The path forward on the enhanced Affordable Care Act (ACA) subsidies remains uncertain, despite the fast-approaching Jan. 1 expiration date. Democrats continue to push for a clean three-year extension, a position that is a nonstarter for congressional Republicans. Senate Republicans now have a bill drafted by Senate Committee on Finance Chair Mike Crapo (R-Idaho) and Senate Committee on Health, Education, Labor, and Pensions Chair Bill Cassidy (R-La.) that would offer people in some ACA plans up to $1,500 each of the next two years in tax-advantaged health savings accounts; the bill would also fund cost-sharing reduction payments. It contains restrictions around immigration, abortion, and gender transition services that could make bipartisan support challenging. There will be a vote on both the Democrat and Republican proposals in the Senate on Thursday.
In the House, Speaker Mike Johnson (R-La.) is developing a House health care package that could serve as a counterproposal but has expanded into several tangential issues. Out today is a House proposal led by Reps. Brian Fitzpatrick (R-Pa.), Jared Golden (D-Maine), Don Bacon (R-Neb.), Tom Suozzi (D-N.Y.), Rob Bresnahan (R-Pa.), and Don Davis (D-N.C.) to extend the expiring credits for two years with a handful of reforms.
Our team is closely monitoring emerging proposals and actively advocating on behalf of our hospitals on any associated issues.
Last Week on The Hill
Last week, the Senate Committee on Health, Education, Labor, and Pensions held a hearing on health care affordability. Committee Republicans emphasized that the ACA exchange structure is driving premiums higher while providing worse coverage, with several members arguing that enhanced premium tax credits (EPTCs) mask the true cost of premiums by routing taxpayer dollars directly to insurers; many members stressed the need for short-term action before Jan. 1 while simultaneously advancing long-term reforms to address underlying cost drivers. Committee Democrats consistently argued that letting EPTCs expire would cause immediate, severe premium spikes and push millions to be uninsured; many members highlighted that the One Big Beautiful Bill Act (OBBBA) already worsened affordability by cutting Medicaid and diverting resources away from coverage.
Committee Activity This Week
The Senate and House are in session Tuesday through Friday this week; the Senate also convened on Monday.
The Senate Committee on Health, Education, Labor, and Pensions will hold a full committee hearing on Thursday, Dec. 11, at 10 am ET, titled, “Examining the Future of the U.S. Organ Procurement and Transplantation Network.”
The House Committee on Energy and Commerce will hold a full committee member day hearing on Friday, Dec. 12, at 9 am ET.
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