Republicans in Congress are on a path to letting enhanced ObamaCare subsidies expire at the end of the year, a result that could amount to a dismissal — or, depending on your perspective, a betrayal — of the MAGA populism that was ascendant in the party.
Rather than heed warnings from MAGA commentators and Trump pollsters that letting the subsidies expire without any alternative plan would spell disaster for the party in the 2026 midterms, a sizeable chunk of Republicans in Congress seem to be driven more by ideological opposition to the big spending on the subsidies and to the Affordable Care Act (ACA) in general.
A few House Republicans I’ve spoken to privately say they don't think the subsidies will be extended — leaving the GOP to take a gamble in the midterm elections where Democrats are waiting to accuse Republicans of betraying their voters on affordability, since the expiration will mean increases in health care premiums.
That dynamic is raising alarm bells for those interested in holding together the MAGA coalition and the influx of working-class voters into the party.
Matt Boyle, the Washington bureau chief for Breitbart News who is very well connected among senior Trump administration officials, has been vocal about calling for a medium- or longer-term extension of the health care subsidies to take the issue away from Democrats in the 2026 midterms and 2028 presidential election.
“If the Republicans do this right or even close to right I think they can take health care away from the Democrats as a political issue,” Boyle said. He pointed the finger at GOP leaders from President Trump’s first term who declined to repeal and replace ObamaCare in 2017, calling an extension of the subsidies a “duct tape solution to Barack Obama’s Unaffordable Care Act.”
“They hold it together with some duct tape until such time as the real America first leaders who have replaced the loser globalists like [former GOP Speaker] Paul Ryan take over and actually come up with real plans about this,” Boyle said.
A July polling memo from Trump campaign pollsters Tony Fabrizio and Bob Ward found voter support in competitive House districts for the generic Republican candidate would crater from a 3-point deficit to a 15-point deficit if the subsidies aren’t extended.
Polling from the health care policy nonprofit KFF released last week found that 72 percent of Republicans enrolled in ObamaCare plans support extending the enhanced subsidies. A previous KFF report found that in some of the most competitive congressional districts, those on marketplace plans could be enough to swing a close election: “In the 10 most competitive districts in the last election, the margin of victory was fewer than 6,000 votes. There are at least 27,000 ACA Marketplace enrollees in each of these districts.”
And in a reflection of how MAGA and moderates could come together on the issue, Sen. Bernie Moreno (R-Ohio) — a MAGA favorite in the Senate — teamed up with moderate appropriator Sen. Susan Collins (R-Maine) on a plan to extend the enhanced tax credits for two years, with reforms like income caps and an elimination of zero-premium plans.
But Republicans opposed to the subsidies stress that they never supported the COVID-era subsidy enhancements, which were signed into law by former President Biden, and even Republicans who are open to extensions say they would need substantial reforms. Others, as I wrote in last week’s edition of The Movement, won’t accept any extension that fails to add prohibitions on plans that cover abortions.
While various groups of moderates are working on compromise plans to extend the subsidies with reforms like income caps, House GOP leaders have said they’re working on releasing an alternate health care plan that may not extend the subsidies at all, and their messaging centers on ObamaCare being broken and trying to put the blame on Democrats for high health care premiums.
Fabrizio spoke to House Republicans in the Republican Study Committee, the largest conservative caucus in the House, whose members generally oppose extending the subsidies, last week. Rather than focus on the subsidies, though, he placed a lot of focus on Trump's moves to reduce drug prices. A GOP aide said Fabrizio presented new polling showing that Americans were more likely to vote for a candidate who reduced drug prices than a candidate who extended ObamaCare subsidies — another way to address voter concerns about affordability.
MAGA World operators have privately expressed concern that Republicans seem to be OK with not extending the subsidies and taking a gamble in the midterm elections, and that Republicans won’t rally around a GOP plan unless Trump pushes them to do so. An ObamaCare subsidy expiration would come on top of Republicans implementing reforms to Medicaid in the One Big Beautiful Bill Act, though those reforms won’t start until after the midterms.
Ahead of Thanksgiving, a White House proposal to extend the subsidies for two years leaked in news reports. But the administration backed off releasing any plan after Speaker Mike Johnson (R-La.) cautioned the president’s advisers that most House Republicans don’t want to extend the subsidies, The Wall Street Journal reported.
For now, Trump is letting Congress take the lead. He said last week that “ObamaCare is horrible health care” and expressed support for sending money directly to people to “buy their own health care” rather than subsidizing insurance companies, which some Republicans have aimed to turn into legislative plans boosting health savings account-like programs.
But while the hour is late, there could still be time for Trump to mount a last-minute push.
“I think that whatever President Trump decides will be what Congress does,” Boyle said.
