Four Republicans defy Johnson to force House ACA vote

Enhanced ACA premium tax credits, created during the pandemic and extended through Dec. 31, 2025, by the Inflation Reduction Act, lower monthly premiums for 22 million Americans who buy insurance through Affordable Care Act exchanges. Without extension, the Congressional Budget Office estimates average monthly premiums would increase from $111 to $383 in 2026—a 245% jump. Enrollment on healthcare.gov exchanges would drop by roughly 4 million people as coverage becomes unaffordable. The subsidies cost approximately $335 billion over 10 years.

On Dec. 10, 2025, Rep. Brian Fitzpatrick (R-PA) filed discharge petition number 12 to force a vote on H.R. 3001, a bipartisan bill extending ACA subsidies for two years and establishing minimum premiums and income caps for enrollees. A discharge petition requires 218 signatures—a simple majority of the 433-member House—to bypass committee and force a floor vote within two legislative days. The tactic is rare because it requires members to openly defy their party leadership.

By Dec. 17, 2025, four Republicans—Brian Fitzpatrick (PA), MLMike Lawler (NY), Young Kim (CA), and Nick LaLota (NY)—joined all 211 House Democrats in signing the discharge petition, reaching the required 218 signatures. All four represent competitive districts Biden won in 2020. Speaker Mike Johnson had presented 10 healthcare options to House Republicans on Dec. 10, none of which included extending ACA subsidies, making clear GOP leadership opposed the extension.

The House voted on Jan. 9, 2026, passing the ACA subsidy extension bill 230-196. Seventeen Republicans voted yes, joining 213 Democrats. The defecting Republicans came from competitive districts where premium increases would hurt constituents and damage reelection prospects. Speaker Johnson and most House Republicans opposed the bill, arguing the subsidies are too expensive and expand government-run healthcare. The vote represents a rare defeat for Johnson in the slim GOP majority.

The bill now goes to the Senate, where it faces uncertain prospects. Republicans hold 51 Senate seats, and most oppose expanding ACA subsidies. Democrats would need at least 10 Republican votes to reach the 60-vote filibuster threshold. Senate Republicans from states with high ACA enrollment, like Susan Collins (ME), Lisa Murkowski (AK), and Thom Tillis (NC), face pressure to support the extension. Without Senate passage and Trump's signature by Dec. 31, 2025, premiums increase in Jan. 2026.

The discharge petition fight reveals deep divisions within House Republicans over healthcare policy ahead of the 2026 midterm elections. Moderate Republicans from Biden-won districts fear being blamed for premium increases, while conservatives oppose any expansion of Obamacare. Johnson's inability to prevent the discharge petition highlights his weak hold on the narrow House majority—Republicans hold just a 220-213 advantage.

The ACA subsidy extension debate exposes the political trap Republicans face on healthcare. Repealing or letting subsidies expire raises costs for millions of voters, including many Trump supporters in red states. But extending subsidies means accepting and expanding Obamacare, which Republicans campaigned against for over a decade. Polling shows strong bipartisan support for lower healthcare costs, making the issue politically risky for Republicans heading into 2026 midterms.