On December 13, 2025, House Republican leaders presented a health care plan in response to the impending expiration of tax credits that could lead to increased premiums for more than 20 million Americans. The proposal notably does not include an extension of the Affordable Care Act (ACA) subsidies, although it allows for a vote on an amendment that could extend these credits for one to two years, aimed at appeasing moderate Republicans advocating for reforms.

The issue of extending the subsidies has sparked divisions within the Republican Party. Some members argue that the subsidies are susceptible to fraud and that high-income households should not qualify, while Democrats are pushing for a straightforward three-year extension without reforms, a stance that has not gained traction among Republicans.

Key features of the Republican proposal include expanding association health plans, which enable multiple employers to collaborate in purchasing coverage to lower costs, and funding for cost-sharing reduction payments intended to decrease premiums for certain ACA enrollees. Additionally, the plan mandates increased transparency from pharmacy benefit managers to help reduce drug costs. House Speaker Mike Johnson emphasized that the Republican approach aims to address the fundamental drivers of health care costs, focusing on enhancing affordability, access, and integrity within the health care system.

The House Rules Committee is set to review the package, with a potential floor vote expected soon. However, the plan's support among House members remains uncertain. House Minority Leader Hakeem Jeffries criticized the GOP proposal as an inadequate last-minute effort that undermines the health care of American citizens. He expressed a willingness to collaborate with Republicans genuinely seeking to prevent the expiration of ACA tax credits but condemned the proposed legislation as harmful to taxpayers and lacking bipartisan appeal.

In a broader context, the expiration of ACA subsidies and the proposed legislative changes reflect ongoing challenges in U.S. health care reform, highlighting the tension between political agendas and the pressing need for equitable access to affordable health care. As rising health care costs continue to affect millions, the implications of these legislative decisions will likely resonate in upcoming electoral cycles, raising questions about accountability and the prioritization of public health needs.