Jan. 8, 2026, 6:36 p.m.
More than a week after the expiration of enhanced Affordable Care Act premium tax credits, lawmakers are scrambling to find a deal that will revive the subsidies for millions of Americans facing sticker shock, while potentially making changes to the policy and the larger marketplace to meet conservative demands.
As lawmakers race to finalize any bipartisan deal before more notional deadlines—Jan. 15, which is when open enrollment ends, or the end of the month to align with government funding running out—a number of hurdles remain, including an agreement on abortion language, and larger buy-in from both party leaders and President Trump.
A bipartisan group of lawmakers, led by GOP Sens. Susan Collins and Bernie Moreno, along with Democratic Sen. Jeanne Shaheen, met several times over the Christmas break and the first week of the year to reach an agreement that’s so far been elusive.
Those efforts got a bipartisan boost Thursday when the House approved legislation that would serve as a vehicle for any Senate deal to ride on. But several questions remain on whether leadership or the president will sign off on any health care compromise. Obamacare, which Trump continually slams as “unaffordable” and “terrible,” remains politically tenuous for congressional Republicans—so much so that they allowed the subsidies to expire last month.
Seventeen House Republicans ultimately voted for the Democratic-led discharge petition Thursday that would extend subsidies for three years without changes. It’s a symbolic measure that logistically serves as a vehicle for any bipartisan deal, as any tax legislation procedurally would need to originate from the House. The number of GOP members supporting final passage Thursday increased after votes on the procedural motions, signaling a growing consensus from Republicans that puts pressure on the Senate to act on the issue.
“I will tell you, for a lot of my Republican colleagues, there are people you wouldn’t expect are teetering on what to do with this,” GOP Rep. Brian Fitzpatrick, co-chair of the centrist Problem Solvers Caucus, said as he was exiting a meeting with senators Thursday to discuss possible proposals.
Collins and Moreno, who have been the lead GOP negotiators on an extension, have expressed optimism about a bipartisan deal coming together in the Senate. The pair, who introduced a framework for a deal before the Christmas break, have been looking to add to their initial outline to generate more support for any potential bill. Following Thursday’s meeting, the contours of a deal will likely include a two-year extension of the subsidies, with income caps at 700 percent of the federal poverty level, according to a Senate Democratic aide briefed on Thursday’s meeting.
Earlier in the week, some Democrats opposed a proposal eliminating zero-dollar premiums, requiring that enrollees pay a minimum of $5 a month. Some states are notably impacted by it—specifically Georgia, which has not fully expanded Medicaid. Democratic Sen. Raphael Warnock, who represents the Peach State, is a part of bipartisan negotiations.
“There's some division on the minimum premium, and that's something that Republicans really want, and it would have some impact in some states like Georgia,” Sen. Peter Welch, another Democrat involved in negotiations, said Wednesday.
The Democratic aide, however, noted that the issue of minimum premiums is not expected to be a sticking point in talks.
“It's not their favorite policy, but I don't think that that's going to be a deal-breaker for Dems,” the aide said.
The bigger hurdle, the aide added, is the Hyde amendment—language barring federal funds from being used for abortions. For months, Republicans have been drawing a red line on the issue, noting that any deal would have to include expanded Hyde language to apply to the credits—a no-go for most Democrats.
While Trump has dipped in and out of the debate on any health care deal, he threw a curveball at Republicans during a retreat on Tuesday, advising them to be “a little flexible on [the] Hyde” amendment.
"You've got to be a little flexible; you've got to work something,” the president said in a speech before House Republicans at the Kennedy Center. “You've got to use ingenuity."
In his speech, the president argued that in order to turn around the issue of health care for Republicans, lawmakers need to focus on “most favored nations’” drug-pricing policies, reiterating his support for sending ACA subsidy funds directly to enrollees.
The comments surprised lawmakers on both sides of the aisle—with a number of Democrats calling it a sign that Trump would sign off on a deal without Hyde language.
“I mean, it's some indication that he's aware of what we're doing and the goal we have,” Welch said Tuesday. “The reality is we won't be able to succeed unless he gives the OK to Republicans.”
And as GOP lawmakers exited Thursday’s meeting, it seemed the president’s comments had an effect on how some of them intended to address the Hyde issue.
"I think it's resolvable. You heard what the president had to say about flexibility,” said Rep. Dan Meuser, a member of the Problem Solvers Caucus. “I mean, it's already in the ACA, so we'll see how it can be handled, but I don't think it will be a deal-breaker."
A number of Republicans, however, dismissed the idea that the party would relent on adding expanded Hyde language to any deal.
“We’re just simply not going to vote for something that allows for taxpayer dollars to be used to fund abortions,” Sen. Mike Rounds told National Journal Tuesday, moments after the president's comments. “It's pretty straightforward. It's been consistent for as long as I've been in the Senate.”
It was a notable break between the White House and congressional Republicans—a pattern that has become increasingly common. While the president may urge lawmakers to go one way, one GOP staffer noted that Republican lawmakers are likely to align with antiabortion advocacy groups that have been pushing for any deal to include Hyde language.
“I think the line has been drawn by the life groups,” said a Senate GOP health aide. “On Hyde, that’s been the case so far.”
Susan B. Anthony Pro-life America President Marjorie Dannenfelser pushed back against the president’s comments Wednesday, arguing that if “Republicans abandon Hyde, they are sure to lose this November.”
“The voters sent a GOP trifecta to Washington and they expect it to govern like one,” Dannenfelser wrote. “Giving in to Democrat demands that our tax dollars are used to fund plans that cover abortion on demand until birth would be a massive betrayal.”
Some lawmakers maintained they are close to a deal this week, with Moreno telling reporters that bill text could be released by next week. But Shaheen threw cold water on the idea Thursday, cautioning that any proposal will still need sign-off from members of the negotiating group.
Any deal that comes together would need buy-in from the GOP conference, its leadership, and Trump. While Senate Majority Leader John Thune has mostly left negotiations to rank-and-file members—with the caveat that any deal would need a significant amount of Republicans to be on board—House Speaker Mike Johnson has set up hurdles for putting any measure on the floor, leaving moderate Republicans to team up with Democrats to force a vote. If any deal passes muster in the Senate, questions remain on whether it has a viable path in the House.
“I'm not sure it will be the majority of Republicans, but I think it will be many, and that should probably be enough,” Meuser said.
Republican speakers have largely abided by the Hastert rule, a principle that binds the speaker from putting forth a floor vote on any bill that does not enjoy the support of the majority of the conference.
