The Senate vote on health subsidies sets up Georgia’s 2026 race
WASHINGTON — Thursday’s U.S. Senate vote on extending health insurance subsidies that help millions of Americans afford medical coverage has become a major fault line in Georgia’s 2026 midterm campaign.
U.S. Sen. Jon Ossoff, D-Ga., has made this three-year extension a core part of his reelection message, arguing that an estimated 1.4 million Georgians could see their premiums spike if the tax credits lapse at the end of the year.
“In this building, maybe it’s about the politics. But in the real world, and in Georgia, this is life or death,” Ossoff said in Washington this week. “My constituents cannot afford this. Some of my constituents cannot survive this.”
The vote isn’t expected to pass because Democrats don’t have enough support from Republicans. Senate Majority Leader John Thune has called the proposal “designed to fail.”
Democrats are framing the lapse of subsidies used by roughly 24 million Americans as a high-stakes fight over basic health care access heading into next year’s midterms, when every statewide office in Georgia, including Ossoff’s Senate seat, is on the line.
Ossoff is using the vote to draw a sharp contrast with his top Republican rivals. U.S. Reps. Buddy Carter and Mike Collins, along with former football coach Derek Dooley, each opposing extending the subsidies.
They say the pandemic-era program, adopted in 2021 during COVID-19 restrictions, was meant to be temporary. Conservatives also argue Democrats have spent years papering over deeper problems in the health care system with piecemeal fixes.
“Whenever you have to subsidize a federal program, that means it’s not working,” Carter, R-St. Simons, said, adding that Congress should “be empowering patients with affordable health care options that work best for them.”
Dooley called the enhanced subsidies “a mess” created by Democrats, and blamed Washington for “putting Band-Aids on bullet holes and sticking taxpayers with the bill.” And Collins, R-Jackson, demanded the government halt “endless subsidies to the largest insurance companies on the globe.”
Republicans have not unified around an alternative. Thune may bring a rival GOP proposal that allows the subsidies to expire but creates new government-funded health savings accounts. That bill is also expected to fail; even if all 53 Republicans support it, seven Democrats would be needed to overcome a filibuster.
House Republicans are considering their own proposals, including an option to scale back subsidies through new income caps and eligibility requirements. But there is no consensus on what the GOP can pass, given its slim majority and disagreement over the political fallout.
The legislative gridlock could leave millions of consumers on the hook for sharply higher premiums as a new enrollment year begins. People shopping for coverage on the Affordable Care Act exchanged have until Monday to select a policy for coverage beginning Jan. 1. Without the subsidies, the cost of coverage is expected to more than double on average, according to analysis by KFF.
Nora Pullen, an ACA enrollee in Fayette County, said her plan will nearly double from $362 a month to $660 a month without subsidies. Now she’s considering what was once unthinkable.
“Without ACA tax credits, my health insurance plan will become completely unaffordable to the point that I might have to drop health insurance altogether,” she said.
Thursday’s vote is the byproduct of the record 43-day government shutdown that Democrats framed as a clash over health care. Ossoff faced pressure to break party ranks during the impasse, but he joined the vast majority of Democrats who insisted any deal to reopen the government must also extend the subsidies.
A handful of Senate Democrats struck a deal with Republican to reopen the government, but that compromise did not extend the subsidies. Ossoff voted against that government funding measure, a move aligned with a base that demands more grit and less compromise under President Donald Trump’s second term.
As part of that shutdown-ending deal, Thune promised to schedule a floor vote on the subsidies extension. But he did not guarantee the bill would pass. And House Speaker Mike Johnson wouldn’t commit to taking it up at all.
The Senate vote that Thune committed to holding is happening later Thursday. Stay with AJC.com for more coverage.
About the Authors
Greg Bluestein is the Atlanta Journal Constitution's chief political reporter. He is also an author, TV analyst and co-host of the Politically Georgia podcast.
Tia Mitchell is the AJC’s Washington Bureau Chief and a co-host of the "Politically Georgia" podcast. She writes about Georgia’s congressional delegation, campaigns, elections and the impact that decisions made in D.C. have on residents of the Peach State.
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