House Votes to Extend ACA Subsidies, Eyes Turn to Senate

The House of Representatives today voted to extend health insurance subsidies under the Affordable Care Act (ACA).¹ The subsidies were set to expire at the beginning of 2026, leaving millions to face increased costs for their health care premiums.² The projected rise in uninsured rates due to these expirations could lead to many downstream effects, making the subsidies a key issue moving into the new year. The House vote brings the topic back to the forefront of lawmakers’ agenda but may see more pushback as it moves to the Senate.

The House vote comes as a result of a 221-205 vote for the Democrat discharge petition that forced the bill to extend the subsidies by 3 years to be considered on the floor. The 9 GOP representatives who voted in favor of moving to consider the legislation on Wednesday said that they were concerned about the political consequences should the subsidies remain off the table.³ All Democratic representatives voted to proceed with the consideration of the bill.

Although the House passed the bill on Thursday in a 230-196 vote, with 17 Republicans joining all Democrats,¹ there are not currently the 60 votes required to pass in the Senate, at least as the bill stands. An extension of the subsidies would then require bipartisan cooperation to find a compromise in order to get the legislation off of the ground. A group of bipartisan senators is looking to negotiate this week on a compromise that would leave both parties happy, though it is not guaranteed that these negotiations will result in a bill.⁴

One of the current plans of compromise includes a 2-year extension of the subsidies, wherein the patients using the plans on the ACA could have funds deposited into a health savings account instead of paid to the insurance companies starting in the second year of enrollment. An income cap may also be on the table to satisfy Republican demands, as well as specific language on prohibiting federal funding from being used for abortion. However, even if these bipartisan talks go well, there may still be senators who are not keen on passing the new bill due to not wanting to extend the subsidies at all, which could throw a wrench into the passing of any bill.

With the passing of the bill in the House, the subsidies remain a top priority item moving forward for both Democrats and Republicans. The future of the subsidies still remains unclear and bipartisan talks on ways of compromising could take some time. With so many people relying on ACA for their health care, and the affordability being a key factor to keeping people insured, the results of these bipartisan talks will be important to monitor for all of those affected by the increased premiums seen in the early days of 2026.

References

1. Peller L, Chang E, Parkinson J. 17 House Republicans vote with Democrats to extend Obamacare subsidies for 3 years. ABC News. January 8, 2026. Accessed January 8, 2026. https://abcnews.go.com/Politics/house-vote-obamacare-subsidies-extension-after-9-republicans/story?id=129026545
2. Steinzor P. 5 consequences if ACA premium subsidies end in 2026. AJMC^®. October 31, 2025. Accessed January 8, 2026. https://www.ajmc.com/view/5-consequences-if-aca-premium-subsidies-end-in-2026
3. Guggenheim B. 9 Republicans back Dem effort to revive Obamacare subsidies. Politico. January 7, 2026. Accessed January 8, 2026. https://www.politico.com/live-updates/2026/01/07/congress/house-advances-three-year-extension-of-obamacare-subsidies-00714710
4. Gringlas S. House to vote on renewing ACA subsidies as a potential deal takes shape in the Senate. NPR. January 8, 2026. Accessed January 8, 2026. https://www.npr.org/2026/01/08/nx-s1-5662625/house-vote-affordable-care-act-subsidies