The House on Wednesday cleared the first procedural hurdle teeing up a vote Thursday evening on passage of a clean three-year extension of the enhanced Affordable Care Act subsidies that expired at the end of 2025.
The measure passed by a 221-205 vote. Notably, nine House Republicans broke ranks and voted with Democrats in favor of the procedural motion to discharge. These lawmakers include Reps. Mike Lawler and Nick LaLota of New York, Rob Bresnahan, Ryan Mackenzie and Brian Fitzpatrick of Pennsylvania, Maria Salazar of Florida, David Valadao of California, Thomas Kean of New Jersey, and Max Miller of Ohio.
While the passage vote -- largely a political one -- is expected to clear the lower chamber with bipartisan support, a tangible path forward that sends legislation to the Resolute Desk to address the expired subsidies remains unlikely.
ACA subsidies that lower monthly insurance premiums for millions of Americans set to expire
The subsidies were part of the original ACA passed during the Obama administration and were enhanced during the COVID-19 pandemic to increase the amount of financial assistance to those who were already eligible and to expand eligibility to more people.
An estimated 22 million of the 24 million ACA marketplace enrollees are currently receiving enhanced premium tax credits to lower their monthly premiums, and many are seeing their premiums soar in 2026.
Last month, the Senate rejected a three-year extension of the subsidies when the measure fell short of the 60-vote threshold, though four Republicans -- Sens. Susan Collins of Maine, Josh Hawley of Missouri, and Lisa Murkowski and Dan Sullivan of Alaska -- all crossed the aisle in support of the measure.
President Donald Trump has publicly expressed his opposition to extending the subsidies.
"I'd like not to be able to do it. I'd like to see us get right into this. I don't know why we have to extend -- this can be done rapidly if the Democrats would come along," Trump said on Dec. 18 in the Oval Office.
After Speaker Mike Johnson resisted pressure to allow a vote on the subsidies late last year, a quartet of House Republicans banded together before the holiday break -- signing on to the Democrats' discharge petition to force a vote on an ACA extension, much to the chagrin of GOP leaders.
The moderate Republicans who rebelled against their leadership were Reps. Fitzpatrick, Lawler, Bresnahan and Mackenzie.
ABC News' Mary Kekatos contributed to this report.