Virginia Republicans split over extending health care subsidies

Swing-district Virginia Republicans faced a choice last week on whether to break with GOP leadership in the U.S. House of Representatives and vote with Democrats to extend enhanced federal subsidies for health insurance premiums that expired at the end of last year.

Affordable Care Act premiums are set to spike. A new poll shows enrollees are already struggling

One voted yes and another voted no, as Congress looks for a solution to a looming health care crisis that could cost Republicans their majority in midterm elections in November and represent a political challenge to President Donald Trump in the second half of his term.

U.S. Rep. Rob Wittman, R-1st, representing parts of the Richmond area in his 19th year in Congress, voted last Thursday in favor of extending the subsidies for three years after resisting an extension in both a massive tax-cut package that Trump signed into law in July and a short-term funding resolution that ended a 43-day federal shutdown last fall without addressing the health care issue.

U.S. Rep. Jen Kiggans, R-2nd, a two-term congresswoman representing Hampton Roads, voted no, despite publicly calling for a one-year extension of the subsidies with tighter limits on eligibility.

What they have in common is formidable opponents in elections in districts that Democrat Abigail Spanberger carried in her landslide election as governor in November and that General Assembly Democrats want to redraw this year to make it even harder for Republicans to win. Spanberger won the 1st District by 2 percentage points and the 2nd by 8 points, according to the Virginia Public Access Project.

"It's totally about the midterms," said Richmond political analyst Bob Holsworth. "That's why I'm so surprised that Kiggans didn't join Wittman in what would be a relatively free vote."

With election pressures mounting — Trump warned Republicans this week that Democrats will impeach him again if they regain control of the House — 17 Republicans voted with all 213 Democrats to pass the Ending Gridlock Act to force a vote on the House floor to extend the subsidies. Congress first enacted the subsidies during the COVID-19 pandemic in 2021 and renewed them the next year to broaden access to health insurance in state and federal marketplaces under the Affordable Care Act.

Extending the subsidies was the central demand of Democrats in repeatedly rejecting the stopgap funding bill pushed by Republicans, resulting in the longest shutdown of the federal government, which ended without a solution to the potential loss of health care coverage for millions of Americans.

But Democrats haven't let up on pressuring Republicans to address the issue, especially potentially vulnerable incumbents such as Wittman and Kiggans.

"The government has opened, but the Democratic narrative is still driving Washington politics," said Steve Farnsworth, director of the Center for Leadership and Media Studies at the University of Mary Washington.

Wittman and Kiggans explained their votes on Friday with statements on social media, coming to different conclusions about the best policy moving forward.

"Across Virginia's First District, I've heard from you about the rising costs of healthcare, which is why I voted in favor of extending the enhanced premium tax credits," Wittman said on X.

Wittman's accompanying statement decried the current health care system as "too expensive, too confusing and too heavily driven by Washington" and called for "real reforms."

But he acknowledged that families would see huge increases in their monthly health care premiums without the enhanced credits.

"Allowing those costs to spike overnight would have punished working families — while doing nothing to fix the underlying problems in the system," he said. "That's why I supported a strictly temporary, three-year extension of the credits."

Kiggans, a former nurse practitioner, said in a statement on Facebook that the Democratic legislation "failed to make meaningful reforms to the ACA premium tax credit system that would ensure those who truly need this assistance receive it."

"A clean 3-year extension with no reforms is nothing more than a continuation of a failed system that rewards insurance companies and not patients," she said.

Wittman's vote didn't spare him from criticism by Henrico County Commonwealth's Attorney Shannon Taylor, who announced before the vote on Jan. 6 that she has raised more than $750,000, including $400,000 in the last quarter, in her bid to unseat him.

"Rob Wittman voted time and time again to let health care costs skyrocket, only flipping his position out of his own political self-interest and after premiums have already risen for families across our district," she said.

Former U.S. Rep. Elaine Luria, D-2nd, who lost her seat to Kiggans in 2022 after her district was redrawn to include more Republican-leaning voters, is trying to return the favor this year. General Assembly Democrats want to force a mid-decade redistricting in response to Trump's push for Republican-controlled states to draw new political maps to add seats for the GOP.

Luria immediately attacked Kiggans last Thursday for her vote against the extension.

"Once again, Jen Kiggans votes against making health care more affordable, putting her own political interests above Coastal Virginians," she said. "Health insurance premiums have skyrocketed for families because of Kiggans' failed leadership, and Hampton Roads can't afford anymore of her political games."

Nearly 400,000 Virginians bought their health insurance on the state-run marketplace, which had estimated that more than 100,000 would lose their health coverage if the enhanced subsidies disappeared. So far, enrollment is down by about 10,000 for health insurance this year, with more than double the cancellations of policies.

However, state officials say they likely won't know until March how many Virginians will decline to pay higher premiums and let their policies lapse. The marketplace automatically renewed existing policies in October for 357,000 Virginians, who must decide whether to cancel them.

"The question is how many people have just walked away and let their coverage expire," said Keven Patchett, director of the Health Benefit Exchange, a division of the State Corporation Commission that manages the state insurance marketplace.

Some "are waiting and hoping to see" if Congress extends the credits, he said.

Patchett said the state had extended the enrollment deadline by two weeks to Dec. 31 for coverage to begin on Jan. 1, but people can still enroll for coverage to begin on Feb. 1.

The debate now moves to the Senate, where Republicans have previously blocked the three-year extension that Democrats proposed, but the House vote could change the odds of passage.

"With 17 Republicans on board with a three-year extension, it's going to be hard for the Senate to say, 'no extension,'" Farnsworth said.

Similarly, if the Senate passes a compromise bill, he said, "Kiggans would be hard-pressed to remain a 'no.'"