax cut and spending law was that earthquake. We have decided to act before the wave arrives.

Local governments will be forced to navigate what policy expert Eric Schnurer described as “fiscal and operational crises,” but few people will be able to connect what happens to a bill passed last year. “Most Americans don’t realize how dramatically state and local governments — which most directly affect their daily lives — are about to change.”

County budget hearings were held in November. They often happen with no public comment, gaveled in and gaveled out in a matter of minutes. Last year we showed up and filled the rooms. We brought letters we had drafted, breaking down projected budget impacts county by county. We delivered testimony from the podium. Our goal was not to blame our county leaders, but to signal our alignment with them. 

After one hearing, a county administrator, a self-identified fiscal conservative, met with us and said, “Every point you raised in your letter was correct. Our county government has to brace for what’s coming, and you made that clear to everyone in the room.”

The people who will be hit hardest

We know our county boards are not responsible for causing this disaster, yet they will be forced to deal with it, while we, the residents, will be the ones who feel the cuts most deeply. Our members of Congress who voted “yes” for this bill are the ones responsible for this mess. 

Letters and testimony are not enough. What we need is power. For regular people like us, there is but one path to power: organizing. That means we have to talk to those who will be most affected, inviting them to see their personal stake in this fight. The single parent in River Falls, juggling two part-time jobs and relying on SNAP to keep food on the table. The kid with asthma in Boyceville, whose parents rely on ACA coverage, now at risk of losing access to care. The retired farmer outside Balsam Lake, whose wife’s long-term care at Golden Age Manor nursing home is covered through Medicaid. 

Our long game is to begin the conversation about what it will take for Congress to repeal the so-called One Big Beautiful Bill Act. The path to repeal will be fraught with political roadblocks and fiercely opposed by the corporate class, which has been true for every consequential victory working people have ever won in this country. Repealing the law must become a defining issue in every political conversation in America – at dinner tables, at bus stops, and on Reddit threads – starting now and continuing until the law is gone. 

Cracks are already beginning to form. Earlier this month, Rep. Van Orden, along with 17 other Republicans in the House of Representatives, backpedaled on his support of the OBBBA by voting to extend ACA tax credits (more than 30,000 people are expected to lose health insurance in Van Orden’s district). However, the opposition stiffens. Shortly after the vote, in a disciplinary move, Americans For Prosperity announced it was pausing support for those who defected.

Cutting services, expanding the machinery of repression

As I write, immigration agents are spilling into western Wisconsin from Minneapolis, swarming small towns and rural communities across the region. They are driving unmarked vehicles with out-of-state plates. Some members of our organization have built rapid response networks in solidarity with immigrant-led groups. Meanwhile, our neighbors are being terrorized, taken from their homes, and families are being ripped apart. Some local Mexican restaurants and grocery stores have closed their doors. Just sixty miles west, in Minneapolis, two American citizens have been killed by ICE agents. 

This is not a coincidence. While showering billionaires with tax benefits, the OBBBA also massively expands the machinery of repression. It quadrupled the budget of ICE, expanding its force by 10,000 agents and thereby transforming the agency into one larger than most national militaries. On one hand, the administration subjects us to the cruel spectacle of paramilitary raids, disappearances and death. On the other, the administration dismantles the social safety nets that keep people alive, then redistributes public resources to the wealthiest few. A loud disruptive culture war creates a smokescreen for a quiet methodical class war. 

The fight for Congress to repeal the OBBBA will be a David versus Goliath fight. It is a fight about whether the super-rich will be able to bleed us dry and starve our local institutions. Whether our neighbors will die as wealth is extracted from above. Whether daily life for a majority of Americans will be defined by relentless top-down class war. 

This fight will not be won by politicians, consultants, or pollsters. It will be won by regular people who have decided to build a movement town by town, county by county, state by state. The ramifications of the OBBBA are so wide and deep that a new political coalition will be necessary, one big enough to include anyone who isn’t a billionaire. Republicans, Democrats, independents, libertarians, socialists, and people who’ve lost faith in politics altogether. White people, brown people, Black people, young people, old people. The poor, the working class, the middle class. 

An unwavering commitment to big tent politics and multiracial solidarity is how we defeat the divide-and-conquer tactics this administration relies upon. Building trust and power across differences. Not reinforcing divides through purity tests or theoretical debate. Listening for common ground and shared humanity. Seeing every person as a potential ally, not an enemy to defeat. We must organize, strategize and mobilize until regular Americans have won the freedom to make ends meet, live with dignity, and have a voice in the decisions that affect us.

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The U.S. Capitol in Washington, D.C., on Oct. 1, 2025. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — Republican leaders in the U.S. House will face a floor vote in early 2026 on Democrats’ plan to extend enhanced Affordable Care Act tax credits for three more years, after passing their own legislation Wednesday night that has little chance of a future in the Senate and does not address the tax credits.

The House vote on that legislation will be required after a handful of moderate Republicans signed on to a discharge petition Wednesday morning. Their dissent with leadership sent a strong signal they are frustrated with the majority’s policies and the rising cost of health care for their constituents. 

Speaker Mike Johnson, R-La., said after a morning vote series on the floor, where he was seen in a heated exchange with Republican Rep. Mike Lawler, that the two “just had some intense fellowship” and “it’s all good.”

Lawler is one of the four centrist Republicans who signed the discharge petition, putting it over the threshold of 218 to force a vote on the legislation. 

“We’re working through very complex issues as we do here all the time,” Johnson said. “Everybody’s working towards ideas — we’re keeping the productive conversation going.” 

The speaker also mounted his own defense, saying he has “not lost control of the House.”

That chamber has seen chaos and intraparty divides in the aftermath of the government shutdown, when Johnson opted to send lawmakers home for nearly two months. 

“We have the smallest majority in U.S. history,” Johnson said. “These are not normal times — there are processes and procedures in the House that are less frequently used when there are larger majorities, and when you have the luxury of having 10 or 15 people who disagree on something, you don’t have to deal with it, but when you have a razor-thin margin, as we do, then all the procedures in the book people think are on the table, and that’s the difference.”

Republicans push through ‘extremely modest’ bill

House debate on Republican leaders’ health care bill later in the day was largely along party lines, with members of both parties talking nearly as much about the Affordable Care Act as they did about the policy in the new legislation. 

Energy and Commerce Committee Chairman Brett Guthrie, R-Ky., said he believes that law, enacted during President Barack Obama’s first term, “has proven to be unaffordable and unsustainable.” 

Guthrie rebuked Democrats for approving the enhanced ACA marketplace tax credits during the coronavirus pandemic and scheduling them to expire at the end of this year, leading to the current deadlock in Congress. 

“Democrats leveraged a public health emergency to shovel hundreds of billions of dollars to big health insurance plans to mask the risk of rising unaffordability of coverage,” Guthrie said.

House Minority Leader Hakeem Jeffries, D-N.Y., urged Johnson to put the three-year ACA extension bill up for a vote this week, instead of in the new year. 

“Republicans need to bring the Affordable Care Act tax credit extension bill to the floor today,” Jeffries said. “Under no circumstances should we leave this Capitol this week, before voting on an extension of the Affordable Care Act tax credit bill that we know will pass.” 

California Republican Rep. Kevin Kiley, one of the centrists looking for bipartisan solutions on the expiring tax credits, expressed dismay at how debate on health care costs has been handled during the past few months by leaders in both political parties. 

“This whole issue encapsulates what is wrong with this institution, where party leaders focus most of their time and energy on trying to blame problems on the other side rather than trying to solve those problems,” Kiley said. 

The House Republican bill, he said, is “extremely modest and it has no chance of becoming law because it was hastily thrown together without, apparently, any bipartisan input when bipartisan support is necessary to pass any measure like this.”

“What are we supposed to tell these folks? ‘Oh, don’t worry, it’s Obama’s fault.’ Or, ‘Oh no don’t worry, we did a show vote on this Lower Health Care Premiums for All Americans Act.’ Is that going to be any consolation?” Kiley said. 

New Jersey Democratic Rep. Frank Pallone called the House GOP bill a “sham” and said without a vote to extend the expiring ACA tax credits millions of Americans will have to decide if they can afford health insurance coverage. 

“They will see prices double, triple and even quadruple,” Pallone said. “It will leave millions with the difficult decision of going without coverage because they simply cannot afford rising costs.”

The House voted 216-211 to approve the Republican health care bill, sending it to the Senate, where it’s highly unlikely it would get the bipartisan support needed to advance without significant revision. 

Senate approach

Senate Majority Leader John Thune, R-S.D., said earlier in the day he hadn’t yet decided whether to put the House Democrats’ bill on the floor if it is passed and arrives. 

“Well, we’ll see. I mean, we obviously will cross that bridge when we come to it,” Thune said. “Even if they have a sufficient number of signatures, I doubt they vote on it this week.”

Thune said the discharge petition on the three-year ACA tax credits extension is far different from the discharge petition that forced a House floor vote on a bill to require the release of the Epstein files. Files related to Jeffrey Epstein, who died in jail in 2019 awaiting federal trial on sex trafficking charges, have become a target of Congress and victims in recent months.

“That came over here pretty much unanimously, 427 to 1,” Thune said. 
“And my assumption is this discharge petition is going to be a very, probably, partisan vote.”

The Senate voted earlier this month on Democrats’ three-year ACA tax credits legislation, a move that Thune agreed to in order to get enough Democratic votes to end the government shutdown. That bill, which is identical to the House version, was unable to get the 60 votes needed to advance on a 51-48 vote. 

Both chambers are set to leave Capitol Hill later this week for their two-week winter break and won’t return to work until the week of Jan. 5. 

‘We have to do something’ 

Sen. Jeanne Shaheen said she sees the House discharge petition reaching the 218-signature threshold as “constructive.” 

The New Hampshire Democrat said “bipartisan, bicameral talks continue that are also constructive, so hopefully we can see some movement.” 

Though she is “hopeful” for a deal in January, Shaheen said “obviously, there’s a lot that needs to happen in order to get something done, but people need relief,” adding that “people in both houses and on both sides of the aisle are hearing from constituents that they want to see something done.” 

Missouri Sen. Josh Hawley — one of four Republicans who voted with Democrats to advance the three-year extension plan — reiterated his calls for lawmakers to take action to address the looming premium spikes. 

“I just think we have to do something on the cost of premiums, and I’m not locked into any one thing,” he said, acknowledging that he voted for both Democrats’ proposal and his GOP colleagues’ alternative bill. That effort also failed, at 51-48, to garner the 60 votes needed to move forward.  

“I mean, advance any solution — that’s my view, but what I think we should not do is just sit back and say, ‘Well, you know, good luck. We wish you all the best.’” 

Frustration breaks through

The House Republican bill, which Johnson released Friday evening, doesn’t extend the enhanced ACA marketplace tax credits.

It would require Pharmacy Benefit Managers “to provide employers with detailed data on prescription drug spending, rebates, spread pricing, and formulary decisions—empowering plans and workers with the transparency they deserve,” according to a summary in Johnson’s release. 

Starting in 2027, the legislation would appropriate funding for cost sharing reduction payments that the summary said would reduce health insurance premiums and stabilize the individual market. 

Johnson decided Tuesday not to allow the House to debate any amendments to the bill, blocking moderate Republicans from having their bipartisan proposal to extend the ACA marketplace tax credits with modifications taken up. 

That led to considerable frustration, and Wednesday morning, Pennsylvania Republican Reps. Brian Fitzpatrick, Rob Bresnahan and Ryan Mackenzie, along with New York’s Lawler, signed the Democrats’ discharge petition, putting it at the 218 signatures needed to force a floor vote in that chamber. 

“We’ve worked for months with both parties, in both chambers, and with the White House, all in good faith, to balance all equities and offer a responsible bridge that successfully threaded the needle,” Fitzpatrick wrote in a statement.   

“Our only request was a Floor vote on this compromise, so that the American People’s voice could be heard on this issue,” Fitzpatrick added. “That request was rejected. Then, at the request of House leadership I, along with my colleagues, filed multiple amendments, and testified at length to those amendments. House leadership then decided to reject every single one of these amendments. As I’ve stated many times before, the only policy that is worse than a clean three-year extension without any reforms, is a policy of complete expiration without any bridge. Unfortunately, it is House leadership themselves that have forced this outcome.”

Jeffries introduced petition

The discharge petition, introduced last month by House Democratic Leader  Jeffries, sat just below the signatures needed for weeks as centrist Republicans tried to broker a deal that could become law. 

When that logjam broke with the moderates’ signatures, it set up a House floor vote, but any legislation must move through the Senate as well and gain President Donald Trump’s signature. 

Without a law to extend the enhanced ACA marketplace subsidies, roughly 22 million Americans will see their health insurance premiums spike by thousands of dollars next year, if they can fit the rise in costs into their budgets. 

U.S. House Speaker Mike Johnson, R-La., talks with reporters inside the U.S. Capitol on Tuesday, Oct. 21, 2025. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — U.S. House Speaker Mike Johnson said Tuesday he will not allow a floor vote this week on a bipartisan amendment supported by moderate Republicans that would extend the Affordable Care Act enhanced tax credits. 

Johnson was confident that blocking the amendment would not lead centrist GOP lawmakers to oppose the Republican health care bill scheduled to get a vote Wednesday. 

“There’s about a dozen members in the conference that are in these swing districts who are fighting hard to make sure they reduce costs for all of their constituents. And many of them did want to vote on this Obamacare, COVID-era subsidy the Democrats created,” Johnson said. “We looked for a way to try to allow for that pressure release valve and it just was not to be.”

The enhanced ACA tax credits are set to expire at the end of the year, sharply increasing the cost of health insurance for the roughly 22 million Americans who purchase plans through the exchange and benefit from the subsidies. 

The House Republican health care bill wouldn’t extend those tax credits, frustrating GOP lawmakers in that chamber who are most at risk of losing their reelection bids during the November midterm elections. 

Johnson said he expects that GOP bill will pass, though he didn’t address its prospects in the Senate, where bipartisanship is needed for nearly all bills to advance under that chamber’s 60-vote legislative filibuster. 

The nonpartisan Congressional Budget Office and the staff of the Joint Committee on Taxation’s analysis of the bill shows it would reduce the federal deficit by $35.6 billion during the next decade. 

An average of 100,000 people per year would lose health insurance between 2027 and 2035, while  gross benchmark premiums for health insurance would drop by 11% on average through 2035, according to the joint analysis. 

‘Idiotic and shameful’

New York Republican Rep. Mike Lawler said in a speech on the House floor that GOP leaders’ decision to let the enhanced ACA tax credits expire was “idiotic and shameful,” especially after changes were added to address fraud and reduce costs. 

“So we have been forced to sign onto two discharge petitions,” he said. “And yet my Democratic colleagues will not join us, but for those that were at the negotiation table.”

Lawler then criticized House Minority Leader Hakeem Jeffries, of New York, for not encouraging Democrats to sign onto the bipartisan discharge petitions, noting that would likely get the 218 signatures needed to force a floor vote. He argued that’s because Jeffries “doesn’t actually want to solve the problem, he wants the issue.”

“This place is disgraceful,” Lawler said. “Everybody wants the upper hand.  Everybody wants the political advantage. They don’t actually want to do the damn work. This problem could be solved today if everybody who says they care about extending this signs the discharge.”

GOP-only bill in 2026?

When the House returns from its two-week holiday break next year, Johnson said, leaders may try to use the complex reconciliation process they used to enact the “one big, beautiful bill” to address health care. 

“What we anticipate going into the first quarter of next year is, possibly in a reconciliation package or in regular order a stand-alone, ideas just like this,” Johnson said after being asked a question about Health Savings Accounts. “We have a long list of things that we know will reduce premiums, increase access and quality of care.” 

President Donald Trump said Monday he wants Republicans to use the reconciliation process or to eliminate the Senate’s legislative filibuster to address health care and other policy priorities. 

“Republicans should knock out the filibuster and we should approve a lot of things,” Trump said. 

Senate Majority Leader John Thune, R-S.D., has said repeatedly he doesn’t intend to change or scrap the filibuster.

Direct payments or tax breaks

Trump also reiterated during the Oval Office event he would like to see Congress send direct payments to Americans to help them buy health insurance or afford health care. 

“I want all money going to the people and let the people buy their own health care. It’ll be unbelievable,” Trump said. “They’ll do a great job. They’ll get much better health care at a much lower cost.”

The Senate voted last week on two health care bills, one from Republicans and one from Democrats, but neither received the support needed to move toward a final passage vote. 

Republicans’ bill would have provided direct payments to some people enrolled in either bronze or catastrophic ACA marketplace plans with up to $1,500 in payments annually for 2026 and 2027. 

Democrats’ legislation would have extended the enhanced ACA marketplace tax credits for three years. 

Cost most urgent issue, poll finds

A bipartisan group of senators is trying to find solutions that bridge the political divide, though they are unlikely to achieve consensus on the details before the end of this week.

Thune said during a press conference Tuesday he believes there’s a way to address the rising costs of health care if Democrats continue negotiations with Republicans. 

“Our views on health care and the Democratic views on health care are very different. And I think that’s a difficult challenge that we have to figure out how to overcome,” Thune said. “But if they’re willing to accept changes that actually would put more power and control and resources in the hands of the American people and less of that in the pockets of the insurance companies, then I think there is a path forward.”

Thune acknowledged that Congress cannot pass anything this week but said he believes “there’s a potential pathway in January if Democrats are willing to come to the table on things that will actually drive down the costs of health care.”

Senate Minority Leader Chuck Schumer, D-N.Y., didn’t entirely rule out using the Jan. 30 government funding deadline to force a partial shutdown over health care, though he implied nothing can be done on the ACA tax credits after they expire at the end of December. 

“Once it expires, the toothpaste is out of the tube,” Schumer said. 

A poll released Monday by the West Health-Gallup Center on Healthcare in America shows that cost is the “most urgent” health issue facing the country, followed by access and then obesity. 

Just 57% of those polled said they were satisfied with how much they pay for their own health care and only 16% were satisfied with the total cost of health care.

Nearly two-thirds of those in the survey said they believe it’s the federal government’s responsibility “to make sure all Americans have healthcare coverage,” while 33% said it’s not. 

The first deadline for people to sign up for health insurance in 2026 through the federal health care marketplace passed Monday. With the loss of enhanced federal subsidies coverage is forecast to decline after rising for several years. (FS Productions/Getty Images)

When Chiquita Brooks-LaSure stepped into her job overseeing the federal health insurance marketplace in 2021, about 12 million Americans were purchasing their health coverage there.

By the start of 2025, that number had doubled.

Brooks-LaSure served as the administrator for the federal Center for Medicare & Medicaid Services in the Biden administration. In addition to managing the federal health insurance programs for people over 65 and people living at or below the federal poverty guidelines, CMS also manages HealthCare.gov — the health insurance marketplace created by the 2010 Affordable Care Act.

The purpose of the marketplace was to make it easier for people who had neither employer-provided  health insurance nor  Medicare or Medicaid to purchase a policy that would cover them.

 The ACA set standards for what the insurance plans are required to cover, and it established a system of nonprofit navigators to guide buyers as they sought to match their own health needs with the coverage that was available to them on the marketplace.

Early during President Joe Biden’s term, Congress passed and Biden signed legislation that increased tax credit subsidies making insurance plans purchased at HealthCare.gov much more affordable. Those enhanced tax credits brought in a flood of new insurance coverage.

“By the time we left, there were 24 million people who were enrolled” in marketplace health plans purchased through HealthCare.gov, Brooks-LaSure said during a video call with reporters last week. The call was organized by Opportunity Wisconsin, an economic issues messaging and organizing group aligned with the Democratic Party.

The federal move to give people on marketplace health plans larger  tax credits drove that increase in enrollment, health policy watchers agree.

Now the enhanced tax credits are due to expire at the end of this year. So far attempts in Congress to extend them, whether permanently or even temporarily, have gone nowhere.

On average, Brooks-LaSure said, premiums for 2026 have gone up by 26%. “For many people, they will choose to not buy health insurance coverage at all,” she said. “But others may choose to buy coverage that doesn’t cover all of their health care needs.”

Monday was the first of two red-letter days in the current history of the ACA and the health care marketplace. People hoping to get coverage starting Jan. 1 were required to sign up by the end of the day.

People can still sign up between now and Jan. 15, but policies won’t take effect until Feb. 1.

After four years of increases in the population with health insurance, the Congressional Budget Office has forecast about 4 million people will drop their coverage in 2026 without the higher subsidies.

“For 275,000 Wisconsinites, these tax credits have saved them on average almost $600 every month,” said Sen. Tammy Baldwin in another call with reporters. “Without them, these Wisconsinites will pay double, triple, or even worse for their premiums next year. And for 30,000 Wisconsinites, the price will be just too high. And they’ll choose to go without insurance.”

That was a decision that Shana Verstegen of Madison said she and her husband briefly considered. Verstegen spoke on Baldwin’s call about the choices the couple is having to make on behalf of themselves and their two sons, ages 7 and 10.

She and her husband both work for a small community gym, Verstegen said. Their employer has too few employees to be able to purchase a group health policy, so they went to the ACA marketplace.

This year they pay $460 a month, already a squeeze, but that will increase to more than $700 a month in 2026, she said.

“It’s an amount we just simply can’t afford,” Verstegen said. Realizing that they could not risk the family’s health by going without coverage, they’ve looked at other options — including possibly giving up work that has been a long-term career in order to find a job with employer-sponsored health insurance.

In the end, Verstegen said, the couple decided to increase their work hours and cancel some events in 2026 to save money to afford their higher-priced health plan.

“These are really tough and frustrating emotional and scary choices,” Verstegen said. “We’re a middle-class, healthy, hard-working family and like so many others we’re simply struggling to keep up.”

Forecasts are murky

The most recent “snapshot” from CMS on HealthCare.gov enrollment covers Nov. 1-29 this year. In Wisconsin, it shows enrollment down by almost 4,000 people compared to Nov. 1-30, 2024.

Nationally, however, the numbers are up — 5.76 million in November this year compared with 5.36 million a year ago. There isn’t enough data to confidently forecast a trend, however.

Of the people signing up in November, “a lot of those folks were probably people who already had coverage and were either renewing it or picking a new plan, but there were also likely some new enrollees,” said Louise Norris, a health policy analyst at healthinsurance.org, an insurance information website.

Norris said there could be a large upswing in enrollment ahead of Monday’s deadline for coverage starting Jan. 1. “Then again you’ll see another sort of surge as we get to mid-January” — the Jan. 15 deadline for coverage starting Feb. 1, Norris said.

Both Norris and Brooks-LaSure said that initial enrollment numbers also don’t tell the whole story.

“The people who are enrolling right now are people who absolutely know they need to have coverage,” Brooks-LaSure said. “But the number always drops when people have to pay their premiums. And so, it’s really the number in January, once people are enrolled, that we think that will be the important number to know about coverage.”

People who are not changing plans may be automatically renewed in their current plans, which can explain some of the initial signups, said Brooks-LaSure. In addition, she said, some people signing up may be opting for less expensive — but also less generous — health insurance than they purchased in the past.

HealthCare.gov classifies health plans as Gold, Silver or Bronze. Gold plans have costlier premiums but more generous coverage with lower deductibles and less cost-sharing required of patients. Bronze plans have lower premiums with higher deductibles and more cost-sharing, and Silver plans are in between.

Brooks-LaSure said she has heard anecdotally from people stepping down from Silver to Bronze plans, for example.

“Coverage is really important, of course, but your ability to actually pay when you go to the doctor is equally, if not more, important,” she said. “It may be that we don’t see the drop in the uninsured rate. We see people shifting to less generous coverage.”

Kelley Bruns, a Sawyer County resident who spoke on Baldwin’s call, said she and her husband took that route for 2026.

Bruns said her husband, a veteran and career firefighter, had to end his career early due to work injuries and resulting disabilities.

When the premium for the policy they had in 2025 rose to more than $1,600 a month — 40% of their monthly income — they opted for a less expensive plan for 2026. That plan, however, has copayments of up to $100, a $15,000 deductible and a cap on out-of-pocket expenses of more than $21,000.

“We have to pray we don’t need surgery or any other major medical procedure,” Bruns said, “since our out-of-pocket maximum is almost half of our annual income and would be a catastrophic expense for our family.” 

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Click here to read highlights from the story

• Free clinics like Bread of Healing in Milwaukee and Open Arms Free Clinic in Walworth County serve as a final safety net for community members who can’t afford health care.

• They are bracing for higher demand as more residents are expected to forgo insurance as a crucial tax credit is set to expire and premiums spike.

• Clinic staff say they may need more resources to meet demand. 

• The U.S. Senate on Thursday rejected dueling plans related to helping people pay for plans on the federal marketplace.

Editor’s note: This story has been updated to note the U.S. Senate’s rejection on Thursday of legislation to address the expected rise in health care premiums.

Cars filled the small parking lot outside of Milwaukee’s Cross Lutheran Church on a recent Monday afternoon. The church’s pews sat empty, but downstairs visitors waited around folding tables. Not to hear a sermon, but to see a volunteer physician. 

Staff and volunteers walked patients past a row of dividers used to separate the “waiting room” from the folding tables where doctors and counselors filled out paperwork. 

In front of the free health clinic’s four exam rooms, two phones rang. 

“This is the Bread of Healing Clinic. Can you hold for a moment?” asked Diane Hill Horton, the free health clinic’s assistant.

Across from Hill Horton, another staff member scheduled an appointment in Spanish. 

On a typical Monday, the clinic sees up to 30 patients. Bread of Healing treated 2,400 patients in 2024 across three clinics it runs in Milwaukee. Patients typically lack any health coverage and aren’t asked to pay for their visits.

“We don’t turn anyone away,” Hill Horton said.

But without action from lawmakers in Washington, clinic staff worry that it will become harder to answer every call.

Free clinics like Bread of Healing serve as a final safety net for community members who can’t afford health care. They are bracing for higher demand as more residents are expected to forgo insurance as a crucial tax credit is set to expire and premiums spike.

Affordable Care Act premiums in Wisconsin will increase on average by 17.4% next year, a previous Wisconsin Watch analysis showed, with wide variation depending on age, income, family status and geography. Meanwhile, experts estimate more than 270,000 Wisconsinites rely on the enhanced premium tax credit to make insurance more affordable. It will expire at the end of the month without intervention. 

People without insurance are less likely to get preventative care. Bread of Healing focuses on treating chronic conditions to prevent people from overwhelming emergency rooms, said Executive Director Erica Wright.

“If we don’t try our best to move with that demand, we’re not going to be able to see as many people, and there’s going to be a lot of folks falling through the cracks,” she said.

Wright oversees all three Bread of Healing locations. While the clinics have some room to take on more patients right now, she wants to significantly increase their capacity over the next year — adding money and volunteers to serve a possible “monsoon” of demand.

“We’re never going to be able to serve everybody, we know that,” Wright said. “But I don’t want it to be where our phones are ringing off the hook and we just can’t meet at least a good chunk of the demand.”

Higher premiums and shrinking options

Ashley Bratz paid about $545 a month for a low-deductible marketplace plan this year. That same plan cost over $700 when she went to sign up for 2026.

Even with her job at Open Arms Free Clinic in Walworth County covering a portion of her health care costs, the only option in Bratz’s price range had deductibles higher than what she expects to spend.

 “It’s supposed to be reasonable, and this is not reasonable,” Bratz said.

Bratz, who works as the nurse clinic coordinator, said she did not receive enhanced marketplace subsidies this year. Those who did will face a particular shock as the tax credit expires — while also confronting rising prices and shrinking options.

The income-based tax credits have lowered some marketplace enrollees’ monthly premium payments since they became available in 2014.

In 2021, the federal government expanded those subsidies, further bringing costs down for lower-income enrollees and extending smaller subsidies to people making over four times the  federal poverty level — $62,600 a year for one person in 2025.

Without an extension, monthly premiums are expected to more than double on average nationally for subsidized enrollees, according to KFF, an independent source for health policy research.

A quarter of enrollees surveyed by KFF said they were “very likely” to go without insurance if their premiums doubled.

The U.S. Senate on Thursday rejected a Democratic plan to extend marketplace subsidies. Republicans, who have long criticized the Affordable Care Act (ACA), have instead called for a broader overhaul. The Senate also rejected a Republican plan that would have expanded access to high-deductible insurance plans and deposit $1,000 to $1,500 in enrollees’ health savings accounts — without renewing enhanced subsidies.

Sara Nichols, Open Arms Clinic executive director, is forging ahead regardless. When Bratz told her about her shrinking affordable coverage options, Nichols started working with an insurance broker to find a new plan for the clinic’s small team of paid staff.

“We cannot have health care workers not have health insurance,” Nichols said.

The move left Bratz relieved. Now she’s preparing to help more clients who can’t afford coverage or just need help navigating the complicated system.

They face challenges beyond lost subsidies and premium hikes. President Donald Trump’s “big” bill-turned law included additional changes to Medicaid funding and the ACA that are expected to increase the number of people without insurance by 10 million over the next decade, according to the Congressional Budget Office.

“We always take what is thrown at us and we figure out how to handle it,” Bratz said. “Do I think we could also use more help? Yes.”

Resources needed to meet demand

Open Arms Free Clinic is already seeing higher demand, Nichols said. 

It operates a dental clinic five days a week, and she’s considering whether further demand would require opening its medical clinic for an additional day.

That would take more volunteers and money. 

While the Legislature sent state dollars to free clinics in its latest budget, private grants and donations have been harder to secure this year, Nichols said. She expects the clinic will have to get even leaner next year.

But she won’t start turning patients away.

The clinic provides dental, medical and behavioral health to low-income people who live and work in Walworth County. Its 250 volunteers help with things like translating, nursing, greeting patients and connecting people to the clinic. They also provide vision and pharmacy services.

“I know that we have enough smart people and kind people that we’re going to come up with a solution to anything that comes up,” Nichols said.

This is far from the first time Wisconsin’s free clinics have faced big changes, said Dennis Skrajewski, the executive director of the Wisconsin Association of Free and Charitable Clinics. 

Free clinics adapted to the COVID-19 pandemic, operating with fewer volunteers and switching to telehealth services and opening vaccine programs, Skrajewski said. Then clinics prepped for increased demand in 2023 after Medicaid unwinding.

“We’re used to waking up and the world changed yesterday, so we’ll adjust,” Skrajewski said.

Wisconsin’s free and charitable clinic association is collaborating with other safety net health providers as part of the Wisconsin Owns Wellbeing initiative, which will host statewide planning meetings to strengthen the state’s safety net services. 

Clinic co-founder: ‘I just wish it weren’t needed’ 

Rick Cesar started working as a parish nurse at Cross Lutheran Church in the 1990s. He took people’s blood pressure at a weekly food pantry and ran an HIV testing site and needle exchange out of the church’s basement.

He helped co-found the Bread of Healing Clinic in 2000, a decade before the ACA passed. 

“There were so many people that had no coverage,” Cesar said.

Demand for free services persisted even after more people enrolled in marketplace plans. The clinic expanded to two other locations and hired paid staff. Cesar retired from nursing in 2019 but still regularly volunteers. He feels proud watching the clinic grow.

“I just wish it weren’t needed,” he said.

The clinic is adaptable, Cesar said, whether it’s responding to a pandemic with vaccine drives or helping clients navigate ACA changes.

“We’re going to be here and do as much as we can,” Cesar said. “But those resources, you never know how long they are going to last when the demand is so great.”

‘We don’t turn anyone away’: Wisconsin’s free clinics fill gaps as thousands expected to go uninsured is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

U.S. House Speaker Mike Johnson, R-La., talks with reporters during a press conference on Wednesday, Dec. 10, 2025. Also pictured from left are Republican Conference Chairwoman Lisa McClain of Michigan, Majority Whip Tom Emmer of Minnesota and Majority Leader Steve Scalise of Louisiana. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — U.S. House Speaker Mike Johnson committed Wednesday to hold a vote next week on a package of bills that he said would lower health insurance premiums for hundreds of millions of Americans, not just those enrolled in Affordable Care Act plans. 

But the Louisiana Republican’s promise didn’t come with any details about which bills would be included in the package or whether the legislation will have the GOP votes needed to pass, amid vastly different views among his members about the federal government’s role in health care. 

“You’re going to see a package come together that will be on the floor next week that will actually reduce premiums for 100% of Americans who are on health insurance,” Johnson said. 

That will be a challenging task for Johnson and other House Republican leaders since they hold an especially narrow 220-213 majority. Democrats are unlikely to support GOP bills that don’t extend the enhanced tax credits for people who buy their health insurance through the ACA marketplace. Without the tax credit subsidies, costs are expected to rise sharply.

House Majority Leader Steve Scalise, R-La., said just after a closed-door meeting of House GOP lawmakers on health care that leaders were still finalizing which bills would go into the package. 

“We showed a list of what the three committees of jurisdiction have been working on for months today. And then encouraged all the members to give their feedback. And they did,” Scalise said. “A lot of members spoke today at the mic, which we want. They gave their feedback. And frankly, a lot of it was very positive about those bills.”

Senate votes Thursday

The House bills are part of a larger debate in Congress and at the White House about the rising cost of living, including health care affordability, that surged to the forefront in October and November after Democrats shut down the government. 

Senate Democrats throughout the six-week shutdown demanded a vote to extend the enhanced ACA marketplace tax credits, which are set to expire at the end of the year.

Senate Majority Leader John Thune, R-S.D., promised Democrats a floor vote on a health care bill of their choosing in exchange for votes to end the shutdown. 

The Senate is expected to vote Thursday on a Democratic bill that would extend enhanced ACA marketplace tax credits for three years.

The nonpartisan Congressional Budget Office estimates that proposal would increase the federal deficit by $83 billion during the next decade. 

That three-year extension would boost the number of people with health insurance by 400,000 in 2026, 3 million in 2027, 4 million in 2028, and 1.1 million in 2029, compared to current law. 

Senators will also vote Thursday on legislation from Louisiana Sen. Bill Cassidy and Idaho Sen. Mike Crapo, both Republicans, that would provide up to $1,500 annually for people who buy either bronze or catastrophic health insurance plans from the ACA marketplace.

The funding would go directly into a Health Savings Account for people between the ages of 18 and 64 who make up to 700% of the federal poverty level. That would be about $109,550 for one person or $225,050 for a family of four. The funding would last for 2026 and 2027 but end after that. 

Neither proposal is expected to get the 60 votes needed to advance under the Senate’s legislative filibuster rule. Even if a bill moved through the Senate, it would still need to get a House vote, a prospect that seemed like a long shot now that House GOP leaders are putting out a package of their own. 

Abortion coverage

South Carolina Republican Rep. Ralph Norman said after the conference meeting that “the devil’s in the details” of exactly which bills go to the floor but added GOP lawmakers had begun to form a “consensus.”

Maryland Republican Rep. Andy Harris said he doesn’t believe GOP lawmakers are responsible for addressing any aspect of the Affordable Care Act, including the expiring tax credits. 

“It’s not our responsibility to fix Obamacare,” Harris said. “They broke it. They should fix it.”

Harris, chairman of the far-right Freedom Caucus, said he wouldn’t support any bill to extend the enhanced ACA marketplace tax credits unless it restricted abortion access in those health insurance plans to only cases of rape, incest, or the life of the pregnant patient. 

That issue has become a central negotiating point for many GOP lawmakers, even those who are open to extending the tax credits a little while longer. 

‘Moment of truth’

Democrats argue adding those constraints, often referred to as the Hyde Amendment, is unacceptable and would represent a new restriction on abortion access. 

“I don’t understand when you’ve had a number of Republicans in the House and the Senate say they get it, this is a disaster to have these premiums double and triple, why they want to mess around right now and put abortion politics into the middle of this,” Minnesota Democratic Sen. Amy Klobuchar said. “They know that that’s not going to work.”

Senate Minority Leader Chuck Schumer, D-N.Y., said the only proposal on the table to extend the enhanced ACA marketplace tax credits, avoiding a surge in premiums next year, is the Democratic bill. 

“Tomorrow is a moment of truth for the Republicans here in the Senate,” Schumer said. “Are they going to bring health care costs down, or will they sit by and let premiums explode for millions of Americans?”

Discharge petition on bipartisan bill

Later in the day a potential solution emerged when a bipartisan group of House lawmakers filed a discharge petition that would force a floor vote on their compromise bill if they can get at least 218 signatures. 

Pennsylvania Republican Rep. Brian Fitzpatrick wrote in a statement the legislation represents a “solution that can actually pass—not a political messaging exercise.”

“This bill delivers the urgent help families need now, while giving Congress the runway to keep improving our healthcare system for the long term,” Fitzpatrick wrote. “Responsible governance means securing 80 percent of what families need today, rather than risking 100 percent of nothing tomorrow.”

The 79-page bill, formally titled the Bipartisan Health Insurance Affordability Act, is co-sponsored by Nebraska Republican Rep. Don Bacon, Pennsylvania Republican Rep. Rob Bresnahan, North Carolina Democratic Rep. Donald Davis, Washington state Democratic Rep. Marie Gluesenkamp Perez, Maine Democratic Rep. Jared Golden, New York Republican Rep. Nicole Malliotakis and New York Democratic Rep. Tom Suozzi. 

The legislation would extend enhanced ACA marketplace tax credits through 2027 and expand access to Health Savings Accounts, among several other changes.

Golden wrote in a statement announcing the bill’s introduction Tuesday that it “implements sensible income caps” on who can receive the ACA marketplace tax credits.

“This moment requires leaders to abandon their partisan corners and govern,” Golden wrote. “Our bill provides a path out of gridlock and toward solutions.”

Gluesenkamp Perez wrote that no one “wants to shell out more cash to insurance companies or (pharmacy benefit manager) middlemen.”

“At the same time, we can’t lose sight of the fact that national health doesn’t come from insurance coverage — it hinges on people having good jobs, being able to sleep 8 hours a night, cook real food and see their kids at night,” she added. “Affordable healthcare and medicine are imperative and worth the fight, but a strong nation is longer work.”

Jacob Fischler contributed to this report.