The House of Representatives on Wednesday approved, by a vote of 216 in favor and 211 against, a Republican health care package that does not extend expiring Affordable Care Act (ACA) subsidies.
Four moderate Republicans who earlier Wednesday had bucked GOP leaders and signed a Democratic-backed discharge petition voted in favor of the health care package. Rep. Thomas Massie was the only Republican to vote against it.
The measure now moves to the Senate, where it is unlikely to pass, meaning Congress will go on Christmas recess as millions of Americans will see their health care premiums skyrocket.
Earlier Wednesday, House Speaker Mike Johnson denied he had “lost control of the House” after GOP moderates rebelled and joined Democrats’ effort to force a vote on a three-year extension of ACA subsidies.
House Speaker Mike Johnson speaks during a news conference to unveil the official Trump Accounts website, at the Treasury Department in Washington, Dec. 17, 2025.
Aaron Schwartz/Reuters
“We have the smallest majority in American history, okay? These are not normal times. There are [processes] and procedures in the House that are used less frequently when there are larger majorities,” Johnson said. “When you have a very narrow margin, like we do, then every procedure in the book that people believe is on the table, and that’s the difference.”
Johnson’s statement came after the four Republicans broke ranks and signed House Democratic Leader Hakeem Jeffries’ discharge petition, giving him the 218 signatures needed to force a vote, although that likely won’t happen until January 2026 at the earliest.
The decision by moderate Republican Reps. Brian Fitzpatrick, Mike Lawler, Rob Bresnahan and Ryan Mackenzie to join Democrats came after the Republican-controlled House Rules Committee on Tuesday night blocked the advancement of amendments to extend ACA subsidies.
Johnson has also resisted allowing an up-or-down vote on an amendment to extend expiring subsidies, which were a focal point for Democrats during the record 43-day government shutdown this fall.
Asked whether he would allow a vote on extending the ACA in January, Johnson said, “Everyone stay tuned. We’re having conversations.”
The speaker, who was seen huddled with moderates in the room during Wednesday morning’s votes, said, “We just had some intense camaraderie… We’re working on very complex issues, like we do here all the time, and it’s good. Everyone is working on ideas. We keep the conversation productive. That’s what happens.”
Rep. Michael Lawler, R-New York, during a television interview at the U.S. Capitol in Washington, Nov. 12, 2025.
Graeme Sloan/Bloomberg via Getty Images
Moderate Republicans who signed the petition took aim at House leadership.
Lawler, of New York, said he does not support Democrats’ bill as written. but “when leadership blocks action entirely, Congress has a responsibility to act. My priority is to ensure that Hudson Valley families are not caught in the gridlock,” Lawler wrote in X.
Pennsylvania’s Fitzpatrick again urged voting for or against extending ACA subsidies, asking leaders to “let the House do its will.”
ABC News Capitol Hill correspondent Jay O’Brien pressed Fitzpatrick on whether signing the Democrats’ recall petition will force Republican leadership to take a different approach.
“I hope so,” he said. “But you have to let the people’s voices be heard in the House. You can’t not introduce bills because you’re afraid they’ll pass. That’s not how this place should work.”
Rep. Brian Fitzpatrick listens to debate as the House Rules Committee meets to prepare Republican legislation to address health care affordability, on Capitol Hill in Washington, Dec. 16, 2025.
J. Scott Applewhite/AP
Bresnahan, who also represents Pennsylvania, said leaders on both sides of the aisle failed to reach a bipartisan compromise on ACA subsidies.
“Doing nothing was not an option, and while this is not a bill I ever intended to support, it is the only option left,” he said. saying in a statement.
What happens next?
Republican-controlled House will vote on a clean three-year extension of ACA subsidies; However, the vote is not expected to occur until January 2026 at the earliest, given the rules on when a discharge petition can come to the floor.
The big question now is how the Senate will respond. The Senate already rejected a clear three-year extension of subsidies in a pair of dueling votes on health care last week, although several Republican senators crossed the aisle to join all Democrats in supporting it.
