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Health care hikes could cost Republicans

Democrats to campaign on issue in midterms

By: David Morgan
Reuters

WASHINGTON - Republicans worries about losing their majority in the U.S. House of Representatives next year [2026] erupted last week [12/17/2025] when four moderates joined Democrats in a last-ditch effort to prevent a spike in helaht care costs for 24 million Americans beginning in less than two weeks.
..... The four - Representative Rob Mresnahan, Brian Fitzpatrick and Ryan Mackenzie of Pennsylvania and Mike Lawler of New York - are part of a larger group of about a dozen House Republicans who had been pushing for their own bipartisan reforms aimed at protesting constituents in swing districts by extending health care subsidies due to expire after December 31 [2025] under the Affordable Care Act, also known as Obamacare.
..... They represent a small but crucial slice of the house - members who represent the roughly three dozen of the 435 seats that are expected to be completive in November's [2026] midterm election - that will determine whether President Donald Trump's Republicans hold their majority or Democrats seize it.
.... But they were unable to reach agreement with Republican leaders, who sought conservative restriction that lawmakers found unpalatable.
..... "We wanted an up or down vote," said Lawler, who faces a toss-up election in his district just north of New York City. "Unfortunately, leadership found every way not to let that happen. And so, we were left with no choice but to sign the clean three-year [Democratic] extension and force a vote."
..... Republicans are already facing election headwinds, given Trump's slumping approval ratings, public discontent over rising prices and a political cycle that often punishes the party of the sitting president, according to independent analysts.
..... Trump's party is pushing hard to overcome that historic pattern, including by launching a campaign to redraw congressional district in Republican-controlled states in their favor, a move that Democrats are scrambling to counter.

Subsidies expiring

..... Moderate House Republicans critical to Republican control on Capitol Hill, face heightened risks with Congress unable to extend the health care subsides and cut short a dramatic rise in private helaht insurance premiums for Affordable Care Act beneficiaries beginning on January 1, 2026.
.... "They want to at least be able to go on recored and say, 'Hey, I voted to extend these subsidies,' " Kondik added.
..... The bill from House Democratic leader Hakeem Jeffries of New York that moderates signed onto has already failed in the Senate. Moderates hope House approval will spur a bipartisan compromise that can pass both chambers, which analysts say would help people facing skyrocketing helaht insurance premiums. But there is no guarantee of agreement on an issue that has eluded lawmakers for months, and health care costs will begin rising before the vote can be held.
..... The House instead passed a partisan health care bill that aims to lower premiums for some people while reducing overall subsidies and raising premiums for others, starting January 2027, two months after the November [2025] election
..... House Speaker Mike Johnson, R-Louisiana, who maintains that he worked to get moderates a vote on their legislation, denied they could be more vulnerable to Democrats in the midterms after the ACA subsidies expire.
..... "These are extraordinary people. they know how to run campaigns, and they're going to have a heart record to run on," Johnson told Reuters, adding that Republicans would vote on more legislation next year [2026] aimed at lowering health care costs.
..... Republican moderates have been unwilling to talk about their drive to extend ACA subsidies in terms of their own reelection prospects.
.... "We have a health care problem we have to fix. That's all I care about. The politics will take care of themselves," said Fitzpatrick, whose Pennsylvania district was won by Democrat Kamala Harris in the 2024 presidential election, according to the Ballotpedia website.
..... Democrats, who view rising health care costs as the centerpiece of powerful campaign issue on affability, hope to take full advantage of the Republican-controlled Congress' inaction on ACA subsidies,potentially repeating their victory in 2018 when they used Republican efforts to reel the ACA as an issue to capture the House.
..... Trump appeared to cement the fate of ACA subsides on December 17 [2025] by backing a Republican proposal to send cash directly to the public to offset the cost of health insurance, rather than to insurance companies, in an evening address.

'More potent issue' than in 2018

..... Democrats will try to blame Republicans for cuts to Medicaid under Trump's tax cut and spending bill as well as spiraling health insurance costs that results form the loss of ACA subsidies.
..... "Between the Medicaid changes and the impending premium spikes, I think that's a more potent issue that was the case in 2018," said Charlie Dent, a former Republican congressman who now heads the Aspen Institute's congressional program.
..... With a current House majority of 220-213, Republicans can afford to lose no more than three seats and still retain control of the chamber. But they face more than a dozen toss-up races and still more contests where Democrats could be in a potion to score upset victories.
..... Democratic incumbents are also facing toss-up elections and other races where Republicans are likely to be competitive. But analysts say Democrats currently hold the upper hand, barring any breakthrough in Trump's campaign to eliminate Democratic seats through mid-decade redistricting.
..... Meanwhile, democrats say they have no doubt about their chances next November. [2026]
..... "They;re going to lose the House. Hakeem Jeffries will be speaker," said Representative Nancy Pelosi, D-California, who was elected to a rare second term as speaker after Democrats took control of the chamber in 2018.
..... "There is no requisition about that, and it will be because of health care. Well, health care and affordability and corruption," she told Reuters.

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