Republicans are divided over extending enhanced Affordable Care Act (ACA) premium tax credits, which expire on December 31, risking significant premium increases for millions and potential political fallout in the 2026 elections.A bipartisan push for a compromise is underway, with Democrats planning to use healthcare affordability as a central campaign issue against former President Donald Trump and Republicans.The Congressional Budget Office projects 3.8 million more uninsured people and a 114% average premium increase if credits lapse, while some Republicans seek reforms alongside any extension.