The issue that Democrats last year thought might boost them this year has not gone away. One key Senate candidate understands, as I noted at New York:
Enhanced Obamacare premium subsidies benefiting over 20 million Americans expired at the end of last year. It was such a big deal that the need to address it became the principal Democratic rationale for triggering the longest government shutdown in U.S. history last October. It remained a big deal as 2026 arrived: The House actually passed a “clean” three-year extension of the subsidies on January 8, with 17 Republicans joining Democrats on the vote. There were bipartisan negotiations in the Senate to cut a deal that would include some sort of subsidy extension.
Republicans were all over the place on health-care costs more generally. Some tried to change the subject to non-insurance health-care cost issues like pharmaceuticals. Others spoke of some huge conservative health-care overhaul that would be enacted on a party-line vote using budget reconciliation (a sort of One Big Beautiful Bill Act 2.0). On January 15, Donald Trump himself suddenly announced he was unveiling a “Great Healthcare Plan” that turned out to be a hodgepodge of old Republican gimmicks fleshed out with vague promises, with no real plans for legislation.
And then … everyone got distracted, mostly because federal immigration agents conducted a mass-deportation “surge” in Minneapolis that resulted in two deaths, a terrorized city, worldwide outrage, and a partial government shutdown. Even as the two parties in Congress fought over the immigration-enforcement guidelines Democrats were demanding, prospects for any sort of bipartisan action on health care sickened and died, as The Wall Street Journal reported earlier this week:
“Top Senate negotiators said an effort to renew expired healthcare subsidies had effectively collapsed, likely ending the hopes of 20 million Americans that the tax-credit expansion could be revived and lower their monthly insurance premiums.
“Talks had centered on a proposal from Sens. Bernie Moreno (R., Ohio) and Susan Collins (R., Maine) to extend a version of the enlarged Affordable Care Act subsidies for at least two years, while cutting off higher-income people from participating and eventually giving enrollees the option of putting money into health savings accounts. It also would eliminate zero-dollar premium plans. But lawmakers from both parties now say the chances of a deal have all but evaporated.
“’It’s effectively over,’ Moreno said Wednesday. Sen. Bill Cassidy (R., La.)—the architect of an adjacent plan—agreed.”
Some conservative Republicans are still talking about a second budget reconciliation bill to repeal and replace Obamacare (the task that famously eluded them during Trump’s first term), but this seems extremely unlikely given the fragile nature of GOP control of the House, obvious intraparty divisions over the substance of health-care policy, and the universal preoccupation with the midterms.
Speaking of the midterms, every day that goes by without action on the aftermath of the Obamacare subsidy lapse, it becomes an even more potent campaign issue for Democrats. One Democratic senator whose reelection in November is critical to his party’s hopes of flipping the Senate, Jon Ossoff, has made it his principal campaign issue. It’s pretty clear why he’s focused on the issue. Georgia, like other red states that rejected the Affordable Care Act’s optional Medicaid expansion, is a place where reliance on private health-insurance markets that go under the name of Obamacare is especially important. About 1.5 million Georgians, or 13 percent of the state’s population, obtained health insurance via Obamacare in 2025. Facing premium hikes, that number has dropped by 200,000 in 2026 so far. And those sticking with their policies are paying premium increases averaging 75 percent over last year’s costs. Ossoff talks about this problem constantly:
“‘If we don’t extend these tax credits, it’s projected that half-a-million Georgians will lose their health insurance altogether,’ Ossoff said [in early January]. ‘More than a million Georgians will see their health insurance premiums double, in some cases triple.’
“’I challenge all of my opponents today … to make clear where they stand,’ Ossoff said. ‘This is not a time for vague promises and political talking points. Do my opponents support throwing half-a-million Georgians off their health insruance? … I think it’s a very straightforward policy and moral question.’”
Ossoff is taking advantage of the fact that three major Republicans who are competing in a tight race to oppose him in November — congressmen Buddy Carter and Mike Collins and former football coach Derek Dooley — want to discuss almost anything else. Carter and Collins voted against the subsidy extension, and Dooley has no known position. As they compete for a potentially decisive Trump endorsement for their May primary (with a June runoff quite likely), they are not about to go out on any limbs on health care, particularly if it involves continuing what Trump calls the Unaffordable Care Act.
While the issue is particularly acute in Georgia, it will be a point of contention in campaigns everywhere, particularly if Trump and the GOP continue to ignore it or make vague promises to do something about health-care costs some other day in some other ways. Health-care policy has been a political albatross for Republicans for many years, and this looks like one year it could weigh on them heavily.
