House Passes Last-Minute GOP Healthcare Bill After Moderates Revolt

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Republicans in the House of Representatives passed a healthcare reform bill Wednesday evening targeting rising costs as expiring Obamacare tax credits rally support for change ahead of midterm elections.

The new GOP-backed legislation, titled the Lower Health Care Premiums for All Americans Act, does not extend the Affordable Care Act (ACA) enhanced premium tax credits expiring Dec. 31. The bill, introduced by Republican Iowa Rep. Mariannette Miller-Meeks, passed the House in a near party-line 216-211 vote.
Republican Kentucky Rep. Thomas Massie was the only GOP member to vote no. No Democrats supported the bill.
Miller-Meeks said on the House floor Wednesday that the new legislation lowers health care costs by “forcing transparency” and implementing “common sense solutions.”
“By lowering premiums through choice and competition, by expanding association health plans, we give small businesses and self-employed workers the buying power of large employers, cutting premiums by as much as 30%,” Miller-Meeks said. “Being transparent to drug pricing, we take on the pharmacy benefit managers who have long operated behind the scenes as middlemen, collecting hidden fees while prescription prices climb.”

WASHINGTON, DC – DECEMBER 16: U.S. Speaker of the House Rep. Mike Johnson (R-IL) speaks as (L-R) Rep. Mariannette Miller-Meeks (R-IA), House Majority Whip Rep. Tom Emmer (R-MN), House Majority Leader Rep. Steve Scalise (R-IL) and House Republican Conference Chair Rep. Lisa McClain (R-MI) listen during a news conference at the U.S. Capitol on December 16, 2025 in Washington, DC. House Republican leadership held a news conference to discuss GOP agenda. (Photo by Alex Wong/Getty Images)

Republican Kentucky Rep. Brett Guthrie further argued that the ACA was an “unsustainable” system that has seen premiums increase dramatically since its inception.
“Health care spending has nearly doubled since Obamacare passed. Health care plan options have been decimated by Democrat overreach, and millions of Americans are saddled with medical debt across the country,” Guthrie said on the House floor Wednesday. “Obamacare premiums are up 80% since the program’s inception, with patients paying on average $5000 dollars out of their own pocket to hit their deductible.” (RELATED: Obamacare Deadlock Drags On, But One Healthcare Fix Could Slash Medical Costs Nationwide)
WASHINGTON, DC – OCTOBER 22: House Minority Leader Hakeem Jeffries (D-NY), joined by House Minority Whip Katherine Clark (D-MA) (L) and House Democratic Conference Chair Rep. Pete Aguilar (R), speaks at a news conference on Capitol Hill on October 22, 2025 in Washington, DC. The government shutdown has entered its 22nd day. (Footage by Andrew Harnik/Getty Images)

The passage of the legislation, however, was dogged by the success of a petition from House Minority Leader Hakeem Jeffries.

The New York Democrat successfully lobbied a majority of the House to support a discharge petition requiring Speaker of the House Mike Johnson to hold a vote on a three year extension of the ACA enhanced credits, thanks to the support of four moderate Republicans representing swing districts: Pennsylvania Reps. Brian Fitzpatrick, Rob Bresnahan and Ryan Mackenzie and New York Rep. Mike Lawler.
“The bill before us does nothing for the 15 million Americans who are about to lose health insurance; the one million children who are about to become uninsured; the hundreds of hospitals that are closing or are on the verge of closing,” Democratic Whip Massachusetts Rep. Katherine Clark said Wednesday. “Now that we have a bipartisan discharge petition, ready to vote on today, you can’t find the time to do it? We are ready to vote Mr. Speaker, you have the power to bring it to the floor today. Let the will of the people be the will of the people’s house.” (RELATED: 4 Republicans Sign Democrat Obamacare Petition To Force House Vote On Subsidies)
WASHINGTON, DC – MAY 15: U.S. Rep. Mike Lawler (R-NY) speaks to reporters as he arrives for a House Republican caucus meeting at the U.S. Capitol on May 15, 2025 in Washington, DC. House Republicans met to discuss the Republican budget bill as they attempt to bring it to the floor next week for a vote. (Photo by Kevin Dietsch/Getty Images)

A three year extension of the credits, though, was defeated in the Senate earlier in December in a vote promised as a part of the deal to end the October government shutdown over the same issue of enhanced ACA credits. Jeffries’ petition also must “ripen” for seven legislative days, meaning a House vote on the three year extension wouldn’t come before the credits expire.
“I don’t think the Senate will take it up. It’s just posturing,” Republican Tennessee Rep. Tim Burchett told the Daily Caller News Foundation on Wednesday.
“We gotta fix the problem, and throwing more money at a broken system is not fixing the problem for insurance,” Burchett said. “It’s not transportable, it’s not affordable, and the only people prosper off this are the insurance companies, and they’re getting fat.”
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