House GOP Unveils Health Care Plan Focused on Cost Control Without ACA Subsidy Extension

House Republicans, led by Speaker Mike Johnson, introduced a focused health care legislative package aimed at addressing rising health care costs without extending the expiring enhanced Affordable Care Act (ACA) subsidies. The proposal includes expanding association health plans and CHOICE arrangements, increasing transparency for pharmacy benefit managers to lower drug costs, and funding cost-sharing reductions to reduce individual market premiums. However, the package notably excludes additional funding for health savings accounts and does not directly extend ACA subsidies, which are critical for many Americans. The GOP plan emphasizes giving individuals more control over health care spending, aligning with statements from former President Donald Trump advocating for direct aid to patients via insurance accounts. Republican leadership is also considering an amendment to extend ACA subsidies, with discussions ongoing. The House Rules Committee scheduled to mark up the bill and amendments anticipates a House floor vote soon, likely the last legislative week of 2025. House Democrats criticized the Republican package for failing to address looming premium increases and the impending expiration of ACA tax credits. Democratic Leader Hakeem Jeffries labeled the proposal ineffective in tackling the health care affordability crisis and expressed willingness to collaborate on subsidy extensions. Meanwhile, some House Republicans openly opposed the leadership by pushing separate efforts to extend subsidies. Senate actions remain uncertain, as recent attempts at bipartisan health care bills addressing premium hikes did not advance, indicating potential challenges ahead for comprehensive health care reform. The clash between maintaining ACA supports versus introducing reforms reflects ongoing tensions in the U.S. health care policy landscape as premium costs rise.