With the Senate spinning its wheels yet again, House Republicans are stepping up to show what governing actually looks like. Speaker Mike Johnson unveiled a Republican healthcare alternative late Friday, making clear his party has no intention of rubber-stamping an extension of the enhanced Obamacare subsidies that were created during the COVID-19 era and are set to expire at the end of the year.
As the House enters the final days of its 2025 work period, Johnson and GOP leadership huddled behind closed doors to assemble a package focused on what Republicans argue are the real drivers of healthcare costs—not temporary subsidies designed to prop up a deeply flawed system.
“House Republicans are tackling the real drivers of healthcare costs to provide affordable care,” Johnson said, announcing that the legislation will be brought to a vote next week.
Time is tight. Congress is barreling toward adjournment after Democrats engineered what became the longest federal government shutdown ever this fall, a gambit meant to force Republicans into healthcare negotiations that ultimately failed. That stalemate was followed by the Senate’s inability this week to advance either a GOP healthcare proposal or a Democratic bill extending Affordable Care Act tax credits for three more years.
The House Republican package, which runs more than 100 pages, reflects long-standing GOP priorities. It expands employer-sponsored insurance options and boosts oversight of pharmacy benefit managers, or PBMs—an industry Republicans say plays a major role in driving up prescription drug prices and squeezing independent pharmacists.
One key provision would expand access to association health plans, allowing small businesses and self-employed Americans to band together to purchase coverage. Supporters argue this gives them more negotiating power and lower costs, while critics complain these plans don’t comply with every Affordable Care Act mandate—which, of course, is precisely the point for many Republicans.
The legislation also includes references to cost-sharing reductions for some lower-income ACA enrollees, though those wouldn’t take effect until 2027 and wouldn’t stop premium increases next year. Notably, the proposal does not extend or replace the enhanced ACA tax credits enacted during the pandemic, meaning those subsidies would still expire on Dec. 31.
President Donald Trump addressed the issue Thursday night at a White House holiday reception, reiterating a promise he’s made for years: Republicans will deliver something better than Obamacare. Trump again floated the idea of sending money directly to Americans so they can buy their own health insurance—cutting out bureaucrats and middlemen—but did not provide specific details.
The Senate GOP proposal that failed earlier this week would have funded new health savings accounts, but no similar provision appears in the House plan. That omission has left some centrist Republicans in competitive districts uneasy, with a handful now aligning with Democrats to pursue temporary extensions of the ACA subsidies.
Several discharge petitions are circulating, including bipartisan efforts that would force floor votes if enough members sign on. While discharge petitions are rarely successful, lawmakers did use one earlier this year to force a vote on releasing Epstein-related DOJ files—so they’re not purely theoretical.
House Minority Leader Hakeem Jeffries has so far stopped short of backing those efforts, instead pushing a clean three-year subsidy extension that Senate Republicans have already made clear has no future in their chamber.
The contrast is stark. Democrats want to extend a pandemic-era policy without reform. Republicans, led by Speaker Johnson and backed by President Trump, are pushing structural changes aimed at lowering costs, increasing competition, and empowering patients.
It may not be the easy political path—but it’s the serious one. And as this debate moves forward, Republicans are once again showing they’re focused on long-term solutions, fiscal responsibility, and a healthcare system that works for everyday Americans, not Washington insiders.
