The US House of Representatives has approved a narrow health care package amid mounting pressure over expiring Obamacare subsidies. House Republicans passed the legislation 216-211 on Wednesday, 18 December 2025, despite fierce opposition from moderates within their own party. The health care package does not address the enhanced tax credits set to lapse on 31 December 2025, leaving tens of millions of Americans facing significant premium increases.
Figure 1: The US Capitol in Washington, DC,
Speaker Mike Johnson championed the health care legislation 2025 as a first step toward lowering costs for Americans. However, the bill ignores the looming Obamacare subsidies cliff that threatens to spike premiums by an average of USD 1,016 next year. The measure now heads to the Senate, which is not expected to vote before the holiday recess.
What Does the Health Care Package Include for Americans?
The House GOP health care package introduces several measures aimed at reducing costs for specific groups. Small businesses and self-employed individuals can now band together across industries to purchase coverage through association health plans. This provision aims to lower premiums through collective bargaining power.
Figure 2: Speaker Mike Johnson.
The health care legislation 2025 also provides federal funding for cost-sharing subsidies benefiting lower-income Obamacare enrollees. These subsidies reduce deductibles and out-of-pocket costs for care. Additionally, the package requires pharmacy benefit managers to provide employers with transparent data on drug prices and rebates from manufacturers.
Republicans argue these reforms address immediate cost concerns whilst preparing the ground for broader changes. Critics contend the measures fall short of tackling the most pressing issue facing millions of Americans in January 2026.
Why Are Obamacare Subsidies Creating Political Division?
The enhanced Obamacare subsidies were enacted in 2021 as part of a Biden administration Covid-19 relief package. These tax credits helped millions of Americans afford premium costs during the pandemic. The subsidies expire on 31 December 2025, creating an urgent deadline that House Republicans chose not to address.
If the enhanced subsidies lapse, enrollees will see annual premium payments increase by 114 per cent on average in 2026. This translates to approximately USD 1,000 more per person annually, according to KFF, a nonpartisan health policy research group. The Congressional Budget Office estimates roughly 2 million more people will become uninsured next year if the subsidies end.
GOP centrists have pressured Speaker Johnson for months to reverse course on the subsidies. These moderates pushed bipartisan efforts to extend the subsidies whilst adding safeguards to prevent misuse. Johnson repeatedly blocked attempts to bring compromise proposals to a floor vote.
Enhanced Obamacare subsidies expire on 31 December 2025, threatening coverage for millions of Americans.
How Did GOP Moderates Rebel Against the Health Care Package?
Wednesday marked a dramatic escalation in the Republican Party’s internal conflict over health care legislation 2025. Four GOP Representatives signed onto a Democratic-led discharge petition to circumvent leadership and force a floor vote. The petition seeks to extend the Obamacare subsidies for three years without additional reforms.
Representatives Brian Fitzpatrick, Mike Lawler, Rob Bresnahan, and Ryan Mackenzie defied Speaker Johnson by supporting the Democratic initiative. Their action represents a nuclear option rarely deployed against party leadership. Fitzpatrick told reporters leadership feared his own legislative proposal would pass if brought to the floor.
The discharge petition has now reached the necessary signature threshold to compel a vote in January 2026. However, Senate Majority Leader John Thune has indicated the measure would die in the upper chamber. House GOP moderates are discussing bipartisan compromise options with Senate counterparts before the next government funding deadline on 30 January 2026.
Representative Jen Kiggans of Virginia expressed frustration over the lack of opportunity to vote on subsidy extensions. She stated it had been frustrating for a group genuinely wanting to see a vote reach the floor.
What Happens Next with Health Care Legislation 2025?
The Senate is not expected to vote on the House Republican health care package before lawmakers leave for the holiday recess. This effectively guarantees the enhanced Obamacare subsidies will expire as scheduled on 31 December 2025. Tens of millions of Americans will face higher premiums starting in January 2026.
Figure 6: Representation of Medical supplies.
House Republicans insist the package represents the first step of a major GOP agenda on lowering costs. Speaker Johnson and his team aggressively pushed the plan to the floor this week despite internal opposition. They view the legislation as foundational for broader reforms in the coming year.
Moderate Republicans continue negotiating with Senate counterparts on a bipartisan compromise bill. These lawmakers hope to produce a proposal before the 30 January 2026 government funding deadline. Any such measure would need to pass both chambers and navigate significant ideological divisions within the Republican Party.
The health care package passage marks a win for Johnson’s leadership whilst simultaneously exposing deep fractures within his caucus. President Donald Trump faces pressure to demonstrate progress on lowering costs for everyday Americans as premium increases loom.
How Will Premium Increases from Obamacare Subsidies Impact Families?
The expiration of enhanced Obamacare subsidies will create immediate financial strain for millions of families. KFF estimates premium payments will increase by an average of USD 1,016 annually per enrollee in 2026. This represents a 114 per cent spike in costs for those relying on the enhanced tax credits.
Lower-income and middle-class families will bear the brunt of these increases. Many individuals who could afford coverage with subsidies may find premiums unaffordable without them. The Congressional Budget Office projects approximately 2 million additional Americans will become uninsured as a direct result.
Figure 7: The Obamacare logo displayed on a mobile device.
Healthcare advocates warn the subsidy cliff could reverse gains made in coverage rates since the Affordable Care Act’s implementation. Families already struggling with inflation and rising costs face difficult decisions about maintaining health insurance. The political standoff over the health care package leaves these households in limbo as the deadline approaches.
Republican hardliners opposed extending the Obamacare subsidies without significant reforms to the programme. They argued the enhanced tax credits represented excessive government spending that needed reining in. Moderates countered that allowing subsidies to expire would harm constituents and undermine Republican credibility on healthcare.
FAQs
Q1. What is included in the House Republican health care package?
Ans. The health care package allows small businesses to form association health plans, provides federal funding for cost-sharing subsidies, and requires pharmacy benefit managers to provide transparent pricing data to employers.
Q2. When do the enhanced Obamacare subsidies expire?
Ans. The enhanced Obamacare subsidies expire on 31 December 2025, affecting tens of millions of Americans who rely on these tax credits to afford health insurance premiums.
Q3. How much will premiums increase without the subsidies?
Ans. Premium payments will increase by an average of USD 1,016 annually per enrollee in 2026, representing a 114 per cent spike, according to the KFF health policy research group.
Q4. Did the House Republican health care package extend the Obamacare subsidies?
Ans. No, the health care legislation 2025 passed by House Republicans does not extend the enhanced Obamacare subsidies, which will expire on 31 December 2025 as currently scheduled.
