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?”
Jacob Fischler contributed to this report.
