GOP Divisions Emerge Over Health Care Plans Amid Biden Administration Proposals

GOP divisions are surfacing over health care plans amid proposals from the Biden administration. The Republican indecision comes as COVID-era tax credits are set to expire on January 1, 2025, which could lead to sharp premium increases for millions of Americans.

Speaker of the House Mike Johnson, R-Louisiana, spoke with reporters following the final vote to end the longest government shutdown in history on November 12, 2025. Senate Majority Leader John Thune, R-South Dakota, responded to Senate Democratic Leader Chuck Schumer's call to reopen the government by suggesting Republicans could extend the expiring health care subsidies for one year.

The tentative proposal from President Donald Trump seeks to extend Affordable Care Act subsidies for two years while adjusting eligibility requirements. So far, this proposal has not garnered significant response from Capitol Hill as Republicans are divided on whether to overhaul, tweak, or simply allow the subsidies to expire.

The impending expiration of COVID-era tax credits is prompting concern as premiums could double for subsidized enrollees, according to an analysis by the health care research nonprofit KFF. With millions reliant on these subsidies, some lawmakers are looking for bipartisan solutions, though a compromise seems unlikely.

Republican Senator Thom Tillis of North Carolina indicated that if the subsidies are not addressed by December, there may not be another opportunity to do so next year. The draft White House proposal would impose new income limits on tax credits at 700 percent of the federal poverty level and would require all Obamacare enrollees to pay some premium, effectively eliminating zero-premium plans for lower-income individuals.

Some Democrats are open to these ideas as part of broader negotiations. Nebraska Representative Mike Flood, chairman of the business-oriented Republican Main Street Caucus, expressed support for Trump's efforts to address the ACA tax credit cliff.

Several bipartisan bills exist in the House aiming to extend ACA credits for two years with changes. However, House Speaker Mike Johnson has not committed to bringing a health care bill to a vote, with many Republicans preferring to eliminate the subsidies or completely overhaul the law.

Additionally, Thune and other Republicans are advocating for new language on abortion restrictions, which is a dealbreaker for Democrats. If Congress fails to act, enhanced premium tax credits will disappear, causing significant financial impact for many Americans.

As open enrollment began on November 1, many are already planning for the expected higher costs. Senate Democratic Leader Chuck Schumer stated that when premiums rise, voters will hold Republicans accountable.

Republicans are also considering using budget maneuvers to pass health care packages without Democratic support, a risky political move that could extend into the midterm election year. Much seems to hinge on Trump's direction, as he has signaled support for health savings accounts and has been vocal about not wanting to funnel money to insurance companies.

He emphasized on November 18 that any health care legislation should prioritize returning money directly to the people rather than to wealthy insurers.