Republican lawmakers are racing against the clock to devise a comprehensive health care strategy as they face the impending expiration of essential Obamacare subsidies by year-end. With just a week left before Senate Democrats hold a vote on extending these subsidies, GOP members are deeply divided over their health care approach and the components of a potential alternative plan.

During separate confidential sessions this Tuesday, both House and Senate Republicans discussed various ideas. Speaker Mike Johnson has committed to introducing a health care blueprint soon, whereas Senate discussions have focused on reducing health care costs, possibly through reforms in health savings accounts.

The urgency is compounded by the fear of skyrocketing health insurance premiums if the current tax credits under the Affordable Care Act (ACA) are not extended past December 31. This has led to a tense atmosphere among the GOP ranks, with no clear consensus on whether to sustain the subsidies, a move that would mark the Republicans' first legislative endorsement of Obamacare.

Senator John Kennedy (R-La.) likened the chaotic discussions to a Rorschach test, indicating the lack of clarity and agreement among the party members. The discord within the party risks turning into a political liability as the 2026 midterm elections approach, with potential increases in health care costs likely to become a central campaign issue.

Retiring Senator Thom Tillis (R-N.C.) highlighted the possible electoral repercussions if the subsidies lapse, suggesting that Democrats could leverage the situation against Republicans by focusing on the financial impact on voters.

In a bid to forge a path forward, Senate Republicans, during their weekly lunch, heard from Finance Chair Mike Crapo and HELP Chair Bill Cassidy about their ongoing efforts to craft a Republican proposal. Discussions included providing greater flexibility in the use of health savings accounts, implementing income caps on ACA subsidies, and introducing minimum premium payments for ACA enrollees.

However, Senate Majority Leader John Thune has remained non-committal about the timeline for a vote on any Republican health care measure, despite some senators expecting a decision next week.

On the House side, Speaker Johnson assured members that a GOP health care plan is forthcoming, though internal disagreements persist, particularly around the extension of ACA subsidies. House Majority Leader Steve Scalise faced pushback from centrist Republicans, who stressed the necessity of addressing health care reforms before year’s end.

In the midst of these internal debates, House Problem Solvers Co-Chair Brian Fitzpatrick (R-Pa.) is exploring a bipartisan solution, working on a bill that aligns with a health care framework recently considered by the White House. Fitzpatrick is hopeful that this bill, which avoids contentious issues like abortion restrictions, could garner the necessary support across party lines.

As the deadline looms, the pressure mounts on Republicans to unify their stance on health care, a task that remains daunting amidst their varied and often conflicting views on how to proceed.

*Contributions to this report were made by Benjamin Guggenheim and Mia McCarthy.*