With the 2026 midterm elections on the horizon, the Republican Party is embroiled in a contentious internal debate that could significantly impact its legislative agenda. Key GOP members are divided over whether to push forward with a second reconciliation bill focused on health care, following the expiration of enhanced Obamacare subsidies.

The idea of a second bill has been met with mixed reactions within the party. Some members view it as a crucial opportunity to secure legislative victories ahead of the elections, while others, wary of the narrow Republican majorities in both the House and Senate, see it as a potential failure due to deep divides over health policy specifics.

Speaker Mike Johnson is advocating for the bill, aiming to satisfy hard-liners who demand a more extensive conservative overhaul of health care than what was attempted earlier this month. In contrast, voices like Rep. Jason Smith of Missouri, chair of the Ways and Means Committee, are skeptical about the party's ability to unite for another reconciliation effort after the difficulties faced during last summer's tax-cut-focused megabill.

Amidst these strategic disagreements, some GOP lawmakers are considering innovative funding approaches, such as using tariff revenues to help taxpayers with rising health care costs. However, this proposal has yet to gain widespread support, particularly among senior Republicans and those concerned with deficit reduction.

The Budget Committee chairs, including retiring House Budget Chair Jodey Arrington and Senate Budget Chair Lindsey Graham, are prominent proponents of a new reconciliation push. They argue that it's time the party delivered on long-promised health care reforms. Yet, their enthusiasm is not universally shared, with many committee chairs expressing doubts about the compatibility of GOP health initiatives with the strict fiscal rules of reconciliation.

Adding to the complexity, the Republican Study Committee recently discussed a second party-line bill that would address affordability concerns, including an expansion of health savings accounts. The committee's chair, Rep. August Pfluger, emphasized the importance of uniting around effective policies, noting the need to align with President Trump's agenda.

The political stakes are high, as demonstrated by the Democrats' struggle to pass the Inflation Reduction Act in a tight midterm year. GOP leaders, including Senate Majority Leader John Thune and House Majority Leader Steve Scalise, acknowledge the challenges of reconciliation but remain open to exploring its potential if a clear and unified purpose emerges.

As January approaches, the GOP must navigate these internal divisions to determine whether a second reconciliation bill is viable or if it risks further fracturing the party in a critical election cycle.