House GOP Proposes Health Care Plan Excluding ACA Subsidy Extension

House Republicans led by Speaker Mike Johnson introduced a targeted health care package aiming to reduce costs without extending the expiring enhanced Affordable Care Act (ACA) subsidies. The 111-page proposal focuses on expanding association health plans, implementing new transparency rules for pharmacy benefit managers to lower drug prices, and funding cost-sharing reductions to lower individual market premiums. Association health plans enable employers to collectively purchase coverage, potentially increasing market options. The GOP package excludes additional funding for health savings accounts, emphasizing systemic cost drivers over subsidy extensions. Although Speaker Johnson has criticized expanded taxpayer subsidies as benefiting insurance companies, some House Republicans are considering an amendment to extend ACA subsidies, reflecting internal party dynamics. The bill's Rules Committee markup is scheduled for Tuesday, with subsequent House votes on the subsidy amendment and the overall measure expected before Senate consideration. Former President Donald Trump expressed support for directing health care funds directly to patients through insurance or health care accounts, seeking alternatives to the ACA's structure. While he has not ruled out ACA tax credit extensions, he insisted any such deal include Republican-favored conditions. The House GOP aims to pass the package in the final legislative week of 2025, but Senate action appears unlikely, leaving enhanced subsidies near expiration. House Democratic Leader Hakeem Jeffries criticized the Republican proposal for failing to address rising ACA premiums and called for bipartisan cooperation to protect subsidies relied on by millions. Across the House, over a dozen Republicans have defied leadership by advocating votes to extend ACA subsidies. Meanwhile, competing Senate health care bills intended to mitigate premium increases recently failed to advance, underscoring congressional gridlock on health care affordability solutions. This legislative standoff highlights ongoing divisions within and between parties over strategies to manage health care costs and coverage accessibility. The GOP's focus on association plans and pricing transparency contrasts with Democratic priorities of subsidy extensions. With premium increases imminent and subsidy expirations approaching, the outcome of these measures will significantly impact health insurance markets and consumers in the U.S.