House Speaker Mike Johnson is facing a fresh round of criticism from within his own party after declining to share details of Republicans’ long-promised health care proposal—an omission he attributed to fears that colleagues would leak the plan to the press. The rationale, delivered in a Fox News interview, immediately touched off a storm of backlash, including from Rep. Marjorie Taylor Greene (R-Ga.), who has publicly pressed Johnson to present a concrete blueprint as negotiations continue over government funding and the future of Affordable Care Act (ACA) subsidies.

Pressed by the host to respond to Greene’s complaint that the speaker has discussed “ideas” without providing a single actionable policy proposal to his conference, Johnson argued that the secrecy is strategic. “Obviously, we’re not going to be on a conference call explaining all of our plans and strategies for health care reform because they’re leaked in real time,” he said, adding that journalists often tweet details from GOP conference calls “literally” as they happen. “They’re supposed to be private, but they’re not. And so Marjorie knows that.”

Greene, who has increasingly used her platform to demand more aggressive action from House leadership, has framed Johnson’s caution as evidence that there is no substantive Republican replacement ready to address rising costs and coverage instability. “Where is the Republican plan?” she asked recently, noting that committees of jurisdiction may be “working on it,” but rank-and-file members have yet to see even a single concrete proposal. Her critique taps into a decade-long vulnerability for the GOP: after campaigning for years on repealing and replacing the ACA, the party has struggled to coalesce around a unified alternative that preserves popular protections while promising lower costs.

Johnson pushed back on the accusation that Republicans are empty-handed. He pointed to his tenure chairing the Republican Study Committee (RSC), the conference’s largest caucus, noting that the group “published 60 or 70 pages of health care reform ideas in 2019.” He also emphasized that any comprehensive plan would be the product of committees and policy specialists working “around the clock.” For Greene or any member seeking specifics, Johnson said his door is open: “She knows she can come into my office any day at any hour and I’ll lay out everything for her.”

Yet the speaker’s reliance on a 2019 policy compendium—a pre-pandemic document produced before the recent inflation spike, Medicaid continuous coverage unwinding, and persistent workforce shortages—has only fueled critics who say Republicans have not meaningfully updated their approach in years. Skeptics argue that if the party had a near-final framework, leadership would be able to share at least its broad contours without jeopardizing negotiations.

Democrats, meanwhile, have seized on the intraparty rift to underscore their contention that Republicans are engineering a new health care crisis by refusing to extend ACA premium subsidies that have helped hold down costs for millions of Americans. The dispute has become entangled with the broader government funding fight, raising the stakes for families who could see premiums climb if enhanced subsidies lapse—and for providers bracing for renewed coverage churn.

Policy analysts note that crafting a comprehensive replacement for the ACA is inherently difficult. Any plan that seeks to lower premiums across the board must grapple with trade-offs: how to structure tax credits, whether to preserve essential health benefits, how to handle protections for preexisting conditions, and how to balance deregulation with consumer safeguards. Republicans have floated a patchwork of ideas over the years—expanding health savings accounts, allowing insurance sales across state lines, promoting association health plans, block-granting Medicaid, and rolling back certain ACA coverage mandates—but have not rallied behind a singular model that could pass both chambers and earn a presidential signature.

Inside the House, the political calculus is equally complicated. With a narrow majority and diverse ideological blocs, leadership must manage members who want a sweeping deregulatory overhaul alongside others from swing districts where ACA benefits are popular. Leak fears—real or perceived—are hardly new in Washington, but using them as the chief reason to withhold a plan has invited accusations of evasion. “You can outline principles without spilling tactical details,” one GOP aide, speaking on background to avoid inflaming tensions, said of the uproar. “The conference needs clarity on the destination, not necessarily the route.”

For Greene and conservative media allies, Johnson’s posture has become a proxy for broader frustrations: they see a leadership structure that promises action yet remains reluctant to take combustible votes. For Democrats and progressive advocates, the episode offers a vivid contrast heading into an election year: the White House and its allies will tout a record of expanded coverage and capped out-of-pocket drug costs, while casting Republicans as unable—or unwilling—to reveal what would replace those policies.

The human stakes are not abstract. Families who rely on ACA marketplace plans, small-business owners who purchase coverage for employees, and rural hospitals operating on thin margins all have a direct interest in whether subsidies are extended and what rules will govern plan designs next year. Insurers, for their part, need predictability months in advance to set rates, benefits, and networks. Prolonged ambiguity from Congress can translate quickly into higher premiums or skinnier options on the exchanges.

Johnson’s allies insist the speaker is trying to protect fragile negotiations from being derailed by social-media skirmishes and selective leaks that misrepresent proposals before they’re fully baked. But critics counter that transparency—at least at the level of clear policy pillars—is indispensable if Republicans expect to be taken seriously as the stewards of a post-ACA system. They argue that a party confident in its plan would welcome debate, not muzzle it.

Whether the House ultimately produces a unified Republican health care proposal may hinge less on leaks and more on the core substance: how to cut costs without cutting coverage, how to spur competition without inviting junk plans back into the market, and how to contain federal spending without shifting pain to patients. Until leadership articulates those choices in public, the political narrative is likely to remain where Greene has placed it—on the absence of a plan, not the details within it. And for millions watching their premiums, deductibles, and drug prices drift upward, patience for a secret strategy may be in even shorter supply than time.