The US House of Representatives has passed legislation to re-establish tax credits that lowered premiums for Affordable Care Act (ACA) health plans. The bill, which was passed with a vote of 230-196, would extend the credits for three years. All Democrats voted in favor of the measure, along with 17 Republicans, many of whom were moderates who wanted to prevent a hike in healthcare costs for their constituents.

The tax credits were first created under Joe Biden but expired at the end of last year. Despite efforts by Democrats to continue them, they were not renewed. The House measure is likely to be revised by the Republican-controlled Senate before it is enacted. Republican congressman Mike Lawler stated that he voted in favor of the bill to send it to the Senate, where it can be revised and potentially become law.

The bill’s passage is a significant rebuke to Donald Trump, who has opposed extending the tax credits. Trump has dismissed concerns about affordability as a “hoax,” but Democrats see the tax credits as a key part of their pitch to voters ahead of the midterm elections in November. The party plans to make healthcare and the high cost of living a major issue in 2026.

The Republican speaker, Mike Johnson, has also opposed the credits, arguing that they would enable fraud. However, moderate Republicans sought to strike a compromise that would be palatable to both parties. After Johnson refused to bring any deal to the floor, four Republicans signed a discharge petition that forced a vote on the legislation.

Experts expect that premiums for enrollees of the plans will roughly double without the subsidies. The bill’s passage is seen as a significant step forward in addressing the “affordability crisis” that Democrats have emphasized as a key plank of their platform. The House minority leader, Hakeem Jeffries, stated that the affordability crisis is “very real” and that the party will continue to push for measures to lower healthcare costs.

The Senate will now consider the bill, and it is likely to be revised before it is enacted. The Republican-controlled Senate may try to add their own provisions to the bill, which could potentially change its scope and impact. Nevertheless, the passage of the bill in the House is a significant victory for Democrats and a rebuke to Trump’s opposition to the tax credits.