Democratic Leader Hakeem Jeffries, who led his party’s effort to push the health care issue forward, particularly challenged Republicans in competitive congressional districts to join if they really wanted to prevent steep premium increases for their constituents. Before Wednesday’s vote, he called on colleagues to “address the health care crisis in this country and make sure that tens of millions of people have the ability to go see a doctor when they need one.”

Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan Mackenzie, all from Pennsylvania, and Lawler signed the Democrats’ petition, pushing it to the magic number of 218 needed to force a House vote. All four represent key swing districts whose races will help determine which party takes charge of the House next year.

Johnson, R-La., had discussed allowing more politically vulnerable GOP lawmakers a chance to vote on bills that would temporarily extend the subsidies while also adding changes such as income caps for beneficiaries. But after days of discussions, the leadership sided with the more conservative wing of the party’s conference, which has assailed the subsidies as propping up a failed program.

Lawmakers turn to discharge petitions to show support for an action and potentially force a vote on the House floor, but they are rarely successful. This session of Congress has proven an exception.

A vote requiring the Department of Justice to release the Jeffrey Epstein files, for instance, occurred after Reps. Ro Khanna, D-Calif., and Thomas Massie, R-Ky., introduced a petition on the Epstein Files Transparency Act. The signature effort was backed by all House Democrats and four Republicans.