Johnson's health care mess
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House Speaker Mike Johnson is starting the new year in a familiar, uncomfortable predicament:
- He's got a shrinking majority, a loss of control over the legislative agenda, and pressure from President Trump to embrace an issue many in the GOP want to avoid.
Why it matters: Trump is urging Republicans to make health care their issue and to be "flexible" on long-standing red lines.
- 💊 But many Republicans see health care as a losing issue for the party, especially in the 2026 midterms.
Driving the news: Trump urged House Republicans at their policy retreat today to soften demands for expanded Hyde Amendment protections.
- The vast majority of House Republicans oppose extending Affordable Care Act tax credits without Hyde protections, which bar the use of federal funds for abortions.
- "This is a well settled principle of ours," Johnson said in early December. "We do believe in the sanctity of human life and think it's important that taxpayer dollars not fund abortion."
State of play: The House is expected to pass an extension of the ACA tax credits Thursday, with no additional Hyde protections, after four swing district Republicans in December joined Democrats in signing a discharge petition.
- It has no clear path to becoming law right now, but a group of senators hopes it can be used as a vehicle for a bipartisan bill to send back to the House.
The big picture: A growing number of Republicans are pointing to jarring internal polling by the GOP firm GrayHouse, which shared its findings with Senate Republicans. The polling said:
- 31% said Republicans do a better job than Democrats in handling health care.
- 38% said they approve of how Trump deals with the issue.
- 36% said Republicans are to blame for rising health care costs, compared to 26% for Democrats.
What they're saying: "Our polling shows that if health care is the main focus of 2026, Republicans are likely to fare poorly in the midterms," GrayHouse founder Landon Wall told us last month.
- Another plugged-in Republican told us that if "2026 becomes a 'healthcare election'... we will deserve the midterm catastrophe that follows."
The other side: Republicans facing tough reelection bids say health care can't be ignored.
- "Healthcare is not going away, even if people wish it away." Rep. Mike Lawler (R-N.Y.), one of the four Republicans to sign the Democratic discharge petition to extend the ACA subsidies, told us.
- Behind the scenes, GOP members and aides say there is widespread doubt that leadership could push through a second reconciliation bill on health care when members will be increasingly preoccupied with re-election.
Between the lines: Johnson can now only lose two votes on party-line legislation, assuming full attendance.
- Rep. Marjorie Taylor Greene (R-Ga.) officially resigned from Congress on Monday night.
- Rep. Doug LaMalfa (R-Calif.), 65, died unexpectedly on Monday.
- And Rep. James Baird (R-Ind.) will be out of commission for several weeks after a car accident.
— Kate Santaliz and Alex Isenstadt
