A newly circulated health-care framework from the White House — intended to extend expiring subsidies under the Affordable Care Act (ACA) — is encountering sharp internal resistance from Republicans due to its failure to address abortion funding, setting up a major showdown over the fate of any deal.

Many Republican lawmakers and anti-abortion groups insist that any extension of ACA subsidies must come with strict application of the Hyde Amendment, which bars most federal funding for elective abortions.

Their demands make inclusion of abortion restrictions a non-negotiable “red line,” yet the administration has so far declined to commit publicly, prompting fierce backlash inside GOP ranks.

The draft proposal under consideration does include conservative-favoured adjustments — such as new income eligibility caps and mandatory minimum premiums — but it remains silent on whether subsidised insurance plans would be allowed to cover abortion.

That omission has left many lawmakers uncertain whether they can support the measure.

One senior Republican aide warned that asking colleagues to back a plan without Hyde protections would be “impossible.”

Democrats have countered forcefully.

They argue that attaching abortion restrictions to insurance subsidies is tantamount to weaponising women’s healthcare, and have vowed to reject any plan that undermines access to abortion.

As lawmakers negotiate a short-term extension — with subsidies set to expire at year-end — the impasse threatens to derail an agreement just when many Americans face looming insurance premium hikes.

Some Republicans have suggested new directions, such as redirecting subsidies into tax-advantaged savings accounts rather than paying insurers directly — a move backed by the administration — but experts warn it could destabilise the ACA marketplace if implemented alone.

With ideological divisions deep and timing tight, both sides warn that failure to strike a compromise would imperil millions of Americans’ health coverage and expose insurance markets to shockingly steep premium increases early next year.