Republicans must hold the line on ending expanded Obamacare subsidies Image By Adam Radman Key Points Congressional Republicans should follow President Trump’s advice and refuse to negotiate with Senate Democrats on extending COVID-era Obamacare subsidies, which would add nearly $450 billion in new spending. A Paragon Institute report found widespread abuse in the ACA marketplace—millions of improper enrollees and “phantom enrollees” driving up taxpayer costs without delivering meaningful care. Extending Obamacare subsidies risks alienating the GOP base, undermining conservative voter enthusiasm and small-dollar fundraising ahead of the 2026 midterms, while giving Democrats political credit on healthcare. Congressional Republicans should heed President Trump's advice to "hold the line on the shutdown” and resist efforts to extend the temporary COVID-era Obamacare subsidies. Negotiating with Sen. Chuck Schumer and Senate Democrats on these subsidies not only puts our country further in debt, but could have serious political consequences heading into the midterms. After more than a decade of broken promises, Obamacare still fails to empower patients or reform healthcare markets for the better. While flooding insurance companies with higher profits, it leaves taxpayers footing the bill for waste, fraud, and abuse. Sold as a short-term pandemic fix, Democrats have shut down the government to make these credits permanent, which would cost taxpayers nearly $450 billion over the next decade. The actual cost is even higher than the sticker price suggests. A recent report from the Paragon Institute revealed staggering levels of fraud and waste in the Obamacare exchanges, primarily driven by the expanded premium tax credits. The report identifies two categories of enrollees mainly responsible for the surge in waste: zero claim enrollees and improper enrollees. Improper enrollees are individuals who falsely report their income to qualify for fully subsidized Obamacare plans. An estimated 6.4 million individuals fell into that category in 2025, costing taxpayers $27 billion alone. Paragon also found a growing number of "phantom enrollees" who receive taxpayer-funded healthcare, but never actually use it. Many of these "phantom enrollees" are signed up without their knowledge. These enrollees incur no medical claims and represent about 35% of all Obamacare participants. Paragon demonstrated that these policies drove a massive increase in individual market enrollees with no medical claims, while allowing for widespread abuse. While some Americans may worry about short-term premium increases, letting these subsidies expire will remove the incentive for insurers to raise prices, ultimately saving patients money while mitigating fraud. In late September, Americans for Tax Reform and 34 conservative and free-market organizations released a coalition letter urging President Trump to let the expanded Obamacare subsidies expire at the end of the year. The coalition applauded President Trump for rejecting the "unserious and ridiculous demands" made by Democrats. The message is simple: no compromise. Grassroots conservatives and Tea Party-era voters fought for over a decade to repeal Obamacare. If Republicans vote to extend these Obamacare subsidies they once condemned, it risks depressing turnout and small-dollar fundraising as campaign season ramps up. CNN's Harry Enten even admits President Trump is in a much better spot during this government shutdown than he was in 2018-2019. Trump's net approval rating has increased slightly compared to the 2018-2019 shutdown. In fact, the percentage of Americans who blame him has decreased significantly compared to the previous shutdown. Recent polling by Reuters/Ipsos shows Republicans hold the edge over the Democrat Party on several key issues, including the economy, immigration, and crime, while the public trusts Democrats more on healthcare. Even if Republicans voted to pass some Obamacare extension, Democrats would still get credit for expanding healthcare access. Republican cooperation muddies the message without winning any new votes. With no top-of-the-ticket presidential contest in 2026, Republicans must rely on mobilizing their base to drive voter interest. Voter enthusiasm will be key. Extending Obamacare subsidies offers no political upside for Republicans and a significant downside with their own voters. Democrats will claim credit either way, while conservative voters will see compromise as a defeat. Instead, Republicans should pivot to a proactive message of reform—expanding HSAs, lowering costs through competition, and exposing the fraud-ridden structure of Obamacare. Standing firm now will energize the base, sharpen contrasts ahead of the midterms, and reaffirm the GOP as the party of fiscal responsibility and freedom. Adam Radman is the Director of Advocacy at Americans for Tax Reform. *The opinions expressed in this column are those of the author and do not necessarily reflect the views of HealthPlatform.News. SUGGESTED STORIES Ending unchecked spending with the One Big Beautiful Bill Over the past four months, the Office of Management and Budget, or OMB, has worked tirelessly to deliver on President Trump’s promise of a federal government that works for the American people, not bureaucrats and the entrenched establishment. Under the previous Administrat Read more Championing rare disease innovation, ending foreign dependence Every patient deserves a chance at a healthy life — especially those facing the most devastating, life-threatening illnesses. Yet, of the more than 10,000 known rare diseases, only 5% have an FDA-approved treatment. 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