Congress adjourned Thursday without resolving the future of Affordable Care Act (ACA) subsidies, leaving roughly 22 million Americans facing higher health insurance premiums starting in 2026. The Republican-led House and Senate failed to reach a deal before leaving town, despite bipartisan efforts from swing-district lawmakers to extend funding. House Speaker Mike Johnson, R-La., and Senate Majority Leader John Thune, R-S.D., oppose continuing the COVID-era subsidies, which were enacted by Democrats in 2021.
Meanwhile, Democrats warn they will use the issue to pressure Republicans ahead of next year’s midterm elections. As the debate continues, Americans are bracing for rising costs, and lawmakers face mounting political and public pressure to find a compromise before premiums increase.
Political Fallout in Swing Districts
“They are absolutely screwing over millions of people, including my constituents, which pisses me off,” said Rep. Pat Ryan, D-N.Y., who represents a competitive Hudson Valley district. “It’s just pathetic. The last time there was a major Republican effort to repeal the ACA, voters responded overwhelmingly against them. I expect the same outcome here.”
Before leaving town, four Republicans from swing districts made a last-minute effort to revive the funding debate. Partnering with Democrats, they filed a “discharge petition” to force a vote on a three-year extension of ACA subsidies. That vote is expected during the week of Jan. 5 when the House reconvenes.
The Republicans involved—Reps. Brian Fitzpatrick, Rob Bresnahan, Ryan Mackenzie of Pennsylvania, and Mike Lawler of New York joined 214 Democratic signatories to bypass Johnson, who has called for allowing the subsidies to expire.
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GOP Divisions Over ACA Funding
GOP leaders argue that the COVID-era funding, enacted initially by Democrats in 2021, should expire as scheduled. While many Republicans prefer letting the subsidies lapse, some are open to a temporary extension if it includes limits or a gradual phase-out.
Competing Republican proposals in the House and Senate offered conservative alternatives but did not restore ACA funding. House Republicans passed their plan on Wednesday, though it is widely considered unlikely to become law.
Rep. Madeleine Dean, D-Pa., said Republicans in competitive districts are increasingly aware of the political risk of inaction.
“I was in Mr. Bresnahan’s district at a town hall with over 200 attendees,” Dean said. “Voters know he voted for Medicaid cuts in the ‘big, beautiful bill.’ The message is clear—they’re in trouble politically.”
Senate Pushback and Procedural Hurdles
Several Senate Republicans told NBC News the House bill is dead on arrival, even among members who support at least a short-term ACA subsidy extension.
“There’s no way it’s going to sail through,” said retiring Sen. Thom Tillis, R-N.C., who favors a limited extension but not a full three years without reforms. “The vote count would likely be much lower than last week’s attempt.”
The Senate rejected a three-year extension last Thursday in a 51-48 vote, with four Republicans joining Democrats, far short of the 60 votes needed to break a filibuster.
Even centrist Sen. Susan Collins, R-Maine, who has frequently diverged from her party on ACA issues, did not endorse the House bill.
“We are trying to create a bipartisan bill with reforms and a two-year extension,” Collins said. “House passage would keep momentum going, but the bill also needs measures like an income cap to make it viable.”
Lawmakers Seek a Bipartisan Solution
Sen. Lisa Murkowski, R-Alaska, emphasized the potential for compromise despite the timing.
“It’s too late to prevent the initial impact, but it’s not too late to act,” she said. “I refuse to accept the notion that we should just give up.”
Sen. Jim Justice, R-W.Va., highlighted the financial strain Americans will face if the subsidies expire without a replacement plan.
“We need an exit ramp,” Justice said. “My proposal: 90% funding now, 60% next year, 30% the following year. It eases the transition without creating a crisis.”
Sen. Mike Rounds, R-S.D., cited abortion funding restrictions as a significant roadblock in bipartisan negotiations. Republicans want to tighten restrictions tied to ACA funds, which Democrats have labeled a nonstarter.
“People are working on it, but resolution is uncertain,” Rounds said.
The Stakes for Americans
Thune declined to predict the Senate response if the House approves a three-year extension.
“We’ll cross that bridge when we come to it,” he said.
Democrats warn that the delay could make it nearly impossible to reverse the premium hikes. “After Jan. 1, when higher premiums kick in, it will be tough to put that toothpaste back in the tube,” said Senate Majority Leader Chuck Schumer, D-N.Y.
Unlike last fall, Democrats are unlikely to link ACA funding to the government funding deadline on Jan. 30. That tactic previously led to a record 43-day shutdown, with Republicans refusing to support a subsidy extension.
“I don’t see that happening,” said Sen. Jeanne Shaheen, D-N.H., who had supported reopening the government during prior negotiations.
Sen. Josh Hawley, R-Mo., who voted for the ACA funding extension, criticized Republicans for letting past disputes dictate current policy.
“People want us to help them with health care costs,” Hawley said. “They don’t care who voted for what 20 years ago—they care about rising insurance premiums.”
What’s Next for ACA Subsidies
The looming expiration of ACA subsidies underscores the broader challenges facing Congress as Americans brace for premium increases. While some Republicans remain open to compromise, political divisions and procedural hurdles suggest the issue will dominate the first months of the 2026 session. Millions of Americans will likely experience higher health insurance costs unless lawmakers find a bipartisan solution quickly.
Frequently Asked Questions
What happened to the ACA subsidies in Congress?
Congress adjourned without extending Affordable Care Act (ACA) subsidies, leaving millions of Americans at risk of higher premiums in 2026.
How many Americans will be affected by the subsidy expiration?
Approximately 22 million Americans could face rising health insurance costs when the ACA subsidies expire.
Why are some Republicans opposing the subsidy extension?
Many GOP leaders want the COVID-era funds to expire as scheduled, arguing for budget discipline and reforms. Some are open to temporary extensions with limitations.
Are there efforts to revive ACA funding in 2026?
Yes. A bipartisan group in the House filed a discharge petition to force a vote on a three-year extension, with discussions continuing in the Senate.
What impact will expiring subsidies have on premiums?
Without ACA funding, insurance premiums are expected to increase significantly, putting additional financial strain on millions of Americans.
Could a bipartisan deal still be reached?
Some lawmakers, including Senators Collins and Murkowski, are exploring compromise options, such as shorter-term extensions with reforms, though challenges remain.
How might this affect the 2026 midterm elections?
Democrats plan to use the subsidy expiration issue to highlight Republican inaction, potentially influencing competitive districts and shaping voter sentiment.
Conclusion
The failure to extend ACA subsidies leaves millions of Americans facing higher premiums and underscores the urgent need for bipartisan action. Without compromise, rising health care costs could strain families and dominate political debates in 2026.
