Sept. 18, 2025, 8:18 p.m.
Republicans are about to walk onto a political minefield this fall in deciding whether to renew the enhanced premium tax credits under the Affordable Care Act—and risk angering the White House, which has yet to articulate exactly what it’s willing to accept on an issue that could help define next year’s midterms.
Based on numerous conversations with GOP senators and staffers, the conference has not gotten a clear idea of the Trump administration’s position on an extension. The White House hasn’t publicly weighed in recently on whether it supports continuing the subsidies, which were expanded during the COVID pandemic to allow for more individuals to be eligible for the tax credits while upping the amount they receive. The credits, which are set to expire at the end of the year, help lower- and middle-income individuals and families cover the premiums for health insurance purchased through the marketplace.
President Trump "hasn’t directly weighed in,” Senate Majority Leader John Thune said on Thursday to reporters. “The White House is obviously going to have to be involved in that conversation at some point. … We have people in a lot of different places on that right now.”
Republicans have been divided on whether or not to extend a lifeline to an Obama-era policy that Trump tried—and failed—to eliminate in his first term, and which was expanded during the Biden administration. The program has gained popularity among both Democrats and Republicans, according to polls. GOP lawmakers who want to renew them ultimately will need the buy-in from the president on any proposal.
Seizing on the popularity of the credits, Democrats have made the expiring subsidies one of the central points of their negotiations in an appropriations battle to keep the government from shutting down in less than two weeks.
Conversations between the White House and Senate Republicans have centered around keeping the government open with their “clean” continuing-resolution proposal, Senate aides told National Journal, and talks between Trump and lawmakers on ACA subsidies have so far been minimal. A small working group of Republicans has formed to extend the subsidies along with reforms aimed to win over conservatives. However, in a sign of how politically toxic the issue is, it’s unclear which Republican is taking the lead on it and who all of the members are in the working group itself.
Some Senate Republicans privately acknowledged that the White House’s silence on the issue poses a risk to vulnerable members.
“The Republicans could be put in an untenable position without a specific statement,” said one Senate Republican who requested anonymity to speak candidly. “It’s almost as if the White House is trying to figure out how MAGA-land is going to react. And the last thing these people want to do is agree to something that they could get trashed [for].”
The senator admitted that the tax credits are “at probably very high risk of lapsing,” and noted that leadership has been trying to see what individual members will do before they put their finger on the scale.
But what is clear so far is that Republicans are looking to the executive branch—specifically Centers for Medicare and Medicaid Services Administrator Mehmet Oz—over what reforms could look like.
Oz, a heart surgeon who was previously a celebrity TV doctor, appeared at the Senate GOP caucus lunches on Tuesday, and he has emerged as a point person between the White House and the conference on this issue.
Although Oz was there to brief senators on the implementation of a $50 billion rural hospital fund on Tuesday, conversations eventually turned to the premium tax credits.
“There’s a lot of discussion right now around how to make the ACA work best for the American people,” Oz said during a press conference Tuesday alongside Senate Republican leadership. “It’s the topic that I personally think about the most.”
Sen. Dan Sullivan, an Alaska Republican who's one of the only identified members of the working group, noted that he’s been in frequent conversations with Oz over what reforms could look like, including questions about the length of possible extensions and pay-fors.
“Dr. Oz has been really digging into it, so I'm really digging into it,” Sullivan said when asked about the White House’s involvement. “There's got to be a way to reform the program as you look to extend it.”
The average premium monthly tax credit that Alaskans on the Obamacare exchange received was $1,009—second only to West Virginia, according to KFF.
Other Senate Republicans, however, are not exactly thrilled about the idea of renewing a costly Democratic proposal.
“It needs to expire,” Sen. Rick Scott told National Journal. “And we need to make sure people can get health care. And there’s a lot of other ways they can.”
Scott—who led one of the nation’s largest hospital chains before he entered politics—is among several Republicans who claim fraud in the ACA marketplace: enrollees receiving insurance subsidies above the amounts they’re entitled to, misstating their income on applications, or being switched into new plans without their consent.
A number of Republican senators are open to the idea of renewal only on the condition that it come with changes that tackle the allegations of fraud.
“I think that I would like for us to find a way to extend them,” said Sen. Jon Husted. “However, they can't be like they are right now, because the American taxpayers are being ripped off.”
Although the enhanced subsidies are set to expire at the end of the year, insurers have filed their initial premium rates for the upcoming year—and some state regulators have already approved rate hikes, ahead of an open-enrollment period that begins on Nov. 1.
And with Republicans wanting to separate any extension from the government-funding fight, waiting to address any ACA proposal in the next government vehicle—which will likely be in November—is expected to result in a hike in premiums next year.
A House Republican, who requested anonymity to speak frankly and has advocated for the subsidy’s renewal, told National Journal this week that they haven’t heard a plan from leadership on extending the subsidies with reforms, despite promises to tackle it later in the fall before its expiration.
“I think that’s too late—it needs to be addressed as soon as possible,” the lawmaker said. “And I think there’s a lot of Republicans here on the floor that get that this is a problem. Hopefully we get it addressed.”
A White House spokesperson did not immediately respond to a request for comment.
Senate Republicans' conundrum comes as their Democratic counterparts aim to put them on the record for eliminating the subsidies.
Republicans granted Minority Leader Chuck Schumer's request that they vote on both parties' proposals before lawmakers leave town this weekend; many Republicans are flying to Arizona for the Charlie Kirk funeral on Sunday.
Leaders announced an agreement for a vote Friday—a rarity in the Senate—for both House Republicans' CR and the Democrats' counter. Both are expected to fail, as neither will gather the 60 votes needed.
Senate Democrats' counterproposal for a government-funding bill includes permanently extending the expiring ACA tax credits and reversing the Medicaid cuts from the GOP reconciliation bill—a no-go for Republicans.
Thune told reporters on Wednesday he believes the “ACA subsidies will be an issue that will be addressed” but likely not until after the deadline for the government shutdown, which is Sept. 30.
The first fight over these subsidies will come sooner than many Republicans were expecting with Friday’s votes.
Schumer said from the floor on Thursday evening: “Tomorrow, the Senate will hold votes on two bills: the status-quo continuing resolution from Republicans, which will lead to a shutdown, and the Democrats' to prevent a shutdown while avoiding a catastrophe in rising health care costs."
