Congress Adjourns Without Health Care Deal, Premiums Set to Rise

Dec 22, 2025, 3:52 AM

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The Republican-led House and Senate have adjourned until the new year without a resolution on expiring health care subsidies under the Affordable Care Act (ACA). This inaction means that insurance premiums for about 22 million Americans are set to rise next month.

Despite opposition from key Republican leaders, including House Speaker Mike Johnson and Senate Majority Leader John Thune, some lawmakers from both parties are still optimistic about finding a solution by 2026. If no agreement is reached, Democrats plan to leverage the issue to inflict political damage on Republicans in the upcoming midterm elections.

Pat Ryan, a Democrat from New York, expressed frustration over the situation, stating, "They are absolutely screwing over millions of people, including my constituents, which pisses me off." He recalled that previous Republican efforts to repeal the ACA resulted in significant electoral losses for the party.

Before adjourning, four Republicans from swing districts collaborated with Democrats to initiate a "discharge petition" aimed at forcing a vote on a three-year extension of ACA funding. This vote is anticipated in the week of January 5, when the House reconvenes. Republican Representatives Brian Fitzpatrick, Rob Bresnahan, Ryan Mackenzie, and Mike Lawler joined 214 Democratic signatories in this effort, attempting to bypass Johnson's call to let the enhanced subsidies expire.

While GOP leaders are inclined to allow the Covid-era funds to lapse, some Republicans are open to a temporary extension if it includes certain limitations or a phase-out. However, competing bills introduced by House and Senate Republicans do not propose restoring or replacing the ACA funds, and the House's recent proposal is unlikely to pass in the Senate.

Madeleine Dean, a Democrat from Pennsylvania, noted that Republicans in competitive districts are beginning to recognize the political risks associated with inaction. She highlighted a recent town hall meeting where constituents expressed their dissatisfaction with their representatives' votes on Medicaid cuts.

The Senate recently voted down a three-year ACA funding extension, falling short of the 60 votes needed to overcome a filibuster. Even centrist Republicans like Susan Collins have refrained from endorsing the House bill, advocating instead for a bipartisan approach that includes reforms alongside a two-year extension.

Lisa Murkowski of Alaska acknowledged the challenges ahead, stating, "It's too late to avoid the shock factor, but it's not too late to do something about it." She emphasized the need for a collaborative effort to address the funding issue.

Jim Justice from West Virginia warned that the expiration of ACA funds without a replacement would be detrimental to his constituents. He proposed a gradual reduction of funding to ease the transition. Meanwhile, Sen. Mike Rounds from South Dakota pointed out that disagreements over abortion funding restrictions complicate bipartisan negotiations.

Senate Minority Leader Chuck Schumer indicated that the window for action may be closing, stating that once higher premiums take effect on January 1, it will be "very hard to put that toothpaste back in the tube." Democrats have also signaled that they will not tie ACA funding to the upcoming government funding deadline, a strategy that previously led to a significant government shutdown.

As the political landscape evolves, some Republicans, like Sen. Josh Hawley, are urging their colleagues to prioritize constituents' needs over longstanding grievances with the ACA. "People want us to do something to help them with the costs," he remarked, emphasizing the urgency of addressing rising health care expenses.

With Congress now adjourned, the future of health care subsidies remains uncertain, leaving millions of Americans facing increased financial burdens in the coming months.

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