Daijiworld Media Network - Washington

Washington, Dec 14: As millions of Americans brace for a sharp rise in healthcare costs, US President Donald Trump is facing an open split within his own Republican Party, a divide lawmakers fear could hurt the party in the 2026 midterm elections.

The immediate flashpoint is the impending expiration of subsidies under the Affordable Care Act (ACA) that help low- and middle-income families afford health insurance. These enhanced subsidies are set to lapse on December 31, potentially impacting around 22 million Americans.

The United States already has some of the highest healthcare costs globally, with citizens spending more than twice as much on medical care compared to people in other developed nations, according to the Organisation for Economic Co-operation and Development (OECD).

Republican leadership remains firmly opposed to extending the subsidies, viewing them as an extension of “Obamacare”, the landmark healthcare law introduced under former president Barack Obama. Party leaders insist that allowing the subsidies to continue would further entrench a system they have long sought to dismantle.

President Trump, whose handling of healthcare remains a weak point in public opinion, struck a more conciliatory tone on Thursday, expressing willingness to work with Democrats on a long-term solution. However, his remarks have done little to ease tensions within the party, given his past opposition to the ACA.

The rift became evident when four Republican senators broke ranks to support a Democratic bill proposing a three-year extension of the subsidies. Although the measure failed, the move underscored growing unease among lawmakers facing pressure from voters.

Missouri Senator Josh Hawley said the vote was meant to send a message that action is needed, warning that lawmakers are “under pressure” as premiums threaten to surge.

Health policy group KFF estimates that if the subsidies expire, monthly insurance payments for many beneficiaries could more than double, while overall marketplace premiums may rise by an average of 26 per cent.

Concerns are also mounting in the House of Representatives, where several Republicans from swing districts have joined Democrats in efforts to force votes on extending the subsidies, defying party leadership in the process. Speaker Mike Johnson has opposed such moves, but moderates fear political fallout if insurance costs rise sharply ahead of elections.

Republican leaders unveiled a separate healthcare funding proposal on Friday that excludes any extension of the ACA subsidies, though lawmakers will be allowed to vote on an amendment to retain the aid, which party leaders expect to fail.
Democrats have said they are open to bipartisan talks aimed at lowering healthcare costs, while accusing Republicans of rigid partisanship.

With healthcare emerging as one of President Trump’s weakest policy areas in opinion polls, the subsidy showdown poses a significant political dilemma — either back an extension of a law he once vowed to repeal or risk voter backlash from rising insurance premiums.