The U.S. House of Representatives approved a three-year extension of expired Affordable Care Act (ACA) subsidies on Thursday, with 17 Republicans, including Representative Monica De La Cruz from Edinburg, aligning with the Democratic minority to support the legislation.
The ACA tax credits, utilized by millions of Texans last year to lower their health insurance premiums, became a focal point during last year’s government shutdown and are expected to be a crucial issue in the upcoming midterm elections. De La Cruz stands out as the only Texas Republican facing targeted Democratic efforts for the 2026 elections.
“Rising health care costs remain a concern for many in our South Texas communities,” De La Cruz stated. “I am committed to collaborating with colleagues on both sides to find a bipartisan solution that expands options for families, reduces health care costs, and mandates price transparency for prescription drugs. While this is not the ideal outcome we sought, today’s vote serves the best interest of South Texas families, providing necessary certainty for those relying on these credits.”
In contrast, 22 other Texas Republicans voted against the extension, while two representatives, Michael McCaul and Wesley Hunt, abstained from voting. All 12 Texas Democrats cast their votes in favor. The bill, which was brought to the floor despite opposition from House Republican leadership, passed with a vote count of 230-196.
Following the vote, Democratic members erupted in applause, with Representative Sylvia Garcia from Houston celebrating with high-fives and Representative Al Green waving his cane in triumph.
However, the bill faces significant challenges in the Senate, where it requires the backing of 13 Republicans and all Democrats to achieve the necessary 60 votes for passage. Nonetheless, the House approval might motivate a bipartisan group of senators to negotiate a compromise on the subsidy issue.
The ACA tax credits became a contentious topic after Democrats refused to fund the federal government last fall unless Republicans agreed to prolong the subsidies. Initially expanded in 2021, these tax credits—paid to insurers to help reduce monthly premiums for ACA enrollees—contributed to substantial growth in Texas’ ACA enrollment. Republicans have criticized the credits, claiming they are susceptible to fraud and benefit insurance companies without addressing the core issues of healthcare costs.
With the tax credits having lapsed at the end of the previous year, hundreds of thousands of Texans are predicted to either abandon or downgrade their coverage due to rising premium costs.
South Texas has particularly benefitted from the extended tax credits, with over 20% of residents in several counties, including Duval, Hidalgo, and Starr, enrolled in the ACA. De La Cruz’s district encompasses much of Hidalgo County in both its current and newly redistricted forms.
De La Cruz, along with Representatives Henry Cuellar (D-Laredo) and Vicente Gonzalez (D-Brownsville), was part of a bipartisan initiative aimed at reforming and extending the subsidies. The group introduced a bill in December that proposed a two-year extension of the credits while establishing an income cap and safeguards to prevent fraud.
After Republican leadership declined to present a compromise bill, several moderate Republicans collaborated with Democrats on procedural “discharge” motions—first in December and then again on Wednesday—to facilitate Thursday’s vote.
De La Cruz’s affirmative vote undermines a key argument that Democrats could use against her in the midterm elections. The Democratic Congressional Campaign Committee and candidates opposing De La Cruz have previously criticized her stance on the ACA, seeking to make healthcare a pivotal issue in competitive districts nationwide.
