The Republican-controlled House of Representatives on Wednesday advanced Democrat-led legislation that would reinstate expired healthcare subsidies, as the two parties jockey to lure voters in November's congressional elections with competing approaches to an "affordability crisis."
Nine Republicans split with their party and voted with 212 Democrats to tee up the measure for a final vote, expected on Thursday.
The Senate has already rejected the measure, but backers hope a successful House vote could provide impetus for a compromise.
The Democrats' initiative comes at a time when 33% of voters approve of Republican President Donald Trump's handling of the economy and cite healthcare and other costs as a top concern.
Democrats have made this the centerpiece of their effort to win control of the House and Senate in November's midterm elections. Trump has mocked the word "affordability," worrying party strategists that he could be hurting their prospects at the polls.
On Tuesday, he urged Republicans to oppose the Democrats' healthcare initiative but also show some flexibility on their anti-abortion efforts.
The legislation would reinstate healthcare subsidies that lower costs for 24 million Americans who get their coverage through the Affordable Care Act, which expired at the end of 2025.
The nonpartisan Congressional Budget Office estimates that without the subsidies, 100,000 more people annually would go uninsured and the government would spend $36 billion less over 10 years. Outside experts estimate some people's healthcare costs would double.
Conversely, 3.8 million more people would gain coverage and the government would spend $350 billion more over the next decade under the Democrats' proposal, according to the CBO.
Though Democrats do not control the House or the Senate, four Republicans representing swing districts joined them last month to force a vote on the healthcare subsidies over the objections of House Speaker Mike Johnson, R-La.
House Republicans passed an alternative last month that would reduce subsidies overall, while cutting costs for some and raising costs for others, but it would not kick in until 2027.
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