Trump boxed in as Republican health care revolt grows

As millions of Americans brace for soaring health care costs, President Donald Trump is confronting an open rupture inside his own party that lawmakers fear could haunt Republicans in the 2026 midterm elections.

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US patients already face among the highest medical bills in the world, spending more than twice as much on average as people in other wealthy nations, according to the Organization for Economic Cooperation and Development (OECD).

The latest flashpoint is the year-end expiration of Affordable Care Act (ACA) subsidies that help cash-strapped families buy health insurance -- a deadline that has laid bare a widening gulf between Trump's blue-collar coalition and establishment Republicans determined to let the aid lapse.

Fiercely opposed to anything resembling support for the ACA -- a law nicknamed "Obamacare" for its architect, Democratic former president Barack Obama -- Republican leaders insist the subsidies must end on December 31.

Trump, whose handling of health care is deeply underwater in public polling, sought to project flexibility in remarks late Thursday, offering to work with Democrats on a long-term fix.

But the overture sits uneasily alongside his longstanding opposition to Obamacare and his resistance to extending subsidies -- which Republicans argue would further entrench a law they have spent more than a decade trying to dismantle.