In brief
During a recent town hall, Rep. Andy Harris expressed uncertainty over how Republicans will address rising health insurance premiums tied to the Affordable Care Act. With the threat of significant premium increases looming as negotiations continue alongside a government shutdown, Democrats leverage this anxiety to pressure Republicans for an extension of subsidies. The GOP remains divided on its approach to health care as it heads into the midterm elections, with various factions favoring different solutions.
WASHINGTON (AP) — The first caller on a telephone town hall with Maryland Rep. Andy Harris, leader of the House’s conservative Freedom Caucus, came prepared with a question about the Affordable Care Act. Her cousin’s disabled son is at risk of losing the insurance he gained under that law, the caller said.
“Now she’s looking at two or three times the premium that she’s been paying for the insurance,” said the woman, identified as Lisa from Harford County, Maryland. “I’d love for you to elucidate what the Republicans’ plan is for health insurance?”
Harris, a seven-term Republican, didn’t provide a clear answer. “We think the solution is to try to do something to make sure all the premiums go down,” he said, indicating Congress might “probably negotiate some off-ramp” later.
This uncertainty reflects a long-standing Republican dilemma: Fifteen years after the Affordable Care Act was enacted, the party stands united in its criticism of the law but divided on a pathway forward. That divide has sharpened during the ongoing government shutdown as rising premiums serve as a point of leverage for Democrats who want to pressure Republicans into extending expiring subsidies for the Affordable Care Act, often referred to as Obamacare.
While President Donald Trump and GOP leaders suggest they will consider extending the enhanced tax credits set to expire at year-end, they stipulate that Democrats must first vote to reopen the government. Meanwhile, those enrolled in ACA plans are already being notified of steep premium hikes set for 2026.
As town halls fill with frustrated voters and no definitive Republican plan emerges, this issue seems to be gaining political traction leading into the midterm elections.
“Premiums are going up whether it gets extended or not,” stated GOP Sen. Rick Scott, attributing the increases to rising healthcare costs and criticizing Obamacare as a “disaster.”
At the core of the shutdown—now in its fourth week—is a Democratic demand for an extension of Affordable Care Act subsidies enacted in 2021.
Trump has consistently promised a different approach, stating “The cost of Obamacare is out of control” and indicating he is “seriously looking at alternatives.” However, a comprehensive plan has yet to materialize. Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, affirmed on NBC this week, “I fully believe the president has a plan,” though specifics remain elusive.
While Republicans advocate for a sweeping overhaul of the healthcare system, such plans are unlikely to see light before next year. Leadership insists they will not negotiate on expiring tax credits until the government is fully operational again.
A September analysis from the nonpartisan Congressional Budget Office estimated that permanently extending the tax credits could add $350 billion to the deficit from 2026 to 2035. However, doing so could boost the insured population by 3.8 million in 2035.
When pressed this week on CNN regarding GOP plans for the subsidies post-government reopening, House Speaker Mike Johnson claimed they had “proposals” ready “immediately” but acknowledged it as a complex issue requiring time to build consensus.
The escalating political pressure regarding insurance premiums has become evident in Republican town halls across the country. In Idaho, Rep. Russ Fulcher remarked that “government-provided health care is the wrong path,” while in Texas, Rep. Brandon Gill stated that Republicans are working to cut “waste, fraud, and abuse” within the existing system.
Harris reiterated sentiments shared by many in his party, claiming costs are merely reverting to pre-COVID levels. Nonetheless, the reliance on Affordable Care Act insurance has surged since the pandemic, with enrollment exceeding 24 million in 2025, up from about 11 million in 2020, as per the KFF analysis.
Some Republicans show urgency in addressing escalating premiums, as a group of 13 battleground House Republicans urged that the party must address the growing healthcare affordability crisis as soon as the shutdown concludes. They asserted, “While we did not create this crisis, we now have both the responsibility and the opportunity to address it.”
Even amidst these discussions, projections indicating that ACA premiums may double without the current subsidies are contested by some Republicans who view such estimates as exaggerated, attributing issues of fraud and abuse to the law.
Amidst concerns relating to health insurance, a recent AP-NORC poll indicates that approximately 40% of U.S. adults trust Democrats to better manage healthcare, contrasted with about 25% who lean toward Republicans.
In summary, the Republican party faces mounting pressure to reconcile its differences and present a coherent strategy on healthcare as premium hikes threaten many constituents’ access to necessary coverage. The coming weeks could prove critical as discussions continue and the political landscape shifts ahead of the midterms.
