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By Andrew Stanton
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Some Republican senators are started to eye an extension to the premium tax credit, a key provision of the Affordable Care Act (ACA), set to expire at the end of the year, according to a new report.
Newsweek has reached out to Senate Majority Leader John Thune, a South Dakota Republican, and House Speaker Mike Johnson, a Louisiana Republican, for comment via email.
Why It Matters
The premium tax credit, which helps lower-income Americans purchase health care in the ACA marketplaces, is set to expire at the end of 2025 if Congress does not act. This could pose a problem in messaging for Republicans, who have generally opposed the ACA, as they face some challenges ahead of the 2026 midterms, when they are hoping to thwart losses that often come with the first midterms under a new administration.
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If Congress does not extend the premium tax credit, 4.1 million Americans would lose their health insurance, according to a report from the Congressional Budget Office (CBO) released in June.
President Donald Trump and his supporters have generally opposed the ACA, also known as Obamacare, and have pushed for its repeal. During his first administration, Trump almost repealed the health care law, but was famously rebuffed by Republican Arizona Senator John McCain voting against the administration.
Trump criticized the tax credit in a 2012 post to X, writing Obamacare's "tax credit is underperforming by over 95% creating an even bigger cost to the debt."
Polling suggests the ACA has remained popular, with a June KFF poll finding that 66 percent of all Americans support it.
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What To Know
A handful of Republican senators have expressed an openness to extending the premium tax credit, according to remarks in Punchbowl News.
North Carolina Senator Thom Tillis, who recently voted against Trump's "One Big Beautiful Bill Act" due to concerns about Medicaid cuts, told the publication it would be a "perfect opportunity for us to move past the reconciliation process, which is clearly a partisan exercise."
Tillis has already announced he won't run for reelection in 2026, making North Carolina a top target for Democrats in trying to slim the 53-47 GOP majority in the upper chamber.
Senators Lisa Murkowski and Dan Sullivan, both of Alaska, expressed support for bipartisan talks to extend the credit, while Senator Josh Hawley of Missouri said Republicans must do something to "allow people to afford health care."
"The cost of insurance on the exchanges is just astronomical. That's why so many people are on Medicaid," he said.
Thune told the publication that leadership is having conversations about how to deal with the expiration, but leaders have not said for sure whether they support the extension.
The debate about whether to extend the premium tax credit is "sure to be fierce and complicated," Michael Sparer, chair of Columbia University's Department of Health Policy and Management, told Newsweek.
"That this vote will be close is not a surprise. Most Republicans have long opposed the expanded credits but many in the party also worry about the political backlash that might well follow a failure to extend the credits," he said.
Medicaid cuts in the "One Big Beautiful Bill Act" further complicate the policy battle, though Republicans "delayed" the impact of those cuts "after the midterm elections in an effort to reduce the political backlash," according to Sparer.
Republicans will hope to use the cuts in publicly funded insurance benefits to "scale back the nation's safety net as part of an effort to reduce the size of the federal government while also enabling their desired tax cuts," he said. Those efforts could, however,, lead to millions losing coverage, he said.
Congressional Republicans have mostly opposed the ACA and sought to repeal it during Trump's first term, with those efforts ultimately being blocked by GOP Senators Murkowski, McCain and Susan Collins. Trump has frequently criticized the ACA and the premium tax credit over the years.
Trump's plan to replace the ACA would have included the end of the program's premium tax credits, replacing it with a new tax deduction based on age.
The report comes just one day after Trump pollsters Tony Fabrizio and Bob Ward indicated Republicans in swing districts could benefit from supporting the extension ahead of the midterms. Historically, the party that controls the White House loses seats in the midterms, and their latest poll suggested Democrats have an early advantage against the GOP in swing districts.
What People Are Saying
Pollsters Tony Fabrizio and Bob Ward wrote in a polling memo: "Republicans can position themselves ahead of Democrats in these districts by extending the premium tax credit and using the individual market as a landing spot for working age adults on Medicaid."
Senator Ron Wyden, an Oregon Democrat, told Punchbowl News: "I'll work with anybody, but I don't see anything resembling that, and what I do see is all over the political rags is they're already planning the second reconciliation partisan bill."
A Peterson-KFF report from June said: "The enhanced premium tax credits are now set to expire at the end of 2025. Unless the premium tax credits are extended, consumers can expect increases in both the net premium payments and gross premiums."
What Happens Next
Health care will likely remain a key issue in the midterms, particularly following Medicaid cuts in the One Big Beautiful Bill Act.
Whether GOP leadership decides to extend the premium tax credits remains to be seen at this point.
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