U.S. Rep. Carlos Giménez has joined with 12 other Republicans demanding that House leadership take steps to save health care subsidies.

In a carefully worded letter to House Speaker Mike Johnson, the letter effectively calls for lawmakers to immediately take up an extension of Affordable Care Act credits set to expire at the end of the year.

The lawmakers want the Republican leader to promise the matter gets taken up as soon as Democrats agree to end a federal government shutdown. The group praises Johnson’s “strong leadership” in demanding passage of a budget resolution passed by the House in September.

“Once the government is reopened, however, we should immediately turn our focus to the growing crisis of healthcare affordability and the looming expiration of the enhanced Affordable Care Act (ACA) premium tax credits,” the letter states.

Giménez was the only member of Florida’s congressional delegation to sign onto the letter, the first significant push by GOP members of the House to salvage a part of the Affordable Care Act that leadership has heavily criticized.

Of note, every other member of Congress representing a larger group of ACA enrollees than Giménez does also represents a Florida district. U.S. Rep. Mario Díaz-Balart, a Hialeah Republican, represents the highest concentration in the country, and told Florida Politics this week he wants the shutdown to end and afterward, the subsidies could be extended.

Democratic U.S. Reps. Darren Soto of Kissimmee and Frederica Wilson of Miami-Dade both have supported Democrats’ demand that any budget resolution include an extension of the credits.

U.S. Rep. María Elvira Salazar, a Coral Gables Republican, represents 236,000 enrollees, more than Giménez, but she did not sign the letter. Florida Politics reached out to Salazar’s Office last week on the topic and has received no comment.

The GOP lawmakers who signed the letter to Johnson say Republicans cannot insist on letting subsidies simply disappear. Many represent districts with high concentrations of constituents who rely on the ACA-created Insurance Marketplace and on federal subsidies for coverage, the assistance that will expire at the end of 2025 absent congressional action.

“Millions of Americans are facing drastic premium increases due to short-sighted Democratic Policymaking. While we did not create this crisis, we now have both the responsibility and the opportunity to address it,” the letter reads.

“Allowing these tax credits to lapse without a clear path forward would risk real harm to those we represent. Nevertheless, we must chart a conservative path that protects working families in our districts across the country who rely on these credits.”

A Kaiser Family Foundation study shows the expiration could impact constituents in Giménez’s district significantly.

Giménez, whose district includes parts of Miami-Dade and all of Monroe counties, represents the congressional district with the fifth-highest number of ACA enrollees in the country. The 344,000 Marketplace enrollees there make up 32% of his district, and 241,000 of those take advantage of the Advanced Premium Tax Credit.

The letter echoes comments Giménez made to Florida Politics last week, when he said Congress should extend the credits temporarily.

“I have cosponsored a bill to extend the subsidies for a year. It’s interesting that it was the Democrats who put the expiration date when they passed the original bill,” the Miami-Dade Republican said. “A number of Republicans want to extend the subsidy. We need the Democrats to open so we can fix the mess they created.”

Giménez isn’t listed as a target of the Democratic Congressional Campaign Committee this election cycle, but he has been one before. He won election to the House in 2020 after unseating Democratic U.S. Rep. Debbie Mucarsel-Powell.

The lawmakers sending the letter say an extension should be taken up quickly, but notably, the message doesn’t express an unending commitment to the ACA. Rather, it calls for Congress to explore health care reforms.

“Let us be clear: significant reforms are needed to make these credits more fiscally responsible and ensure they are going to the Americans who need them most. Our Conference and President (Donald) Trump have been clear that we will not take healthcare away from families who depend on it. This is our opportunity to demonstrate that commitment through action,” the letter reads.

“We stand firmly behind you as you lead our Conference toward ending the government shutdown. Once the government is reopened, we are ready to work with you to advance healthcare solutions that protect families and lower costs.”