By Siobhan Hughes, Lindsay Wise and Richard Rubin

WASHINGTON -- Four vulnerable House Republicans revolted against Speaker Mike Johnson (R., La.) and backed a Democratic effort to force a vote on extending Affordable Care Act subsidies, exposing GOP fractures over surging healthcare costs headed into next year's midterm elections.

Rep. Mike Lawler (R., N.Y.) joined three Republicans from Pennsylvania swing districts -- Reps. Brian Fitzpatrick, Rob Bresnahan and Ryan Mackenzie -- in signing a petition led by House Minority Leader Hakeem Jeffries (D., N.Y.) that would force a vote on a three-year extension of ACA subsidies. The lawmakers acted after the GOP leaders blocked votes on compromise measures aimed at extending and trimming the subsidies, saying the needs of their voters were urgent.

The open split among Republicans shows the challenges facing the party, with about 20 million people on ACA plans facing higher costs due to the expiration of the enhanced subsidies at the end of this month. Republicans are hoping to hang onto a razor-thin majority in the House, but the party is divided over whether to rescue the enhanced ACA subsidies, which Democrats initially passed in 2021 with no GOP support.

"I am pissed for the American people. This is absolute bulls -- ," said Lawler about the standoff in Congress. "Everyone has a responsibility to serve their district, to serve their constituents," he said.

With the GOP signatures on the discharge petition, Jeffries now has the 218 needed to force a vote, which wouldn't likely occur until after the holiday break. But the centrists' move could keep up pressure on both parties to reach a deal, and talks were continuing in the Senate on a possible compromise for early in the new year.

The defections delivered a blow to Johnson's leadership in the House, where he has been forced to manage a historically narrow majority -- currently 220-213 -- that gives any small bloc of Republicans power to derail or hijack his agenda.

"We're keeping a productive conversation going," Johnson told reporters after the defectors signed onto the Democratic plan. "I have not lost control of the House."

Johnson had said he wouldn't hold any vote on ACA subsidies this week, citing widespread objections from many Republicans, pledging that the party would tackle broader healthcare-policy changes in the new year. In a television appearance earlier Wednesday, Johnson had warned members against trying to bypass leadership.

"Doing an end-run around the majority party, the speaker or the regular process is not the best way to make law," he said on CNBC.

House Republicans still are expected to pass a GOP healthcare bill late Wednesday that would expand access to association health plans, which generally allow small employers to band together and provide health insurance, and appropriate money to fund the cost-sharing reductions that reduce out-of-pocket spending for lower-income ACA enrollees. It doesn't include any ACA extensions or the health savings accounts favored by many Republicans.

The four Republicans who signed the petition haven't been troublemakers in the conference and had been loath to line up behind Jeffries, whom they saw as playing hardball politics meant to embarrass Republicans rather than seeking a deal. But in the end their aggravation with their own party led them to deliver the crucial signatures.

"I didn't think it would be fair to just to rip the rug out from the people in northeastern Pennsylvania," said Bresnahan, a first-term Scranton-area lawmaker. He noted he wasn't in Congress for past ACA fights and said it was frustrating that centrists' plans weren't getting votes.

Democrats sought to press their advantage, saying that the House should stay in session so that the vote on a three-year extension could occur immediately, before the subsidies expire.

"Mike Johnson needs to bring our bill to the floor immediately in order to protect the healthcare of the American people," Jeffries told reporters. He said "it certainly will create a great deal of pressure on the Senate."

All four Republicans are up for re-election next year in races that are competitive or have the potential to be so, especially in Pennsylvania, which Trump and Sen. Dave McCormick (R., Pa.) flipped in 2024 in part over the issue of high inflation. With g ross premiums for ACA plans set to rise about 26% for benchmark plans headed into the 2026 plan year, based on data from health-research nonprofit KFF, Democrats said that Republicans were essentially boxed into a corner as consumers searched for a lifeline to defray those costs.

"It feels like the dam is breaking," said Sen. Chris Murphy (D., Conn.). "I mean, they're going to be ruined politically if they continue to hold their ground," he added. "This is such a terrible thing for the American people, and it's such terrible politics for the Republican Party."

Senate Majority Leader John Thune (R., S.D.) has previously ruled out holding a vote on a straight three-year ACA extension, after a similar measure failed to advance in the Senate last week. But Republican Sen. Shelley Moore Capito (R., W.Va.), a member of Senate GOP leadership, said the action in the House could add to pressure on Senate Republicans to find a compromise that can pass.

"I mean, it may bring more momentum [for a deal] into January," Capito said. "It probably will."

Talks have continued in the GOP-run Senate between rank-and-file senators. Ideas include a short-term extension paired with measures capping eligibility based on income, as well as mandating a minimum payment for all users to cut down on fraud. Any bill would need 60 votes to advance in that chamber.

Sen. Susan Collins (R., Maine) said news of the successful discharge petition in the House would help keep momentum going in the Senate.

"What we're trying to do is put together a bill that would have reforms plus a two-year extension. That is the best approach in my opinion," Collins said. "We're making good progress."

In 2021, Democrats expanded and enlarged tax credits for buying health insurance through the ACA marketplace, lifting a cap that limited the subsidies to people below a certain income level. Starting next year, the subsidies will revert to prepandemic levels for lower- and middle-income Americans. The subsidies will end entirely for households earning more than four times the federal poverty line -- currently about $128,600 for a family of four.

The Congressional Budget Office said the House GOP bill would reduce the federal deficit by $35.6 billion over a decade, but it would also reduce the number of people with health insurance by an average of 100,000 a year. The Democrats' three-year extension of the enhanced ACA subsidies would add about $83 billion to the federal deficit, the CBO estimated.

Write to Siobhan Hughes at Siobhan.hughes@wsj.com

(END) Dow Jones Newswires

December 17, 2025 16:53 ET (21:53 GMT)

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