The Republican-controlled U.S. House of Representatives on Wednesday was poised to advance Democratic legislation that would reinstate expired healthcare  subsidies, as the two parties jockey to lure voters in November’s congressional elections with competing approaches to solving an “affordability crisis.”

The Senate already has rejected the measure but backers hope a successful House vote could provide impetus for a compromise.

The Democratic initiative comes at a time when 33% of U.S. adults approve of Republican President Donald Trump’s handling of the U.S. economy and voters cite healthcare and other costs as a top concern. Democrats have made this the centerpiece of their effort to win control of the House and Senate in November’s midterm elections.

Meanwhile, Trump has mocked the word “affordability,” worrying party strategists that he could be hurting their prospects for the midterm elections.

On Tuesday, he urged Republicans to oppose the Democratic healthcare initiative but also show some flexibility on their anti-abortion efforts.

The Democrats’ legislation would reinstate healthcare subsidies that lower costs for 24 million Americans who get their coverage through the Affordable Care Act, which expired at the end of 2025. The nonpartisan Congressional Budget Office estimates that without the subsidies 100,000 more people annually would go uninsured and the government would spend $36 billion less over 10 years. Outside experts estimate some people’s healthcare costs would double.

Conversely, 3.8 million more people would gain coverage and the government would spend $350 billion more over the next decade under the Democrats’ proposal, according to CBO.

Though Democrats do not control the House or the Senate, four Republicans representing swing districts joined them last month to force a vote on the healthcare subsidies over the objections of House Speaker Mike Johnson.

If they win the first procedural vote, a vote on final passage would likely occur on Thursday.

House Republicans passed an alternative last month that would reduce subsidies overall, while lowering costs for some and raising costs for others, but it would not kick in until 2027.

—

(Reporting by Richard Cowan; Editing by Andrea Ricci )