Even Republicans are worried about how their party is discussing healthcare as we head into the 2024 presidential election. Former President Donald Trump teased the idea of “some very good concepts of a plan” for healthcare just this past September 2024 in a Republican debate. Though, thus far, he hasn’t offered any specifics. With health care premiums skyrocketing and ticking off voters, there’s pressure building within the party to match that urgency and do something right now to tackle these problems.
The Republican Party is unequivocal in their stance against the ACA. Fractures within are emerging over how to proceed best. A group of 13 House Republicans from battleground districts has urged the party to prioritize “the growing crisis of health care affordability.” It’s evident from their statement that there is no time to waste. They are committed to addressing the sky-high costs that are hurting millions of Americans.
As of 2025, over 24 million people were enrolled in ACA marketplace plans. This would be a monumental leap from approximately 11 million in 2020. Even more than the hype, this surge reflects the increasing dependence on these ACA provisions as millions of Americans face the brunt of rising health care costs. Perhaps the swiftest challenge at hand was acknowledged by new House Speaker Mike Johnson. He boldly claimed that GOP has “ideas” ready to deal with the expiring ACA subsidies. As for the details of these proposals, well that’s all pretty vague at this point.
Republican leaders have not yet outlined how they will manage the impending expiration of tax credits associated with the ACA. A recent analysis by the Congressional Budget Office (CBO) estimated that permanently extending these tax credits would add $350 billion to the deficit from 2026 to 2035. According to the Congressional Budget Office, making the ACA credits permanent would increase the number of insured people by 3.8 million. This increase would be realized by 2035.
Yet some Republicans treat as alarmist projections that ACA premiums would more than double without these subsidies. GOP Senator Rick Scott remarked, “Premiums are going up whether it gets extended or not,” attributing this increase to rising healthcare costs associated with what he termed a “disaster” in Obamacare. He further criticized the ACA, stating, “The cost of Obamacare is out of control, it’s not good healthcare.”
Michael Cannon, director of health policy studies at the Cato Institute. Now, Mr. McClatchy is working directly and daily with a dozen or more congressional offices to develop and pursue viable alternatives to the ACA. That call for new strategies has taken flight as more Republicans realize that the status quo is simply not tenable. Brian Blase noted, “At least among Republicans, there’s a growing sense that just maintaining the status quo is very destructive.”
Trump has had constant discourse over nonexistent healthcare plans. Almost ten months into his presidency, he has yet to release a fully fleshed-out proposal. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, expressed confidence in Trump’s intentions, stating, “I fully believe the president has a plan” for healthcare, though he did not provide specifics.
Voter frustration with skyrocketing premiums is palpable. Lisa from Harford County, Maryland shared her distress: “Now she’s looking at two or three times the premium that she’s been paying for the insurance.” Just like you know, Sara from Middleville, Michigan asked, “Well, okay, so how do you overcome that? These voices are part of a larger wave of constituent concern driving members to pursue solutions.
Rep. John Moolenaar (R-MI) insisted that policymakers make time for negotiation to develop a workable healthcare plan. He continued, “We have time to work out and find a modest plan going forward, and I really think that’s something we can do.” His comments suggest a willingness among some lawmakers to engage in collaborative discussions to develop effective solutions.
Rep. Andy Harris articulated a common sentiment within the party: “We think the solution is to try to do something to make sure all the premiums go down.” As Republicans come to terms with these often difficult and conflicting realities, building a consensus promises to be no easy task.
House Speaker Mike Johnson acknowledged the complexity of healthcare reforms, noting, “It’s a very complicated, very complex issue, that requires a long time to build consensus around.” The Republican party’s struggle to unify on a comprehensive healthcare strategy underscores the significant challenges it faces as the election cycle intensifies.
