The House of Representatives passed a three-year extension of COVID-19-era premium tax credits on Thursday, as a group of Republicans defied House leadership to back the Democrat-led measure.

The extension passed by a 230-196 margin, with 17 Republicans joining 213 Democrats in voting for a policy which Speaker of the House Mike Johnson, R-La., and the majority of the House Republican conference has opposed for months.

Five Republicans did not vote.

There were some notable Republican defections to the Republican side, such as Reps. Brian Fitzpatrick, Ryan Mackenzie, and Rob Bresnahan of Pennsylvania; as well as Mike Lawler, Andrew Garbarino, and Nick LaLota of New York. Most of the Republicans who voted alongside Democrats were from blue states or swing states.

A group of moderate Republicans, joined Democrats to successfully control the floor and pass legislation. 

Under former President Joe Biden, Democrats voted unilaterally to enhance the benefits of premium tax credits under Obamacare, as well as to remove income caps on the benefit.

Democrats first enacted the tax credits to subsidize health plans under the Affordable Care Act during the COVID-19 pandemic.

Democrats later extended the expiration of the credits to the end of 2025 in a separate party-line spending bill.

Republicans have consistently criticized the premium tax credits as inflationary and prone to fraud, while also alleging that they more closely resemble direct subsidies to health insurance companies.

The extension has little chance of passing the Senate, where Republicans and Democrats are negotiating the possibility of a reformed extension of the credits.

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