Republican leaders on Capitol Hill are grappling with a growing challenge as they navigate the internal strain between moderates and hardline anti-abortion advocates over the extension of Obamacare subsidies. The debate has been further complicated by the looming threat of a government shutdown less than a week away, which could worsen the political stakes for both parties. The Democrats’ proposal for extending the Affordable Care Act subsidies, which were expanded in 2021 and are set to expire at the end of the year, has become central to the discussion. Without an extension, insurance premiums are expected to rise sharply, creating a potential fiscal crisis for families. While some Republicans have expressed willingness to negotiate and broker a bipartisan deal, especially considering the ramifications for the crucial midterms, prominent anti-abortion groups have intensified their efforts to pressure lawmakers. These groups argue that the expanded tax credits effectively subsidize abortion services, which could deepen existing divides within the GOP and complicate the efforts of Speaker Mike Johnson and Senate Majority Leader John Thune to find common ground. The internal conflict over health care and abortion is becoming increasingly critical, as it could influence the party’s ability to maintain control of Washington.
The lobbying campaign by anti-abortion advocates is exposing an internal GOP rift over health care that has become a defining feature of President Donald Trump’s second term. Over the summer, a conservative push to reduce Medicaid became a major flashpoint within the party, and now similar tensions are emerging regarding Obamacare subsidies and abortion. Trump’s silence on the issue has once again become a critical wildcard. Susan B. Anthony Pro-Life America, which mobilizes its large grassroots network to elect anti-abortion candidates, is taking an active role, most recently making its case during a briefing last week with staffers for members of the conservative House Republican Study Committee. The organization is engaging with relevant congressional committees, lawmaker offices, and party leaders to find a solution. Marilyn Musgrave, the organization’s vice president of government affairs and a former Republican congresswoman from Colorado, has been meeting directly with lawmakers. The in-person lobbying follows a letter sent to lawmakers in early September from nearly 90 anti-abortion groups, including Susan B. Anthony Pro-Life America, which called on Congress to ensure that any extension of ACA subsidies is protected by the Hyde amendment. This call to action underscores the deepening divide and the growing pressure on Republicans to take a stand on the issue.
The debate over the Hyde amendment is also central to the discussion. Democrats argue that the ACA already includes guardrails to ensure compliance with the Hyde amendment, which bars the use of federal funds for abortion except in specific cases. However, opponents of abortion argue that these guardrails are mere legal artifacts and that the tax credits effectively subsidize plans that cover abortion services. A memo circulated by the office of Sen. Steve Daines highlights this argument, stating that taxpayer funds are fungible and that the enhanced credits make it easier for plans to offer abortion services. Autumn Christensen, senior policy advisor at Susan B. Anthony Pro-Life America, emphasizes that the organization is prepared to punish Republicans who vote for an extension without addressing this perceived discrepancy. The group has warned that extending the ACA subsidies without Hyde protections would be a betrayal of this summer’s victory, referring to the Republicans’ sweeping tax and spending law that defunded Planned Parenthood.
Some Republicans, however, are open to negotiation. Sen. John Cornyn (R-Texas), who has stated that the credits should be extended before the midterms, suggests that this issue could be addressed with a compromise. Cornyn is facing an intense Republican primary against Texas attorney general and Trump ally Ken Paxton. Thune, whose spokesperson has not returned a request for comment, has left the door open to a possible deal, arguing that Democrats created the problem and should be the ones to initiate a proposal. Meanwhile, a group of Senate Republicans has been meeting to discuss legislation to extend the credits with new restrictions, including Hyde protections. Speaker Mike Johnson, who is firmly anti-abortion, has indicated that Congress can easily wait until later this year to address the subsidies. Rep. Brian Fitzpatrick (R-Pa.), who wants to secure an extension, is actively pursuing a bipartisan compromise with centrists in the Problem Solvers Caucus. He warns of the real deadline, as the rates are set to kick in on November 1, leaving only October to resolve the issue.
Behind the scenes, however, Johnson’s leadership circle is increasingly viewing the abortion issue as deeply problematic for the prospects of a deal. Senior Republicans believe that leaders won’t be able to extend the subsidies without Democratic votes, and Democrats won’t support an extension that imposes new restrictions on abortion coverage. Sen. Ron Wyden, the top Democrat on the Senate Finance Committee, has criticized the attempt to bring abortion into the debate, stating that it would be a nonstarter for Democrats. Sen. Jeanne Shaheen (D-N.H.), who authored the legislation that created the enhanced credits, has also emphasized the need for bipartisan solutions that can earn support across the aisle. The potential restrictions on abortion access could also pose a challenge for the dozen House Republicans who have signed onto legislation that would extend the subsidies for one year, no strings attached. Many of these moderates are facing tough reelection battles, and any accolades they might earn for extending the subsidies could be offset by backlash from restricting reproductive health services. The ongoing internal conflict within the GOP over health care and abortion is therefore a critical issue that could significantly influence the party’s ability to maintain control of Washington and its legislative agenda.