Republicans are doing something they’ve never done with Obamacare before — here’s why

By the middle of 2012, the GOP-controlled House at the time had taken 30 floor votes attempting to repeal the Affordable Care Act (ACA) and were preparing to take a 31st.

Now, more than a decade later, some Republicans are doing what seemed up until now exceedingly unlikely: They’re trying to protect one of its key provisions, the premium tax credit (PTC).

The PTC is a refundable tax credit that helps lower income Americans cover the cost of health care coverage through the Health Insurance Marketplace under the ACA, more commonly known as Obamacare.

Several Republican lawmakers across the country have been voicing support for extending the tax credits ahead of the 2026 Midterms. At a quick glance, such support may seem a head-scratcher. But upon closer evaluation, it may just be smart politics.

In Florida alone, more than 4 million Floridians would be affected if the PTC were to expire. More impactful to the GOP, the negative impacts to voters would disproportionately affect red states or swing states President Donald Trump carried.

Data shows that nearly 19 million people enrolled in health care exchange plans live in states Trump won in 2024, while only 5.4 million live in states former Vice President Kamala Harris carried.

Those 19 million people — many of them voters, or friends and family of voters — would likely experience a significant negative economic impact. They could suffer financial setbacks or the loss of health coverage altogether, harms that those voters or their loved ones might take with them to the voting booth.

Compounding that possibility for Republicans, a Plymouth Union Public Advocacy poll conducted by Fabrizio Ward this Summer found nearly 8 in 10 voters support tax credits to make health care more affordable for working families. While support was lower among surveyed Trump voters, a whole 68% still supported the tax credit, with just 19% opposed.

Republicans are beginning to take notice.

Earlier this Summer, Senate Majority Leader John Thune acknowledged “having conversations” about “how we might deal with that issue.”

A few days later, U.S. Sen. Tommy Tuberville of Alabama went even further.

“You start cutting that out, we’ve got big problems,” he said on July 18, noting that eliminating the PTC “might lose some folks.”

Several others, from U.S. Sen. Lisa Murkowski of Alaska to U.S. Rep. Mike Haridopolos of Florida have publicly stated either full or tacit support for extending the PTC.

And to ignore the optics among its voters, the GOP could unintentionally harm its leader. Trump ran on lowering costs for Americans. As of right now, there’s little consensus that he’s actually accomplished that, with prices on everyday goods still high and fears swirling about the impact on prices from Trump’s sweeping tariffs.

All 25 states expected to see the highest premium increases should the PTC expire are states Trump carried in 2024, potentially imperiling Republican incumbents in those states or harming chances of Republican candidates who are eyeing a flip in blue districts.

The numbers would be hard to hide from.

Based on premium awards, a couple in a Trump-won state earning $82,000 a year would see their health care costs increase 287%, a spike of more than $19,000 a year in health care coverage costs. A family of four earning just $64,000 a year would see a 244% increase, with more than $2,500 in coverage increases.

Even those at higher earning brackets could see as much as 106% increases to their coverage costs, or more than $11,000.

And Florida is among the most heavily affected states, with 4.7 million enrollees who would face higher costs. That’s more than Texas (nearly 4 million), Georgia (1.5 million), North Carolina (975,000), Tennessee (643,000), South Carolina (632,000), Ohio (583,000), Michigan (531,000) and Alabama (478,000).

Polling shows extending the PTC is a winner in the nation’s 28 most competitive U.S. House districts, with a survey by Trump pollster Tony Fabrizio finding GOP candidates would lead a Democrat on a generic ballot by about 6 percentage points. By not extending the PTC, a generic ballot would favor Democrats by 15 percentage points.

“If Republicans want a good shot at defying the odds and keeping President Trump’s Trifecta to continue the historic wins he is delivering across the board, they will step up and protect the premium tax credits,” a GOP operative told Florida Politics.

“It’s the right thing to do — not just for the 19 million Trump voters who face astronomical price hikes, but for every Trump voter who wants to see the President and Congress continue its mission to keep America great.”

U.S. Rep. Brian Fitzpatrick of Pennsylvania perhaps said it best.

“I think we gotta be doing everything to keep costs low across the board — health care, groceries, energy, all of the above,” he said.

And if GOP lawmakers don’t deliver, data suggests Republicans could set themselves up for major losses in 2026, which would limit the party’s ability to continue its aggressive agenda in the second Trump presidency.