It’s just the next legislative step, but a bipartisan coalition of U.S. House members voted to advance a bill to extend subsidies connected to the Affordable Care Act. Nine Republican joined the Democrats to support a discharge bill to push the legislation forward. The Kaiser Family Foundation says around a half million Alabamians use this program, known as Obamacare, to get health coverage. KFF goes onto say those policyholders are facing cost increases as high as twenty five percent.
The problem is, that price hikes for ACA consumers have reportedly already kicked in. Debbie Smith is the Campaign Manager with Cover Alabama at the nonprofit policy group Alabama Arise. APR News spoke with Smith in the days leading up to the expiration of the ACA subsidies.
“The last time to enroll in coverage for January, 1st was December 15th. But there's also open enrollment goes through January 15, so people can even, like change their plans through January 15th,” Smith explained. “So if Congress were to do the right thing and extend these subsidies, then people could go into healthcare.gov theoretically and adjust their plan.”
Assuming that the House approves extending the ACA, subsidies and that bill survives expected opposition in the U.S. Senate and the White House, ACA consumers may not see relief from the cost increases in their health care costs.
“That would take, you know, healthcare.gov, updating their prices with the new information too,” Smith said. “So it wouldn't be an easy lift by any means. This would have need, ideally, this would have needed to be done like back in September or October, before open enrollment even began.”
The situation appears so politically dicey that Congress is being called upon to be flexible on the issue of abortion to move toward a resolution. President Donald Trump said he wants Republicans to reach a deal on health care insurance assistance by being willing to bend on a 50-year-old budget policy that bars federal money from being spent on abortion services.
“You have to be a little flexible" on the Hyde Amendment, Trump told House Republicans as they gathered in Washington for a caucus retreat to open the midterm election year. “You gotta be a little flexible. You gotta work something. You gotta use ingenuity.”
With his suggestion, Trump, who supported abortion rights before he entered politics in 2015, is asking conservatives to abandon or at least ease up on decades of Republican orthodoxy on abortion and spending policy — something lawmakers and conservatives pushed back on immediately.
At the same time, he is demonstrating his long-standing malleability on abortion and acknowledging that Democrats have the political upper hand on health care after Republicans, who control the White House, the Senate and the House, allowed the expiration of premium subsidies for people buying Affordable Care Act insurance policies. As negotiations on Capitol Hill continue on the matter, some Democrats are pushing to end the Hyde restrictions as part of any new agreements on health care subsidies.
Trump's road map on the Hyde Amendment came more than an hour into a stem-winding speech intended as a part strategy session and part pep rally as Republicans attempt to maintain their threadbare House majority in the November midterms.
The president touted the GOP proposal to replace ACA subsidies — which taxpayers typically steer directly to insurance companies after selecting their policies — with direct payments that taxpayers could use for a range of health care expenses, including insurance. The expanded ACA subsidies expired on Dec. 31, 2025, hitting millions of policy holders with steep premium increases.
“Let the money go directly to the people,” Trump said, before casually slipping in a reference to the Hyde Amendment.
“We're all big fans of everything,” he said. “But you have to have flexibility.”
Turning directly to GOP leaders, including Speaker Mike Johnson, Trump added, “If you can do that, you're going to have — this is going to be your issue.”
House Republicans did not visibly react to Trump's argument. But Senate Republicans appeared unlikely to back off their demands that any new health care legislation maintain existing restrictions on government funding for abortion services.
Senate Majority Leader John Thune reiterated his stance Tuesday afternoon that any legislation must ensure “that those dollars aren’t being used to go against the practice that has been in place for the last 50 years.”
Beyond Capitol Hill, Trump drew swift condemnation from parts of the GOP coalition that want absolute opposition to any policy that might ease abortion restrictions.
Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, said it would sour core conservative voters and make Republicans “sure to lose this November.”
“To suggest Republicans should be ‘flexible’ is an abandonment of this decades-long commitment,” she said in a statement. “The voters sent a GOP trifecta to Washington and they expect it to govern like one. Giving in to Democrat demands that our tax dollars are used to fund plans that cover abortion on demand until birth would be a massive betrayal.”
Even before Trump's speech, activists were ramping up pressure on Republicans in their talks with Democrats.
At Americans United for Life, a leading advocacy group that opposes abortion rights, Gavin Oxley penned an op-ed this week for “The Hill” titled, “Republicans must hold the line: No Hyde Amendment, no deal on health care.”
“If they play their cards right,” Oxley wrote, “Republicans just might earn back enough of their base’s trust to sustain them through the 2026 midterms.”
The Hyde Amendment, named for the late Rep. Henry Hyde, originally applied to Medicaid, the joint federal-state insurance program for poor and disabled Americans, and barred it from paying for abortions unless the woman’s life is in danger or the pregnancy is the result of rape or incest. Hyde first introduced it in 1976, shortly after the Supreme Court's 1973 Roe v. Wade decision, which legalized abortion nationwide.
Over the years, Congress reauthorized Hyde policy as part of spending bills that fund the government. Democrats who support abortion access often joined Republicans who opposed abortion rights as a bipartisan compromise to pass larger spending deals. But as the two parties hardened their respective positions on abortion, Democrats became more uniform opponents of the ban, most famously when presidential candidate Joe Biden reversed his long-standing support for Hyde on his way to winning the 2020 Democratic nomination and general election.
Republicans have maintained their near-absolute support for the amendment.
The anti-abortion movement was initially skeptical of Trump as a presidential candidate in 2015 and 2016. But he has mostly aligned with the key faction of the Republican coalition, especially on Supreme Court appointments that led to the 2022 decision overturning Roe.
