Texas’ entire House GOP delegation voted this week for a health care package that lets the tax credits lapse. They will be forced to vote on a three-year extension of the subsidies in January.
Most Republicans in the U.S. House agree they don’t want to extend expiring Affordable Care Act tax credits, but the party — including members from Texas — still has not coalesced around an alternative plan heading into a critical midterm year.
The subsidies that were at the center of this fall’s federal funding debate have continued to spark debate in Congress in the weeks since the government shutdown. Now, with the House recessed for the holidays and no clear solution in sight, the enhanced premium tax credits that lower health care costs for millions of Americans are all but certain to expire on Dec. 31.
Texas’ entire GOP delegation in the House voted for a health care package on Wednesday that would expand association health plans, place new regulations on pharmacy benefit managers — the intermediaries between drug makers and insurance companies — and fund cost-sharing reductions for low-income ACA enrollees, while letting the subsidies lapse.
Earlier in the day, however, a group of four defecting Republicans joined with House Democrats to force a floor vote next month on a temporary extension of the tax credits, keeping the issue in the spotlight through January.
Through premium tax credits, which have existed since 2014, the federal government pays insurers to lower costs for people who receive coverage through the ACA marketplace. During the COVID-19 pandemic, Congress expanded the credits and their eligibility. The change led to skyrocketing ACA enrollment, including in Texas. In 2021,1.3 million people in the state were enrolled. By this year, the number had jumped to 3.9 million.
Getting rid of the enhanced premium tax credits would double the average premium payment for subsidized enrollees in nearly every congressional district in Texas, according to analysis from health policy organization KFF. Insurers in the state have already requested premium hikes for when the subsidies expire, which could lead to hundreds of thousands of people dropping their insurance coverage.
Experts say the impact of the expiring subsidies will be felt especially hard in Texas. Once the subsidies expire, KFF projects nearly 4 million Americans will drop their coverage and that more than a quarter of these people will be from Texas.
Even so, most Republican representatives from Texas have stood firm in their opposition to the subsidies.
“I’m not going to vote for anything that has any existence of Obamacare,” said U.S. Rep. Roger Williams, R-Willow Park. “Nobody in my district wants any kind of extension on Obamacare.”
Republicans have argued that people take advantage of the credits to defraud the government, wasting taxpayer dollars and benefiting insurance companies without addressing the underlying problem of rising health care costs.
“The Democrats are trying to put forward an extension of a COVID-era, fraud-ridden subsidy,” U.S. Rep. Jodey Arrington, a Lubbock Republican who chairs the House Budget Committee, said in a floor speech Wednesday. “You all have proven that government is the problem, and we’ve got the solution that actually delivers the affordability to the American people.”
Despite their unity in Wednesday’s vote, Texas Republicans have not been in total agreement about the subsidies. While most in the delegation have called for them to be dissolved, U.S. Rep. Monica De La Cruz, R-Edinburg, backed a bipartisan plan earlier this month that would extend the tax credits for a year, with new guardrails in place to prevent fraud and with the potential for another yearlong extension down the road. U.S. Reps. Henry Cuellar, D-Laredo, and Vicente Gonzalez, D-McAllen, also supported the plan.
“Unfortunately, that has not come to the floor,” De La Cruz told The Texas Tribune on Wednesday. She stood behind the GOP’s alternative plan, arguing that it was “a first step to making health care affordable for all Americans, not just those on the exchange.”
De La Cruz worked closely across the aisle to create the bipartisan plan because health care is important to her community in South Texas, she said. Her district, while still a stretch for Democrats to win, is the most competitive Republican-controlled district in the state.
Republicans are concerned that the expiring subsidies could hurt them in the 2026 midterms, especially as Democrats look to capitalize on health care affordability issues. Four Republicans — all from vulnerable districts targeted by Democrats — signed onto a Democratic-led discharge petition to force a vote about extending ACA subsidies for three years. The petition received enough signatures Wednesday and compels a floor vote in January.
De La Cruz would not say how she would vote on the three-year ACA subsidy extension, but she said that a lot could happen between now and when the House returns from the holidays.
“I believe that between now and then, leadership is going to work very closely with those congressmen that are in vulnerable seats … like myself, to find a place for us to have input into health care reform,” she said. “What we ultimately want to do is bring a health care package that works not only for our community, but for all Americans, which ultimately means lower prices.”
Both the GOP’s health care bill and Democrats’ efforts to extend subsidies would face uphill climbs in the Senate. A bipartisan group of members from both chambers is working to craft a plan to address the expiring subsidies, but there are not expected to be any more votes until the new year. Still, some Senate moderates have told reporters they think the House’s discharge petition helps their efforts.
The narrow bill approved by the House on Wednesday would fund cost-sharing reduction payments starting in 2027, which Republicans say will help lower deductibles and other out-of-pocket health care costs for Affordable Care Act enrollees. Funding for these payments was canceled by the Trump administration in 2017.
In an attempt to lower costs for employers, the bill would allow small businesses and self-employed individuals to join association health plans where they can buy coverage together. It also would increase oversight of pharmacy benefit managers by requiring them to report data about drug use and spending.
“It’s important, but it’s only a first step,” U.S. Rep. Nathaniel Moran, R-Tyler, said of the package. “Quite frankly, it does not include a whole lot of the more robust health care policies that we’ve already vetted.”
Notably, the bill would not redirect funding from ACA subsidies to health savings accounts, which has emerged as one of the GOP’s favored health care policies.
U.S. Rep. August Pfluger, R-San Angelo, is sponsoring another piece of legislation that would do just that. Called the More Affordable Care Act, the bill would direct money to “Trump Health Freedom Accounts” that Pfluger says will give consumers more freedom and opportunities to make their own choices.
“In this plan, it would go to their health savings account so that they would get it directly,” Pfluger, chair of the influential Republican Study Committee, told the Tribune. “They could see that as a tangible way to take control and be able to have a little more transparency.”
All of Texas’ Democratic representatives in the House voted against the health care bill on Wednesday, with some noting that a provision of the bill would restrict access to health care coverage for abortions.
Some Democrats called on House leadership to hold a vote on the ACA subsidy extension immediately after the petition received enough signatures, rather than waiting until January.
“We have the votes to pass a three year extension of the ACA tax credits, but Mike Johnson is going to send the House of Representatives home instead,” U.S. Rep. Veronica Escobar, D-El Paso, wrote on social media. “This issue should be addressed with the urgency it deserves, and Mike Johnson is falling woefully short.”
Source: Marijke Friedman, The Texas Tribune
Photo Credit: House Speaker Mike Johnson, R-Louisiana, speaks with reporters in the U.S. Capitol during the last votes of the year on Thursday, Dec. 18, 2025. Tom Williams/CQ Roll Call/Sipa USA via REUTERS
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