The House of Representatives will vote on a bill to extend Biden-era health insurance subsidies early next year, after Speaker Mike Johnson lost control of several of his more moderate members on Wednesday. A handful of GOP congressmen decided that — after Mr. Johnson pushed back against their own legislation — they would simply join with the Democrats. 

The issue of enhanced premium tax credits for the Affordable Care Act exchanges has dominated Washington for months. Democrats tried to get the GOP to include an extension of the subsidies as part of the Big Beautiful Bill Act, though Mr. Johnson declined to do so. Democrats tried shutting down the government to force Republicans’ hands, though that also failed. Now, the tax credits are set to lapse, at the very least, in January. 

On Wednesday, Republicans and Democrats went to the House floor to vote on a procedural measure for other bills to be considered that day. During that vote, Republican leadership was clearly trying to keep all GOP lawmakers in line. Four House members, though, decided to announce they would support Democrats’ clear, three-year extension of the ACA subsidies. 

The bill, authored by the House minority leader, Congressman Hakeem Jeffries, was placed under what is known as a discharge petition. It is a procedural mechanism to force votes on certain bills on the floor over the objections of the speaker. If a petition garners 218 signatures, then the underlying bill must receive a vote within days. 

All 214 Democrats and four Republicans are now signed on to that petition, meaning that the three-year extension must come up for a vote once Congress returns in January. 

On Wednesday morning, it was clear that frustrations with Mr. Johnson had reached a boiling point. 

“I am pissed for the American people,” Congressman Mike Lawler, a Republican who signed the petition, told reporters of Mr. Johnson’s lack of action. “This is absolute bulls—t and it’s absurd.”

Another signatory, Congressman Kevin Kiley, accused the speaker of lying about the health care debate. Mr. Johnson had said that he would allow moderates to have a vote on an amendment to extend the ACA enhanced tax credits, though the amendment had to comply with House rules. Mr. Johnson said Mr. Kiley then proposed an amendment which would have violated those rules. 

“This is false,” Mr. Kiley wrote on X after Mr. Johnson told a reporter that the amendment would not have worked. “I prepared precisely the amendment the Speaker is describing, and he said it would be ruled out of order.”

The other two Republicans to sign the discharge petition are Congressmen Ryan Mackenzie and Brian Fitzpatrick, both from Pennsylvania. Messrs. Lawler and Fitzpatrick are two of three Republican House members who represent districts won by Vice President Kamala Harris last year. 

Now that the tax credits are set to expire, more than 20 million Americans are set to see their premiums increase in 2026. Based on nearly every poll conducted over the course of the last six months, affordability — especially around groceries, energy, and health care — has been the dominant issue for Americans, even though President Trump has called it a “Democrat hoax.”

Mr. Johnson insists that the small revolt he faced on Wednesday is not a sign of a broader distrust among Republicans in Congress. 

“I have not lost control of the House,” he told reporters on Wednesday after the discharge petition received 218 signatures. “We have the smallest majority in U.S. history. These are not normal times.”

Once the House passes the three-year extension — which it almost certainly will if the four Republicans stick by their plan — then the Senate will have to take up the measure, though the Democrats’ bill would have to be amended in order to garner 60 votes. Mr. Trump himself has not yet weighed in on any specific proposal, though he has said that he wants to stop sending federal subsidies to health insurance companies altogether.