House GOP unveils narrow health care package with key deadline looming

House Republicans unveiled a narrow health care package on Friday that does not extend soon-to-expire enhanced Affordable Care Act subsidies — the latest sign that Congress is unlikely to avert skyrocketing insurance premiums for millions of Americans in the new year.

The GOP proposal would instead expand the availability of association health plans, which allow employers to band together to purchase coverage, and fund a cost-sharing reduction program to lower premiums for certain Affordable Care Act enrollees. It would also impose new transparency requirements on pharmacy benefit managers in a bid to lower drug costs.

GOP leaders opted against extending the enhanced subsidies as part of their highly anticipated plan, according to multiple Republican leadership aides. But they do expect to allow a floor vote on an amendment related to those subsidies, which are set to expire at the end of the month. The precise details of that amendment are not yet clear, but are being hashed out by centrist GOP Rep. Brian Fitzpatrick of Pennsylvania and others.

“While Democrats demand that taxpayers write bigger checks to insurance companies to hide the cost of their failed law, House Republicans are tackling the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation’s health care system for all Americans,” Speaker Mike Johnson said in a statement on Friday.

The GOP’s intraparty fight over the fate of the Obamacare subsidies has consumed Congress for weeks, including an hours-long meeting of top House Republican leaders, centrists, and hardliners earlier on Friday at the Capitol.

GOP leaders plan to put the package on the floor next week, which will be the House’s final work week of 2025. But it remains unclear whether the proposal has the support to pass out of the chamber, much less win over the entire House Republican conference.

The release of the House GOP plan comes after the Senate tried and failed to pass dueling health care plans earlier this week, the latest sign of partisan stalemate over the issue.

House GOP leaders are bundling a handful of smaller-scale health care bills that have been pillars of Republican health policy since their first attempt to replace Obamacare in 2017. That includes expanding health savings accounts and restoring a cost-sharing reduction program that would help offset costs for lower-income people by requiring insurers to pay more, as CNN reported earlier this week.

“Every policy you’re going to see in this bill has received a vote in the House under a Republican majority, and every provision has had bipartisan support in the past,” one GOP leadership aide said Friday.

Notably, a big part of the GOP’s plan is restoring ACA cost-sharing reduction payments that Republicans effectively halted during the first Trump administration, amid the party’s failed efforts to repeal and replace the 2010 health law. The loss of those funds prompted health insurers to adopt a complicated practice called “silver loading,” which raised premiums — yet also expanded federal subsidies for enrollees. Conservatives, as a result, have now sought to re-fund the cost-sharing reduction program as a way of limiting federal spending on the ACA’s subsidies.

Under the plan, the cost-sharing payments are then directed to consumers to help cover out-of-pocket costs, such as deductibles and copayments, for lower-income people enrolled in Obamacare plans. But the money does not go toward those Obamacare premiums, which are set to spike for millions of Americans next year once the Biden-era subsidies expire.

If those enhanced subsidies lapse, enrollees will see their premium payments more than double — or about $1,000 — on average, according to KFF, a nonpartisan health policy research group. Roughly 2 million more people are also expected to be uninsured next year if the funding lapses, according to the Congressional Budget Office.

By Sarah Ferris, Adam Cancryn, CNN via The-CNN-Wire™ & © 2025 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.

The Gayly online. 12/12/25 @ 4:52 p.m. CST.