The Gop's Obamacare Defectors Were More Numerous Than Expected

Republicans in competitive seats see a grave threat to their reelections in skyrocketing insurance premiums.

That was apparent Thursday in the defection of seventeen in the House who voted for Democrats’ bill to restore expired Obamacare subsidies for three more years. The GOP revolt was bigger than anticipated and a stunning rebuke to Speaker Mike Johnson and President Donald Trump.

The 17, primarily from swing seats or districts with large numbers of people enrolled in Obamacare plans, sent a clear message from the GOP’s most-at-risk members that they’re more afraid of losing their voters in an unfavorable midterm climate than they are of bucking their party leaders. Premiums for Obamacare customers are rising by an average of 26 percent, according to health research group KFF, because subsidies Democrats created five years ago expired at year’s end.

Some, like Reps. Ryan Mackenzie and Rob Bresnahan of Pennsylvania, Derrick Van Orden of Wisconsin, Tom Kean of New Jersey and David Valadao of California, are considered among the most vulnerable Republicans on the midterms map — with prognosticators rating each of their races as toss-ups. Rep. María Salazar of Florida, meanwhile, represents the district with the highest percentage of people enrolled in Obamacare, per KFF.

The defectors, said Pennsylvania-based GOP strategist Samuel Chen, are “fully aware this is an issue where they could lose their seats if they don’t vote to extend these subsidies.”

Some of the breaks were expected, coming from the same GOP lawmakers who had crossed party lines in December to back Democrats’ effort to end-run Johnson after he refused to put a bill on the floor to extend the enhanced tax credits. Others, like hard-liner Van Orden, shocked even Democratic operatives, as what many expected would be a handful of Republican rebels ballooned.

Van Orden, who’d voted against bringing the legislation to the floor on Wednesday, said in an interview Thursday evening that he’d made up his mind “weeks ago” to support the subsidy extension. Roughly 33,000 people in his western Wisconsin district are enrolled in Obamacare.

“This vote for me today was very difficult, because I fundamentally disagree with sending American taxpayers' dollars to insurance companies,” Van Orden said, blaming Democrats for a faulty health care system.

But “this is a bridging mechanism,” he said. “We need enough time to get the real, meaningful legislation, policy changes, done, without crushing my constituents.”

The health care vote came on a day of multiple GOP breaks with Trump: Just hours earlier, five Republican senators sided with Democrats to advance a resolution to require Trump to seek congressional approval for sending troops into Venezuela, enraging the president who threatened to try to run them out of office.

Democrats pounced on Republicans in competitive districts who voted against the subsidy extension, accusing them of hiking health care prices. And they castigated those who voted for the bill for attempting to “paper over” the Republican congressional majority allowing the subsidies to end in the first place.

“Rob Bresnahan unleashed a health care crisis on Northeastern Pennsylvania by voting for the largest cuts to Medicaid in history, stripping funding from our rural hospitals, and failing to take meaningful action in time to prevent health care costs from skyrocketing for Northeastern Pennsylvanians,” Scranton Mayor Paige Cognetti, a Democrat who is challenging Bresnahan, said in a statement after the vote. “Nothing he does now can paper over the fact that he caused this crisis in the first place.”

Warning signs have been flashing for Republicans on the issue for months as Democrats hammered their opponents for sending Obamacare premiums soaring. Polls have shown broad support for extending the subsidies. A November survey from KFF found most Obamacare marketplace enrollees would blame Trump and congressional Republicans if they expired. Battleground-district surveys from Trump pollster John McLaughlin showed likely voters were less likely to vote for congressional candidates who let them expire. And they also showed the percentage of voters using the credits is higher among those who backed Trump in 2024 than his Democratic rival, Kamala Harris.

“It affects the working-class Trump voters that we need to get Republicans re-elected. In 2025 there was a series of elections where the Trump voters did not come as strongly as they did in 2024,” McLaughlin said Thursday, referencing GOP losses in off-year elections in New Jersey and Virginia and elsewhere. “If you want to get the Trump voters back out, we need to seriously work on a solution where health care becomes more affordable for working class voters.”

The House bill is dead on arrival in the Senate, where a similar Democratic-led vote failed last year. Instead, Republican senators are hashing out a compromise that would reestablish the enhanced tax credit for two years, not three, along with other rule changes, but the outcome is uncertain.

GOP strategists argued that vulnerable Republicans who voted to restore the subsidies could still get some cover.

“It blunts Democrats’ attack, even though the Democrats are going to use it regardless because it’ll be part of their national messaging,” said Pennsylvania-based GOP consultant Christopher Nicholas.

The defectors included several moderates who’ve crossed swords with Johnson repeatedly, including Brian Fitzpatrick of Pennsylvania and suburban New Yorkers Mike Lawler, Nick LaLota and Andrew Garbarino, who prefer a bipartisan deal over another party-line health care bill.

“This is absolute bullshit,” Lawler said in December about his party’s willingness to let the subsidies expire. Lawler went on to call GOP leaders “idiotic” for refusing an up-or-down vote on the issue.

Fitzpatrick broke the dam for Republicans to sidestep the speaker by signing a discharge petition to call up a vote last month. The fifth-term congressman, whose district has roughly 32,000 people on the marketplace, told POLITICO at the time “my people back home care tremendously about this.”

He was joined in signing the petition by Mackenzie and Bresnahan, who flipped their seats in 2024 by some of the thinnest margins in the country and are now among Democrats’ top targets for 2026. Mackenzie told POLITICO last month that he wanted to extend the subsidies to “help bring down the cost for millions of Americans” as Democrats try to wield affordability messaging as a weapon to erode Republicans’ long-held advantage on the economy in the midterms.

Some Republican strategists have worried that Latinos who swung for Trump in 2024 won’t stay with the party in the midterms. Bresnahan’s swath of Pennsylvania features a large Hispanic population. He previously implored Johnson to not cut SNAP, the food assistance program, or Medicaid, the health insurance program for low-income people, arguing that his Hispanic constituents are “expected to bear the brunt of these reductions.”

Kean, in New Jersey, is staring down a crowded field of Democratic rivals that features a physician, Tina Shah, who’s trying to yoke the Republican to the Trump administration’s health care agenda. California’s Valadao, too, is being hammered over health care by his Democratic rivals. He represents large numbers on Medicaid, which Republicans cut funding for in last year’s One Big Beautiful Bill Act.

Republicans in districts with high numbers of Obamacare enrollees piled onto the Democrats’ bill Thursday.

Salazar’s Miami district is among the highest: nearly 1 in 3, or 230,000, of her constituents are enrolled in Obamacare.

Texas Rep. Monica De La Cruz’s district has more than 140,000 Obamacare enrollees.

Nicholas Wu contributed to this report.