A health care proposal circulated by the White House in recent days is running into the reality of Republican divisions on the issue — a familiar struggle for a party that has been trying to scrap or overhaul the Affordable Care Act for the past 15 years.

The tentative proposal from President Donald Trump would extend expiring ACA subsidies for two years while adjusting eligibility requirements for recipients. The plan has so far been met with a stony silence on Capitol Hill as Republicans debate among themselves whether to overhaul the law, tweak it or simply let the subsidies expire.

It’s unclear now when the White House plan might be released, or if it will be released at all.

The Republican indecision comes as the COVID-era tax credits are set to expire Jan. 1, creating sharp premium increases for millions of Americans. Democrats who shut down the government for six weeks over the issue are demanding a straight extension with no changes, though some indicated they could support a plan similar to the one circulated by the White House.

But support may be harder to find in the GOP conference, where many lawmakers say costs are still too high and have been eager to make another run at repealing the ACA. The last effort in 2017 failed when Republicans couldn’t decide on how to provide coverage to millions of Americans who depend on government-run marketplaces for their health care. It’s a dilemma that persists for the party after record numbers signed up for coverage this year.

Senate Majority Leader John Thune, R-S.D., promised a group of moderate Democrats a vote on........

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