President Donald Trump’s call to let federal subsidies under the Affordable Care Act expire has triggered an unusually direct rebuke from congressional Republicans, exposing one of the sharpest policy rifts between the party’s leadership and its most influential political figure.
Trump recently reiterated online and during rally appearances that he does not want to continue the expanded subsidies that help millions of Americans afford health insurance through the ACA marketplace. He criticized the program as overly costly and argued that it should be replaced with a still-undefined alternative. His remarks revived long-running conservative frustrations with the law but also reopened a debate many Republicans hoped had quieted in recent years.
Inside the House, however, GOP leaders are signaling that Trump’s proposal is a nonstarter. Speaker Mike Johnson has indicated he strongly opposes ending the subsidies, with advisers privately warning that doing so would trigger a major spike in insurance premiums shortly before the 2026 midterm elections. Several senior Republicans have also conveyed to Trump’s team that allowing the subsidies to lapse would amount to political self-sabotage.
The subsidies at the center of the dispute were originally boosted during the Biden administration and later secured through bipartisan support in Congress, making them a permanent fixture of the ACA system. Analysts say ending them could lead to 4 to 5 million people losing coverage, while millions more would face significantly higher monthly costs.
Republicans have long campaigned against the ACA, but the party has never rallied around a replacement that could pass both chambers. Over the past decade, resistance to major health-care disruptions has grown among voters, including within conservative districts. That political reality has pushed House Republicans toward extending the subsidies despite their ideological misgivings about the law itself.
The clash represents an early sign of how policy disagreements may test the party’s unity heading into the next election cycle. While Trump remains the dominant force in Republican politics, congressional leaders appear determined to avoid a healthcare battlefield that could threaten their control of the House.
For now, lawmakers are expected to move toward preserving the subsidies as the deadline approaches, even as Trump continues to criticize the program and promises an alternative that has yet to be detailed.
