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In a major setback for Mike Johnson and the House GOP, four Republicans have joined with the Democrats to sign a petition forcing a vote on legislation that will extend for three years premium tax credits for Affordable Care Act healthcare plans.
The rebellion underscores the nervousness among Republicans over an increase in healthcare costs before the 2026 midterm elections, in which the party will be defending its slim control of the House.
Democrats have for months united around extending the subsidies, but Donald Trump and Congress’s Republican leaders have refused, citing their longstanding opposition to the Affordable Care Act. But the party’s moderates have argued that allowing the credits to expire will betray the promise of lower costs they made to their constituents last year.
After failing to negotiate a compromise with GOP leaders, the four Republican opted to sign a discharge petition sponsored by House minority leader Hakeem Jeffries that will compel a vote on the Democrats’ bill.
“We have worked for months to craft a two-party solution to address these expiring healthcare credits. 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,” said Pennsylvania congressman Brian Fitzpatrick, the first Republican to sign the petition.
Fitzpatrick noted that he tried to insert an extension of the credits into a Republican-backed health bill that the chamber is voting on today, but was refused.
“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.”
His signature, with those of Pennsylvania Republicans Robert Bresnahan and Ryan Mackenzie, as well as Mike Lawler of New York, brought the petition to the 218 total it needed to succeed.
Jeffries called for the three-year tax credit extension to be voted on immediately, saying: “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, that the votes exist in a bipartisan way to protect the healthcare of everyday Americans.”
Under the rules of a discharge petition, the bill will probably come up for a vote in January, after Congress returns from its holiday recess.
In lieu of extending the tax credits, Republicans have proposed a number of conservative tweaks to the US healthcare system, including measures to enhance access to employer sponsored health plans and promote the creation of association health plans, which allow businesses and individuals to band together on purchasing insurance.
The House plans to vote Thursday on that bill, called the Lower Health Care Premiums for All Americans Act, and Johnson has said the party will continue making healthcare related proposals through early next year.
“Republicans are the ones who will fix healthcare. It is the Democrats who broke it,” the speaker told CNBC in an interview Wednesday.
But the setback raised questions about Johnson’s grip on the Republican conference, which he quickly sought to dispel.
“I have not lost control of the House,” he told reporters as he arrived at the Capitol. “We have the smallest majority in US history. These are not normal times.”
The premium tax credits were created as a temporary measure early in Joe Biden’s term and later extended through 2025. The Democrats’ demand for their extension was a main factor in the 43-day government shutdown that paralyzed Congress in October and part of November.
While the discharge petition’s success augurs well for the bill’s chances of passing the House, its prospects in the Senate are unclear. The upper chamber last week voted on a Democratic proposal to extend the credits for three years, but it failed to receive enough Republican support to advance.
