Elected Republicans feel emboldened to defy Trump and push back on the administration.

Speaker Mike Johnson is racing to finalize a Republican health care plan in time to present it to his conference at their weekly meeting Tuesday, but his team still needs to decide on major contours of the plan, according to three people granted anonymity to describe internal conversations. GOP leaders are meeting Thursday to nail down what will go in the package, according to the three people. One major decision still to be made is whether to offer up multiple individual bills for floor consideration or to assemble them into one piece of legislation. But top Republicans want to have a GOP alternative to vote on as Democrats hammer them over expiring Obamacare subsidies that will spike premiums for millions of Americans in the new year. If Johnson and fellow GOP leaders don’t make decisions about the way forward Thursday, one senior House Republican said, “it’s going to be bad.” The package is likely to be an assemblage of various GOP bills that have been working through House committees that are largely aimed at providing more options for health care coverage outside of the Affordable Care Act framework. One likely to be included would provide for “association health plans” allowing smaller businesses to join together to offer plans rather than going through ACA exchanges. Leaders are also likely to include options for expanding the use of health savings accounts, something President Donald Trump has endorsed but Democrats have generally opposed. It’s also likely to include bipartisan legislation overhauling the role of pharmacy benefit managers and potentially other bills that could lower prescription drug prices — something Trump pollster Tony Fabrizio advised a group of House Republicans to focus on as Democrats seize on the expiring tax credits. Johnson said in a brief interview that he and leaders plan to walk House Republicans through the health care plan through this weekend and then circulate the framework early next week. He also confirmed what GOP leaders have said in private — they want to vote on a health care package before the end of the year. But Majority Leader Steve Scalise, who had been coordinating the health care deliberations, wouldn’t commit to that timeline shortly after Johnson spoke. Party leaders are facing massive pressure from GOP centrists who are assembling their own compromise plans to extend the expiring subsides with new eligibility requirements. But Johnson, Scalise and many House Republicans have no interest in continuing with the Obamacare framework. Rep. Jen Kiggans (R-Va.), who coauthored a new plan that would provide a one-year extension of the subsidies that has been endorsed by more than two dozen members in both parties, said “we need to act on this issue.” “To do nothing is the wrong answer,” she said. Rep. Brian Fitzpatrick (R-Pa.), who is assembling a separate compromise bill that would include a longer subsidy extension, said his party’s leaders were not going down a path that will prevent a spike in American’s health care costs. “Is it a Republican-only solution? That’s not a serious solution,” he said. “The million-dollar question is, is it bipartisan or not?” Lead Art: House Speaker Mike Johnson briefly stops to speak with reporters as he walks into his office at the U.S. Capitol Dec. 3, 2025. | Francis Chung/POLITICO