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GOP lawmakers returning to Capitol Hill are facing a health care bind, with Affordable Care Act (ACA) subsidies having expired on Dec. 31, 2025, and no clear path forward for extending them. The GOP remains split over whether to extend the subsidies at all. But in December, four Republican centrists, frustrated with party leadership, joined Democrats in backing a discharge petition on legislation to extend the subsidies for three years. (Kochi, 1/5)

The Senate is staring down multiple flash points in the coming months as lawmakers head into a year colored by electoral politics but with plenty of policy fights on the horizon. Lawmakers wrapped up a grueling year by completing some of their pre-holiday agenda, including passing the annual National Defense Authorization Act and confirming scores of nominees. But they punted several key issues into January, including government funding bills to avert a shutdown and a potential deal to extend expiring enhanced ObamaCare subsidies. (Weaver, 1/4)

The leaders of state-based exchanges told CNN that they will be able to update their systems if Congress acts in January, though it may take time. A straightforward extension of the enhanced subsidies would be the quickest to implement. But if lawmakers make changes — such as setting an income limit or requiring minimum premium payments — it could take more time. (Luhby, 1/1)

Renee Rubin Ross is facing the stark reality of having to pay much more for her health insurance this year, now that Congress has ended 2025 without extending the enhanced federal tax credits that brought down the cost of her coverage under the Affordable Care Act. “I don’t even know how to get my mind around it. It’s the opposite of affordable,” said Dr. Ross, who relies on Obamacare to cover her family of four in California. Staying on the same plan for 2026 will cost about $4,000 a month, $2,700 more than the roughly $1,300 per month she had been paying. (Abelson, 1/2)

More than 40 million Americans turn to ChatGPT daily for health information, according to a report OpenAI has shared exclusively with Axios. Patients see ChatGPT as an "ally" in navigating their health care, according to analysis of anonymized interactions with ChatGPT and a survey of ChatGPT users by the AI-powered tool Knit. (Morrone, 1/5)

Obamacare subsidies used by more than 20 million expired Thursday. Now Democrats are ready to make them a centerpiece of their midterm campaigns. The lapse of enhanced premium tax credits, first passed as a pandemic-era relief measure under President Joe Biden in 2021, will immediately hit the pocketbooks of voters — some of whom will see their monthly insurance premiums rise by hundreds of dollars. (Wu, 1/2)

Up to seven states will vote on abortion rights this year. But recent polling indicates that Democrats may not be able to count on the issue in their efforts to drive votes in the 2026 midterms, after making abortion rights the centerpiece of their pitch to voters in the elections that followed the fall of Roe v Wade. In 2024, 55% of Democrats said abortion was important to their vote, according to polling from the Public Religion Research Institute (PRRI). But in October of this year, just 36% of Democrats said the same. (Sherman, 1/1)

President Donald Trump has a GOP revolt on his hands. It’s about weed. In announcing last month that he wants to reduce government regulations on marijuana that have kept taxes high for cannabis companies and made it difficult for researchers to study the drug’s health effects, the president got on the wrong side of the Republican House speaker and four of the party’s top leaders in the Senate. (Brensel and Friedman, 1/4)