U.S. Rep. Ryan Mackenzie, R-Pa., speaks before President Donald Trump arrives at the Mount Airy Casino Resort in Mount Pocono, Pa., Tuesday, Dec. 9, 2025. (AP Photo/Matt Rourke)

U.S. Rep. Ryan Mackenzie (R-PA) was one of four Republicans to sign a discharge petition to extend the Affordable Care Act’s (ACA) premium tax credits. But the swing-district lawmaker has a decade-long history of opposition to both the program and health care expansion in Pennsylvania.

Last week, Mackenzie, along with Reps. Rob Bresnahan (R-PA), Brian Fitzpatrick (R-PA) and Mike Lawler (R-NY), signed the discharge petition to force a vote in the U.S. House on extending the ACA subsidies. The subsidies are set to expire at the end of 2025, and the result will be higher health insurance premiums for millions of Americans who are already entangled in an affordability crisis.

“My position has been clear throughout this process — we need both short-term relief to bring down prices and longer-term reforms to make healthcare in America more affordable for everyone,” Mackenzie said in a press release. “In order to achieve these goals, I have opted for the only remaining option in the House — a three-year extension of the enhanced credits, because this will keep the conversation alive.”

The discharge petition is mostly symbolic, as an extension for the tax credits would need to pass in the Republican-controlled House, Senate and then be signed by President Donald Trump, who has refused to support the extension. Republicans also adjourned Congress for the year without voting on an extension.

But signing the discharge petition gives Mackenzie and other vulnerable Republicans the ability to say they voted to keep health insurance premiums lower, which contradicts years of public opposition and recent votes to slash access to health care. In actuality, Mackenzie has vocally and vehemently opposed the ACA since his early years as a Pennsylvania state representative.

Mackenzie has bashed the ACA for years

During a town hall event in 2013, Mackenzie referred to the ACA as an “infringement upon our rights.” At the time, Mackenzie was serving his first term in the Pennsylvania state House of Representatives, and he also bragged about opposing setting up a state exchange and expanding Medicaid.

“Other things that I look forward to talking about are some of the things that I see coming down the pike are things that are real infringements upon our rights,” Mackenzie said. “Things like Obamacare, I was at a seminar earlier today, and this is turning out to be more of a disaster than I think anybody could imagine.”

Pennsylvania eventually expanded Medicaid (2015) and set up a state-based health insurance program (2019), the latter of which Mackenzie voted for.

Mackenzie did not respond to a request to clarify why he chose a largely symbolic discharge petition to change his mind about supporting the program. In an interview with the Associated Press earlier this month, Mackenzie iterated his support for lowering costs but also referred to the ACA as a broken system.

“I think that we need to deal with the reality of where we are now and even if you have a broken system, that doesn’t mean that you shouldn’t provide or offer relief to individuals who are dealing with those high costs right now,” Mackenzie told AP.

Bob Brooks, a firefighter and Mackenzie’s potential Democratic opponent next year, criticized the freshman lawmaker for hiding his own record on health care.  

“Ryan Mackenzie’s eleventh-hour attempt to paper over his own record of gutting health care and jacking up costs is like an arsonist calling the fire department after he already lit the match,” Brooks said in a statement. “Hardworking people all across the Lehigh Valley are struggling with rising prices and a health care crisis that Mackenzie unleashed when he voted for Trump’s so-called ‘Big Beautiful Bill.’ That’s what Mackenzie did and we will hold him accountable for it.” 

Mackenzie, Bresnahan, Fitzpatrick and Lawler all voted for Trump’s One Big Beautiful Bill, which slashed federal funding for ACA marketplaces and Medicaid. The bill is expected to cause an estimated 15 million people to lose health insurance over the next decade. 

Fitzpatrick avoided voting on a Democrat-written amendment to the bill, which would have included an ACA extension in the final version. The amendment was introduced in the House Ways and Means Committee in May, but the Republican-controlled committee rejected it. All nay votes came from members of the GOP aside from Fitzpatrick, who inexplicably left the room before the vote. 

According to his campaign website, Brooks supports Medicare for All and has garnered support from one of its biggest advocates, U.S. Sen. Bernie Sanders (I-VT).