How Arizona's GOP House members voted on health-care subsidies

More than a dozen House Republicans broke ranks Jan. 8 when they voted to revive a set of enhanced pandemic-era subsidies that expired at the end of December, but Arizona's GOP representatives were not among them.

Sidestepping House Speaker Mike Johnson, 17 Republicans joined all Democrats to pass the bill, a proposal that would extend for three years a set of Affordable Care Act tax credits that have stabilized health insurance premiums for millions of Americans.

Arizona’s delegation voted along party lines, with Democrats supporting the bill and Republicans opposing it.

Notably, GOP Rep. Juan Ciscomani voted against the bill even after issuing dire warnings about the expiration of the subsidies, a decision that kept him in alignment with party leaders before what could be a bruising reelection fight.

The three-year extension proposal faced an uncertain future in the U.S. Senate, where a bipartisan group of lawmakers was reportedly putting together another compromise plan that can get more support from Republicans. One idea was a two-year subsidy extension that includes some cost-saving reforms, such as new income limits.

The Jan. 8 vote shows roiling unease within the GOP caucus and a lingering political appetite on Capitol Hill to act on an issue that could have major consequences for Americans' pocketbooks during a midterm election year.

“The last thing Arizonans need right now are higher prices,” Democratic Rep. Greg Stanton wrote after the vote. “But as of January 1st, more than 400,000 Arizonans have watched their monthly health care premiums go through the roof.”

Rep. David Schweikert, an Arizona Republican who is also running for governor, countered that prices were “still rising” despite the subsidies.

“That’s Washington lighting your money on fire,” he wrote.

Ciscomani votes against subsidies

Ciscomani, who represents a swing district in southeastern Arizona, stood out from the GOP caucus last year when he warned of “massive” consequences for Arizonans if the health subsidies were allowed to expire.

“Doing nothing is not an option,” he wrote in a Dec. 4 news release.

But as negotiations progressed, Ciscomani proved reluctant to use his leverage to advance the issue.

Several members of Congress, including two Republicans, introduced discharge petitions that would force a vote on various proposals to extend the subsidies. Ciscomani didn't sign on to any of them, even as dozens of his GOP colleagues did.

Aide CJ Karamargin told The Arizona Republic that the congressman was “not accustomed” to signing onto discharge petitions, “especially when there's an alternative plan offered by leadership.”

In December, four Republicans joined Democrats to force a vote on the three-year extension proposal, undermining GOP leadership. Ciscomani did not sign on.

The subsidies expired at midnight on Dec. 31, with no clear path to reaching a deal in Congress.

Ciscomani voted against bringing the three-year extension proposal to a vote on the House floor on Jan. 7, and then, the next day, voted against the bill.

In a statement to The Republic, Ciscomani emphasized his points of disagreement with the tax credits’ extension even as, for months, he had argued they were crucial for keeping down his constituents’ health-care costs in 2026.

“I have been clear: my support for a temporary extension MUST be accompanied by real common-sense reforms. Tackling the fraud and abuse that are part of the program is not an option – it is a requirement,” he wrote.

“The three-year extension proposed by the Democrat leader does nothing for families struggling with rising healthcare costs, quite the opposite.  It keeps the status quo and that’s not acceptable.”

Karamargin had previously told The Republic the three-year proposal has “never been the congressman's preferred option.”

Widely seen as one of the most vulnerable incumbents in Congress, Ciscomani relies heavily on campaign money from party leaders. He received well over a half-million dollars from national GOP fundraising committees in the first nine months of 2025, his campaign finance disclosures show.

Democrats in his district have rallied behind one candidate, veteran JoAnna Mendoza, to challenge Ciscomani in this year’s midterm election. Mendoza immediately seized on the latest health care vote as a sign the congressman doesn’t “have what it takes to fight for the people of Arizona.”

“Juan Ciscomani is too spineless to stand up to his party, even when Arizonans’ healthcare is at risk,” she wrote in a news release.

Subsidy bill would keep millions insured, cost $80B

Expiration of the subsidies caused millions of Americans' health insurance premiums to spike at the beginning of the year.

Enrollment in ACA plans doubled in Arizona after the tax credits went into effect in 2022. Without the subsidies, the average annual premium for ACA marketplace enrollees is expected to roughly double, rising to $1,904 in 2026 from $888 in 2025, according to the nonpartisan health policy research group KFF.

Dr. Daniel Derksen, director of the University of Arizona’s Center for Rural Health, has estimated 125,000 to 150,000 more Arizonans will be without health insurance in 2026 if the ACA’s enhanced tax credits go away.

Most Republicans oppose extending the subsidies, citing the cost of the program and concerns about fraud.

An analysis by the Congressional Budget Office found the three-year extension proposal would increase the country’s deficit by about $80 billion over the next 10 years. Schweikert had argued the subsidies were a “financial boon to insurers.”

“Billions are paid for care that never happens and to insurers with no incentive to cut costs,” he wrote on social media leading up to the Jan. 8 vote.

The CBO also estimated that if the bill is enacted, about 4 million more people would have health insurance in 2028.

The expiring tax credits are among several developments that could put pressure on the country’s health-care markets in the new year.

Hospital systems also are bracing for sweeping Medicaid cuts included in the Republican-led federal budget passed earlier this year, a reform that Senate Democrats calculated would cause about 193,000 Arizonans to lose their coverage.

After the vote, Sen. Ruben Gallego, D-Arizona, called on Senate Republicans to send the bill to the president's desk.

“24 million Americans are counting on us,” he wrote.

This article originally published by the Arizona Republic