Florida's Salazar among 17 House Republicans to vote yes on ACA subsidies, defying GOP leaders

In a rebuke of Republican leadership, the House passed legislation Thursday that would extend expired health care subsidies for those who get coverage through the Affordable Care Act as 17 renegade GOP lawmakers, including U.S. Rep. María Elvira Salazar, R-Miami, joined every Democrat in support.

The tally, 230-196, signified growing political concern over Americans' health care costs. Forcing the issue to a vote came about after a handful of Republicans signed onto a so-called "discharge petition" to unlock debate, bypassing objections from House Speaker Mike Johnson. The bill now goes to the Senate, where pressure is building for a bipartisan compromise.

Other Florida lawmakers voted along party lines in favor of extending expired health care subsidies for those who get coverage through the Affordable Care Act.

Salazar's 27th Congressional District has one of the highest ACA enrollment rates in the country.

"I voted YES to extend Affordable Care Act (ACA) enhanced premium tax credits, and I didn't hesitate," she wrote on X Thursday. "I know firsthand how many families in FL-27 depend on this assistance to afford care."

Salazar added: "This isn't partisan. It's human."

Together, the rare political coalitions are rushing to resolve the standoff over the enhanced tax credits that were put in place during the COVID-19 crisis but expired late last year after no agreement was reached during the government shutdown.

"The affordability crisis is not a 'hoax,' it is very real — despite what Donald Trump has had to say," said House Democratic Leader Hakeem Jeffries, invoking the president's remarks.

"Democrats made clear before the government was shut down that we were in this affordability fight until we win this affordability fight," he said. "Today we have an opportunity to take a meaningful step forward."

Ahead of voting, the nonpartisan Congressional Budget Office estimated that the bill, which would provide a three-year extension of the subsidy, would increase the nation's deficit by about $80.6 billion over the decade. At the same time, it would increase the number of people with health insurance by 100,000 this year, 3 million in 2027, 4 million in 2028 and 1.1 million in 2029, the CBO said.

USAFacts reports that 4.6 million people in Florida — about 20% of the state's population — receive the subsidy for ACA enrollment.

Johnson, R-La., worked for months to prevent this situation. His office argued Thursday that the federal health care funding from the COVID-19 era is rife with fraud and urged a no vote.

On the floor, Republicans also argued that the lawmakers should be focused on lowering health insurance costs for the broader population, not just those enrolled in ACA plans.

"Only 7% of the population relies on Obamacare marketplace plans. This chamber should be about helping 100% of Americans," said Rep. Jason Smith, the Republican chairman of the House Ways and Means Committee.

While the momentum from the vote shows the growing support for the tax breaks that have helped some 22 million Americans have access to health insurance, the Senate would be under no requirement to take up the House bill and has already rejected it once before.

Instead, a small group of senators from both parties has been working on an alternative plan that could find support in both chambers and become law. Senate Majority Leader John Thune, R-S.D., said that for any plan to find support in his chamber, it will need to have income limits to ensure that the financial aid is focused on those who most need the help. He and other Republicans also want to ensure that beneficiaries would have to at least pay a nominal amount for their coverage.

Finally, Thune said there would need to be some expansion of health savings accounts, which allow people to save money and withdraw it tax-free as long as the money is spent on qualified medical expenses.

GOP Sen. Bernie Moreno of Ohio, a leader in the group of about a dozen senators, said they hope to deliver a framework next week. He and others met with House colleagues on options.

President Trump has pushed Republicans to send money directly to Americans for health savings accounts so they can bypass the federal government and handle insurance on their own. Democrats largely reject this idea as insufficient for covering the high costs of health care.