GOP pressure is mounting on Speaker Mike Johnson (R-La.) to extend expiring Affordable Care Act tax credits, as a number of rank-and-file Republicans push leaders to prevent the popular subsidies from expiring at the end of the year.

Eleven GOP lawmakers have endorsed legislation extending the benefits for an additional year, punting the issue beyond the midterm elections. Most of them are vulnerable front-liners facing tough reelection contests and wary of the spike in health costs expected to hit patients if Congress doesn’t act.

The issue is a tricky one for Republicans, who had opposed the Affordable Care Act, commonly known as ObamaCare, unanimously in 2010, and united again against the two Biden-era laws that first created, and then extended, the enhanced tax credits for patients during the pandemic.

But with those credits scheduled to expire at the year’s end and millions of patients facing skyrocketing health care premiums as a result even Republican ObamaCare critics are racing to shore up the benefits before then, forcing GOP leaders to confront the topic.

With a dwindling number of legislative vehicles remaining this year, some lawmakers want to tackle the credits as part of this month’s government funding package a strategy Johnson did not rule out this week.

Johnson acknowledged to reporters Monday that “there’s thoughtful conversations about all of it” when asked whether a fix would be taken care of as part of an eventual funding stopgap to prevent a shutdown.

“I’m not going to forecast that right now,” Johnson told reporters, while also saying, “There’s a lot of opposition to it as well.”

He also pointed fingers at Democrats for not extending the tax deadline when former President Biden held office. His comments come after Republicans notably decided not to extend the subsidies in a major tax package passed earlier this summer. 

“It was not a priority there. They missed opportunities. Everyone has,” he said. “We’ll have to see how it shakes out.”

The enhanced subsidies were first put into effect during the height of the coronavirus pandemic as part of Biden’s 2021 economic recovery law and then extended as part of the Inflation Reduction Act.

The subsidies, which have helped cut down insurance costs for enrollees, will expire Jan. 1, absent congressional action.

More than 24 million Americans are enrolled in the insurance marketplace this year, and about 90 percent more than 22 million people are receiving enhanced subsidies. 

The fight over the subsidies comes on the heels of another massive battle over health care: the sharp cuts to Medicaid funding in the GOP’s “big, beautiful bill,” which Democrats are still going on offense over and Republicans are racing to defend.

Now, Democrats are seeking to dial up pressure on Republicans for a bipartisan tax credit extension. 

“Democrats will be united that we are going to make sure that we don’t do anything that will cause prices to rise [or] that will take away people’s health care,” Rep. Hank Johnson (D-Ga.) said.

Rep. Seth Magaziner (D-R.I.) pointed to the ObamaCare subsidies specifically, saying a failure to extend them as part of the current funding debate would be “a red line” ensuring his opposition. Those benefits, he added, make this debate different than the spending fight in March, when Senate Democrats helped Republicans enact the legislation into law.

“This time, the stakes are even higher because of the looming expiration of the Affordable Care Act funding,” he said. “If we don’t address that in this budget in this coming month, that means people will lose their health insurance everybody’s health insurance premiums are going to go up.

“And that, to me, is a red line.”

But in the Senate, where Republicans will need Democratic support to approve a stopgap funding patch, it’s unclear how far the party is willing to take the fight this month.

Some Senate Democratic appropriators have been noncommittal in recent days on whether the party will demand an extension for the credits in exchange for their votes to keep the government’s lights on – particularly as bipartisan funding negotiations remain fragile in the upper chamber.

“I don’t know the answer to that yet,” Sen. Patty Murray (Wash.), the top Democrat on the Senate Appropriation Committee, told The Hill last week when asked about the matter. “We’re looking for bipartisan work on the CR [continuing resolution] and see where that goes.”

According to the Congressional Budget Office, more than 4 million people are projected to lose insurance by 2034 if the subsidies aren’t renewed.

People who buy health insurance through the Affordable Care Act (ACA) are set to see a median premium increase of 18 percent, more than double last year’s 7 percent median proposed increase, an analysis of preliminary filings by KFF also found.

Under an evolving plan gaining bipartisan support in both chambers, appropriators are pushing for a short-term funding patch to keep the government running at current funding levels until sometime in November, buying negotiators more than a month to ramp up fiscal 2026 spending work.

The potential November timeline would provide lawmakers with another opening to act on expiring subsidies, while dialing up the pressure for both sides to begin hashing out a larger, bicameral full-year funding deal.

But some conservatives, as well as the White House, have also been looking at a stopgap into next year an idea some Senate Democrats have already panned as a “nonstarter.”

Republicans in both chambers have signaled an interest in putting new eligibility restrictions on the subsidies but appear cold to the notion of allowing them to expire altogether. 

Sen. John Cornyn (R-Texas) told Semafor he favors narrowing the income eligibility requirements for the health insurance credits from their current level, set at 400 percent of the federal poverty line but not yet doing away with them altogether.

“I don’t think that’s a good idea,” he said.

Senate Appropriations Chair Susan Collins (R-Maine) told reporters Monday that she wants to see the subsidies extended.

But when asked whether a fix could be a part of a funding deal, she said, “I have no idea. That’s above my pay grade.”

Sen. Josh Hawley (R-Mo.) also urged action to reporters on Monday.

“We’re gonna have to do something on that front, because if we don’t, premiums are gonna absolutely skyrocket,” he said.

“I’m open to suggestions, but one option that will absolutely not fly is do nothing. We just can’t. People won’t be able to live, they won’t be able to see a doctor.”

Nathaniel Weixel contributed.