'People Are Going to Die' If Republicans Let ACA Subsidies End, Warns AOC

The US House of Representatives is set to vote on extending Affordable Care Act subsidies next week, and Rep. Alexandria Ocasio-Cortez warned Friday that if Republicans let the ACA tax credits expire at the end of the year, "people are going to die."

The New York Democrat spoke to reporters in Washington, DC a day after only four Republicans voted with Democratic senators in an unsuccessful effort to pass legislation extending ACA subsidies, as over 20 million Americans face a surge in health insurance premiums. A GOP bill to replace the subsidies with annual payments to tax-advantaged health savings accounts also failed.

"We have to remember who's in charge of the House, the Senate, and the White House. Republicans have a House majority, they have a Senate majority, and Donald Trump is president of the United States, and JD Vance is vice president of the United States," Ocasio-Cortez said in remarks shared by her and multiple news sources on social media.

House Speaker Mike Johnson (R-La.) "refused to engage" in a debate on the looming healthcare crisis and "kept Republicans home for over a month so that they would not negotiate," she said. Trump and Vance "did the same thing—they stuck their heads in the sand for the entirety of a... government shutdown where we were urging them to come to a solution on extensions of ACA premium subsidies," she continued, calling for a "clean" extension while the GOP sorts out its supposed healthcare plan.

"People are gonna be kicked off of their insurance. Open enrollment is happening right now, and there are going to be millions of Americans that are affected—that aren't gonna be able to go to a doctor, aren't gonna be able to afford their prescription drugs, because of some petty fight in Washington," the congresswoman said, noting Democratic efforts to force votes on an extension.

As NBC News reported Thursday, early enrollment data from several states shows that "more people appear to be walking away from Affordable Care Act coverage or switching to cheaper plans for 2026 compared to this time last year," which "could reflect signs of financial strain for people who can't afford to pay hundreds of dollars more in monthly premiums once enhanced federal subsidies expire at the end of the year."

Demanding that her colleagues in DC recognize the urgency of the issue, Ocasio-Cortez—who supports Medicare for All—said Friday that "I don't understand why they can't just extend these subsidies so that we can save people's lives while they figure out whatever their political food fight is."

AOC also pushed back against GOP efforts to restrict reproductive healthcare in an ACA subsidy bill, saying "an extension with abortion restrictions kills women—so no, I'm going to allow this Republican majority to kill women in this country so that they can try to do whatever their victory lap is. I will not accept women, and the lives of women, as some political cost for them being able to extend these things. Reproductive care is healthcare. Period."

Since the right-wing US Supreme Court reversed Roe v. Wade and GOP-led states further restricted reproductive rights, multiple stories have emerged from places including Georgia and Texas exemplifying how "Republican abortion bans kill women."

After Johnson met with the House GOP's "Five Families" on Friday, he is expected to allow a floor vote to extend the subsidies next week and, according to Punchbowl News, is considering giving moderates an option without abortion funding restrictions.

As Politico reported Friday evening:

[GOP] leaders ultimately expect the extension vote to fail, resulting in skyrocketing premiums for millions of Americans when the subsidies expire at the end of the year.

Instead, according to House Republican leadership aides, Republicans are preparing to roll out a healthcare framework that would allow businesses that fund their own health plans to purchase "stop-loss" policies—which would protect businesses from going bankrupt from just a few unexpectedly expensive insurance claims.

It also would appropriate funds to pay for "cost-sharing reductions" in Obamacare and include some elements of a separate legislative proposal designed to crack down on pharmacy benefit managers—companies that negotiate drug prices on behalf of insurers and large employers.

Like Ocasio-Cortez—who has faced mounting calls to launch a 2028 primary challenge to Senate Minority Leader Chuck Schumer (D-NY) over his handling of the March funding fight and recent shutdown—the upper chamber's top Democrat put the blame squarely on Republicans after both bills failed to advance on Thursday.

"Republicans must answer for why people will lose coverage. Republicans must answer why families see premiums double and triple over the next year," Schumer said. "Democrats' focus does not change. We fought like hell to stop these hikes, and we're going to continue to fight like hell to bring costs down for the American people on healthcare, on housing, on electric rates, on groceries."

"But Republicans are fighting like hell to send those costs right through the roof," he added. "They're fighting like hell to kick people off insurance. They're fighting like hell to cut taxes and give sweet giveaways to billionaires and the ultrarich. January 1st is coming. Republicans are responsible for what happens next. This is their crisis now, and they're going to have to answer for it."