Wall Street Journal Editorial Board: The GOP’s Better Healthcare Ideas

WASHINGTON - Today's editorial from the Wall Street Journal Editorial Board endorses House Republicans' Lower Health Care Premiums for All Americans Act.

"ObamaCare's structure was shaky by design, and now Democrats want to keep shovelling out subsidies to hide their errors. Repairing the damage the law has done to competition in healthcare markets is a bigger undertaking than the House bill attempts, but the GOP alternative is far superior to the subsidy status quo," the Editorial Board wrote.

Read the full WSJ Editorial here or below:

The GOP's Better Healthcare Ideas

The House bill would expand private insurance options for workers and employers-and reduce costs for taxpayers

Wall Street Journal

Editorial Board

December 16, 2025

Democrats think they have Republicans on the run on healthcare, but maybe not if the GOP fights back. On Friday House Speaker Mike Johnson offered a better alternative to the Democratic proposal to extend pandemic-era subsidies for ObamaCare: Expanding insurance choices for employers and workers. How dare he.

House Republicans plan to vote on their bill this week. The left's chief criticism is that it doesn't extend the sweetened ObamaCare subsidies, which expire on Dec. 31. "This so-called plan is the height of irresponsibility," declared House Minority Leader Hakeem Jeffries. But how is it irresponsible to increase healthcare options at lower cost for taxpayers?

Democrats boosted the ObamaCare subsidies in 2021, purportedly to help those who lost coverage during the pandemic. But the pandemic has long been over, and the richer subsidies are an inducement for fraud. They have also spurred workers to ditch employer coverage for heavily subsidized ObamaCare plans that raise costs for taxpayers.

The GOP bill would make it easier for small businesses to escape the ObamaCare regulatory morass. The bill would expand so-called association health plans that let small employers unite to sponsor group health plans. These plans would reduce premiums by expanding risk pools and give small employers more leverage with insurers.

The plans wouldn't have to adhere to many costly ObamaCare rules, though they still couldn't charge more for workers with pre-existing health conditions. Worker premiums for association plans would likely be lower than for ObamaCare plans. Workers might also see an increase in take-home pay if their employer's insurance costs fall.

Association plans won't work for all small businesses, but the GOP bill offers another option: Health reimbursement arrangements. These would let employers make tax-free payments for employees to buy their own health insurance in lieu of sponsoring a group plan. Employees would be allowed to buy their own insurance with pretax dollars, which would reduce their costs.

The Republican bill also seeks to reduce ObamaCare premiums by fixing a distortion caused by the law's convoluted design. ObamaCare requires insurers to reduce deductibles and co-pays for low-income enrollees in benchmark silver plans. No surprise, insurers have raised premiums for these silver plans to offset the cost of these "cost-sharing" reductions.

Because ObamaCare subsidies are pegged to premiums for silver plans, the cost-sharing mandate has resulted in larger subsidies for all plans. The GOP bill would appropriate funds to insurers to pay for ObamaCare's required cost-sharing reductions. This would reduce premiums for silver plans and, in turn, taxpayer spending on subsidies. A better solution would be to eliminate the cost-sharing mandate, which can make ObamaCare plans more attractive than employer plans for lower-income enrollees.

This is one reason the share of workers who participate in employer medical plans among those with access to them-i.e., the take-up rate-has fallen to 65% from 73% in 2019, according to the Bureau of Labor Statistics. The take-up rate has fallen more among low-earners who get free coverage on the ObamaCare exchanges.

By the way, the Census Bureau's annual survey of insurance coverage this year showed that the share of Americans with any coverage hasn't changed since 2019 despite the larger ObamaCare subsidies. Enrollment in employer plans has declined but government and ObamaCare coverage has increased.

Some of the increase in ObamaCare enrollment owes to fraud, as the Paragon Health Institute has documented and the Government Accountability Office recently corroborated. Millions of people have under-reported their incomes to qualify for bigger subsidies, while brokers enroll people in plans without their knowledge to earn bigger commissions.

This year's GOP tax bill included measures to reduce fraud, such as strengthening income verification, but many reforms don't kick in until 2028. Ending the enhanced subsidies would at least reduce the incentives for fraud.

Yet Democrats apparently don't care if the subsidies are gamed. Senate Democrats this week aim to call a vote under the Congressional Review Act to rescind the Administration's regulatory antifraud reforms, such as requiring minimum $5 premium payments if people don't actively re-enroll. That's right, they object a measly $5 incentive to reduce fraud.

ObamaCare's structure was shaky by design, and now Democrats want to keep shovelling out subsidies to hide their errors. Repairing the damage the law has done to competition in healthcare markets is a bigger undertaking than the House bill attempts, but the GOP alternative is far superior to the subsidy status quo.