House Speaker Mike Johnson is making a high-stakes bet that Republicans can turn health care from a defensive liability into a winning issue heading into the 2026 midterms. It's a bold gamble, but it needs to be done. Republicans have been playing defense on health care for too long. The system Democrats created is broken, and throwing more taxpayer dollars at it won’t fix it. You have to build something better.
But can the GOP win this gamble?
Johnson seems to think so. Last week, he introduced the Lower Health Care Premiums for All Americans Act, a Republican-led effort to deliver more affordable and sustainable health care coverage. The bill seeks to restructure how families access coverage without forcing Washington to keep writing bigger checks. It’s not precisely the repeal-and-replace I was hoping for, but as someone who doesn’t qualify for Obamacare subsidies, it’s probably my best shot to see my insurance premiums go down for a change.
Johnson threw down the gauntlet on Tuesday when he announced there would be no vote on extending those "enhanced" subsidies. Instead, he wanted the House to focus on passing the Republican alternative.
Related: Extending Obamacare Subsidies Won't Fix a Broken System
Unfortunately, four House Republicans in competitive districts threw a wrench into that plan. Reps. Brian Fitzpatrick (Pa.), Mike Lawler (N.Y.), Rob Bresnahan (Pa.), and Ryan Mackenzie (Pa.) sided with Democrats, giving them the necessary votes on a discharge petition to force a vote on extending Obamacare subsidies for three years.
As much as it’s annoying that these Republicans sided with Democrats, they are in a tough spot. Extending the subsidies is a terrible idea, and I think they know it. But they don’t want to take responsibility for premium increases during an election year, even though those high premiums exist because Obamacare failed to make health insurance more affordable in the first place. Voters likely won’t make that distinction.
Still, even if an extension passes the House, there's zero reason to believe it would pass the Senate, which previously rejected extending the subsidies. The subsidies should never have been implemented in the first place, and the increase in premiums might actually give the Lower Health Care Premiums for All Americans Act momentum in Congress, as people affected will be hungry for a solution that lowers their premiums.
Democrats will close ranks against any approach that fails to extend the subsidies or meaningfully alter Obamacare. That leaves Republicans needing a plan that delivers immediate relief so they can credibly claim they’re cleaning up the mess Obama and the Democrats left behind.
Even that is a steep climb. A GOP fix would require total party unity and 60 votes in the Senate to invoke cloture. That outcome looks unlikely. Rising premiums might push public opinion toward a Republican alternative, but it’s hard to imagine enough Democrats crossing the aisle to break a filibuster. Johnson is betting that voters are finally ready to move past Obamacare’s cycle of bailouts and broken promises.
Let’s hope he’s right.
