The U.S. House of Representatives passed a three-year extension of expired Affordable Care Act subsidies on Thursday, with a group of 17 Republicans — including Rep. Monica De La Cruz of Edinburg — joining the chamber’s Democratic minority to approve the measure.
The issue of ACA tax credits — which millions of Texans claimed last year to lower the cost of their health insurance premiums — was at the center of last year’s government shutdown and is expected to be a major campaign issue in the fall midterms. De La Cruz is the only Texas House Republican targeted by national Democratic groups in 2026.
“Rising health care costs remain a concern for many people in our South Texas communities,” De La Cruz said in a statement. “I am committed to working with members on both sides of the aisle to find a bipartisan solution to expand options for families, reduce health care costs, and demand transparency in prescription drug prices. While this is not what we initially wanted, today’s vote is in the best interest of South Texas families and is the only option to provide certainty to those who rely on these credits.”
Twenty-two other Texas Republicans voted against the extension, while two — Reps. Michael McCaul and Wesley Hunt — did not vote. All 12 Texas Democrats voted in favor. The bill, which was passed against the wishes of House Republican leaders, passed by a vote of 230 to 196.
Democrats in the room clapped and cheered after the vote — Houston Rep. Sylvia Garcia greeted members and fellow Houston Rep. Al Green waved his cane in the air.
But the bill faces a tough outlook in the Senate, where it would need the support of 13 Republicans and all Democrats to reach the 60 votes required to pass. But passage by the House could prompt a bipartisan group of senators working on a grant deal to find a compromise.
The ACA tax credits became a hot topic after Democrats refused to fund the federal government last fall unless Republicans agreed to extend the subsidies. Expanded for the first time in 2021, the tax credits, paid to insurers to reduce monthly premiums for ACA enrollees, have led to significant growth in Texas’ ACA population. Republicans have argued that they are riddled with fraud and only serve to benefit insurance companies without addressing the underlying cost of health care.
With the tax credits having expired at the end of last year, hundreds of thousands of Texans are expected to drop or downgrade their coverage due to the rising cost of their premiums.
South Texas, in particular, benefited from expanded tax credits; more than 20% of residents are enrolled in the ACA in many area counties, including Duval, Hidalgo and Starr counties. The De La Cruz district, in its current and future redistricted iteration, includes a large portion of Hidalgo County.
De La Cruz, along with Reps. Henry Cuellar, D-Laredo, and Vicente Gonzalez, D-Brownsville, had been part of a bipartisan group working on a framework to reform and expand the subsidies. The group released a bill in December that would extend the credits for two years while setting an income cap and safeguards aimed at preventing fraud.
But after GOP leaders refused to introduce a compromise bill, several moderate Republicans joined with Democrats on two procedural “discharge” motions — in December and again on Wednesday — to force Thursday’s vote.
De La Cruz’s yes vote neutralizes a key Democratic argument for his potential midterm opponent. The Democratic Congressional Campaign Committee and Democrats campaigning against De La Cruz have criticized her in the past over the ACA, and Democrats have sought to make health care a defining issue in battleground districts across the country.
