Obamacare subsidies used by more than 20 million expired Thursday. Now Democrats are ready to make them a centerpiece of their midterm campaigns.

The lapse of enhanced premium tax credits, first passed as a pandemic-era relief measure under President Joe Biden in 2021, will immediately hit the pocketbooks of voters — some of whom will see their monthly insurance premiums rise by hundreds of dollars.

Efforts to extend them in some fashion continue on Capitol Hill, but Democratic lawmakers and strategists are already moving to turn the expiration of the subsidies into a potent election-year attack on congressional Republicans. They note that unlike other Democratic messaging targets — such as recent GOP Medicaid cuts that won’t kick in until after midterm ballots are cast — the lost tax credits are already tangible proof of what’s at stake on Election Day.

“The public now gets that the subsidies are what’s keeping health care costs down,” said Rep. Ami Bera (D-Calif.). “I think the public’s angry. So I think they will blame the party in charge.”

The strategy has been months in the making. Mindful of how the GOP’s efforts to rein in Obamacare powered their massive gains in the 2018 midterms, top party leaders decided in September to make health care the focus of the government funding fight.

That posture led to a record 43-day shutdown, and while some Senate Democrats ultimately agreed to reopen the government without securing an extension of the tax credits, many in the party are increasingly confident they succeeded in putting the issue into focus ahead of the election year.

They also believe it will play into a broader messaging push around affordability — attacking President Donald Trump and congressional Republicans for their failure to address rising costs, of which insurance premiums are just one conspicuous challenge facing Republicans.

“It’s part of the top issue, which is cost of living — whether it’s groceries, gas, housing, energy costs,” said Rep. Chris Deluzio (D-Pa.). “Health care seems to be top of mind as something that Congress can actually do to bring down the costs.”

A KFF poll released in December found that large majorities of enrollees in Obamacare marketplace plans want the subsidies to continue, regardless of party. About three-quarters of that group said they would blame Trump or Republicans in Congress if the subsidies were to lapse.

Republicans have encountered difficulties forming a coherent counterattack. Trump has questioned whether affordability is even a problem, calling the focus on living costs a “hoax” perpetrated by Democrats and the media. He has instead focused on robust economic growth as a measure of his administration’s success.

On Capitol Hill, top GOP leaders have criticized the expiring subsidies as wasteful — subsidizing some high-income households and susceptible to fraud — but they have not coalesced around a plan to offer relief to the millions of Americans who buy insurance on Obamacare marketplaces. A package of health care measures passed by the House last month on a party-line vote included some conservative proposals to deregulate insurance markets, but they would have little immediate effect before the midterms.

Instead, Republicans are preparing to run on last year’s megabill, which included tax cuts and other provisions that will start kicking in this year. This, they believe, will help them hold onto their congressional majorities.

“House Republicans delivered historic tax relief for working families and are building on it in the new year,” said NRCC spokesperson Mike Marinella. “Democrats spent the year blocking commonsense solutions [for the subsidies] and are now having a temper tantrum over a policy cliff of their own making. Their inability to find a consistent message that sticks proves how out of touch they are with the American people.”

Democrats’ party campaign arm is already geared up to push a health-care focused message for the next 10 months. Its leaders have laid out why they believe it’s a key issue heading into the midterms and have already run ads and rented billboards highlighting the GOP’s opposition to continuing the subsidies.

“Make no mistake, the blame behind the skyrocketing health care costs millions are facing today is squarely at the feet of House Republicans, and the American people know it,” DCCC Chair Suzan DelBene (D-Wash.) said in a statement. “Instead of putting forth a serious proposal to address spiking health care costs, House Republicans chose to focus on delivering massive tax breaks for the wealthiest few — never even allowing a floor vote to save the tax credits before their expiration.”

It is true no vote took place before the expiration, but jitters about an electoral backlash prompted a handful of House Republicans to take the rare step last month of circumventing GOP leadership and signing onto an effort backed by House Minority Leader Hakeem Jeffries to force a floor vote on a three-year extension of the expired subsidies.

That vote is now expected to take place in the coming weeks, though Senate Majority Leader John Thune said he has no intention of holding a vote in his own chamber, and even Senate Minority Leader Chuck Schumer has played down the prospects of a bipartisan extension.

“Once Jan. 1 comes and everyone is locked into their insurance proposals, you can’t put the toothpaste back in the tube,” he said last month.

The purple-district Republicans said they intend to keep trying, and they are coordinating with a bipartisan group of senators that is trying to strike a late compromise to save the subsidies. But Democrats believe it is too little, too late — even as they say it is a telling move.

For the vulnerable Republicans “to come on at the 11th hour shows they get it,” said Rep. Madeleine Dean (D-Pa.). “Their constituents are going to be mighty mad, and they’re feeling it already.”