House Republicans Introduce Health-Care Package Excluding ACA Tax Credit Extensions
On December 12–13, 2025, House Speaker Mike Johnson unveiled a Republican health-care package in the US Capitol that does not extend the enhanced ACA tax credits, which are set to expire on December 31, 2025. The plan leaves intact no extension of the ACA marketplace subsidies, potentially resulting in higher premiums for about 22 million people who rely on these tax credits.
The over 100-page package focuses on expanding association health plans for small businesses and the self-employed to negotiate lower rates. It also aims to tighten data requirements from pharmacy benefit managers (PBMs) to curb drug costs, as critics argue PBMs have padded profits and harmed independent pharmacies.
Cost-sharing reductions for some lower-income enrollees would not take effect until January 2027, delaying any immediate subsidy benefits. The plan does not include provisions for new health savings accounts; a prior Senate proposal that would have funded HSAs with $1,000 per adult and $1,500 for those aged 50–64 was excluded.
Centrist Republicans and Democrats are pushing discharge petitions to temporarily extend subsidies: Brian Fitzpatrick’s two-year extension and Josh Gottheimer’s one-year extension have cross-party support. Meanwhile, Democrats’ own clean three-year extension petition, although supported by 214 signatures, has no Republican backing. The Senate has not advanced either a Republican or Democratic subsidy plan.
President Donald Trump spoke at the White House suggesting providing stipends to offset costs rather than extending tax credits; however, details and amounts were not specified.
