Republicans unveil health care plan to counter Democratic effort to extend ACA subsidies - ABC News
S E E D E D C O N T E N T
With the deadline to address expiring enhanced Affordable Care Act tax credits fast approaching, Senate Majority Leader John Thune announced Tuesday that two competing plans -- one led by Democrats and the other by Republicans -- will get votes on the Senate floor on Thursday.
But neither bill is expected to have the support it needs to advance, leaving in the balance tens of millions of Americans who could see their health care costs soar at the start of the new year.
The Republican plan
Thune's announcement on Tuesday marked the first time Senate Republicans appeared to coalesce around a single health care plan to respond to the anticipated price hikes Americans currently receiving ACA tax credits will face in 2026.
The proposal would do away with the enhanced tax credits, and instead take the extra money from those tax credits and put it into health savings accounts for those who purchase bronze-level or "catastrophic" plans on the ACA exchanges. Republicans say this will help Americans pay for out-of-pocket costs.
Under the plan, individuals earning less than 700% of the federal poverty level would receive $1,000 in HSA funding for those between age 18 and 49 and $1,500 for those age 50-64.
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The plan was first unveiled by Senate Health Committee Chairman Bill Cassidy and Senate Finance Committee Chairman Mike Crapo on Monday.
The senators say it would lower 2027 premiums by 11% by funding cost-sharing reductions and would empower Americans to choose the insurance plan that "fits their needs." The proposal also requires states to verify citizenship and immigration status before coverage to avert "illegal immigrants" from accessing Medicaid. In addition, the proposal would prevent the use of the funds for abortions and gender affirming care.
Thune said the plan represents an effort to reform the ACA and address GOP concerns that the enhanced tax credits have caused insurance premiums to rise. It also, they say, gives money directly to patients, as President Donald Trump said he wants to see happen.
How Affordable Care Act subsidies became a sticking point in the government shutdown
"This is a failed program, and it does nothing but drive premiums up," Thune said of the expanded tax credits that Democrats want to keep in place. "And the increase in premiums, who is that going to? That's going to the insurance companies."
Thune added, "So the proposal that we will put out there will bring insurance premiums down, it will be fiscally responsible, and it will get us away from the practice of giving the money all to the insurance companies and put it back in the hands of the patients."
This plan emerged as the most popular choice for Republicans among a crowded field of GOP health care proposals that have cropped up in recent weeks. Thune said he believes the majority of his conference backs it.
"What I can tell you is as a conference, our members -- and I can't say 100%, but I think for the most part -- are united behind the Crapo-Cassidy proposal which as I said, in terms of its emphasis, is about patients, not insurance companies, and about lowering premiums, not increasing them, and about getting a better return for the federal tax payer," Thune said.
The Democratic plan
The Democratic-led bill would extend the expiring ACA tax credits for three years.
The upcoming vote, which has been weeks in the making, is being granted to Democrats as part of a deal that was struck in November to end the record 43-day government shutdown.
Democrats won no tangible health care concessions as part of the deal to fund the government. But they were promised a vote on a health care bill of their choosing, and they selected this 3-year extension.
Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries meet with reporters about health care affordability, at the Capitol in Washington, Dec. 3, 2025.J. Scott Applewhite/AP
"Democrats have put forward the cleanest, fastest, most realistic solution: a three-year extension of the current tax credits. No gimmicks, no poison pills," Senate Minority Leader Chuck Schumer, the Senate's top Democrat, said on the floor.
Schumer's strategy aligns with Leader Hakeem Jeffries' proposal in the House, where Democrats have filed a discharge petition to force a vote on extending the tax credits for three years. The petition has received 214 signatures, just four shy of triggering a vote in the lower chamber. So far, no Republicans have signed on to the effort.
Will either plan pass the Senate?
Both of these bills are all but certain to fail to get the 60 votes they need to advance in the Senate on Thursday.
Thune has repeatedly criticized the Democratic plan for its failure to implement reforms to the ACA.
"There is no income limit, there are $0 premiums. There are millions of Americans who don't even know they have coverage, they have decided not to do anything -- zero, zero reforms to this program, and so the bill that they are going to put on the floor will fail," Thune said.
Schumer, meanwhile, dismissed the "phony" Republican plan as "dead on arrival."
"Their bill is junk insurance. It's been repudiated in the past. The American people will repudiate it once again because it is junk insurance that puts the burden on people," Schumer said.
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So, there are two plans:
One is to keep throwing money into the money pit ironically called the Affordable Care Act.
The other is an alternative which cuts out insurance companies.
is this the "better and cheaper" healthcare plan that trump promised to unveil in 2 weeks, 10 years ago?
does it cover the cost of MRI's for traitorous child molesters that are rapidly declining into dementia?
/s
The real question is how many MRIs can you get with your $1000 HSA plan?
It is different than what I propose, which is that we go back to private insurance like Blue Cross and teaching our children to think about getting insurance.
The other is an alternative which gives Americans next to nothing and sets them up to go bankrupt if they actually have a health emergency.
An HSA is just an account you can use to pay health insurance that the money YOU put in isn't taxed, so people save 20-30% of their own earned money, which is great to pay for basic annual health needs BUT IT ISN'T INSURANCE! It's YOUR money that you have to pay OUT OF POCKET for health needs. And it's capped so you can't contribute more than $4300 for an individual. Oh yeah, $4300 is going to get you real far when you get diagnosed with cancer. And the bronze catastrophic plans are going to be as expensive if not more expensive than the plan they have now but cover a LOT less since Republicans are stripping the subsidies that have allowed low- and middle-income Americans to afford health insurance.
What laughable horse shit. When they say "empower Americans to choose the insurance plan that "fits their needs." what they mean is that they'll have shit plans for cheap that Americans can choose that might fit their budget but when they actually have to use them they'll realize how deficient the plans really are.
By the way, that supposed "money pit" is the American people's health, our children's health, our grandparent's health, wellbeing and quality of life that we should view as a reasonable and rational expense. But of course, we can't have everyone in one big national pool, that would mean that the white rightwing conservatives would have to pay into a pool that helps blacks, gays and other minorities which is the last thing most of those bigots want to do which is of course why they fight tooth and nail against socialized health care.
Then why were people so better off without national health care?
Here is what the country was saddled with when Barack Obama took a super majority and forced it to pass the ACA:
The Affordable Care Act ( ACA 1 ) was jammed through Congress in 2010 with several enticing promises. Fourteen years later, we look back at the very different real-world results:
This report provides details on these and eight other broken promises regarding life expectancy, emergency room usage, enrollment of unauthorized immigrants, and more.
The Falsehoods of Obamacare: A Dozen Broken Promises, Seven Million Canceled Plans, and Hundreds of Billion in Debt
We were better off without any alternative!
Should we have a national health care system that
a) prevents insurance companies denying coverage based on pre-existing medical conditions
and
b) prevents medical bill bankruptcies
?
please confine your reply to these two topics.
I agree it’s a money pit because while it was a good try at lowering costs by spreading risk, it didn’t do anything to make the system more efficient, lower costs, or even keep them from rising.
There’s nothing wrong, in principle, with having insurance companies, but they need to work for the people, not shareholders. I believe we should have a national system that pays for basic care from cradle to grave, and you never even have to apply for it. You just get it by virtue of being here. That would still allow for supplement insurance to exist, but there needs to be controls on the whole apparatus.
Health care should work something like the mail or the roads. Everyone gets the US Postal Service at no cost, but if you want to splurge for UPS or FedEx, you can. Our roads are similar. 99% of roads are available for everyone to use for free, but toll roads still exist. Yet even with these systems, paying the extra doesn’t require a major expenditure.
And doctors and clinics and pharmaceutical companies charge whatever they want knowing the government will pay? I think we are close to that.
That’s what we already have. And it doesn’t matter who the payer is - government or private insurance. As soon as you tell someone everything will be paid for, they will jack up the price, unless you also put in cost controls.
We discussed this in the office this morning where we are seeing customers with marketplace plans. Neither of these ideas will pass, neither of them addresses the issues Americans face and neither of them will lower the rising costs of healthcare. A pox on both their houses!!!
Thankful to be retired military and do not have to deal with this. Fully covered by TriCare For Life, Medicare A & B, and VA health care. Zero out of pocket except for almost nothing copay on monthly meds.
I have complete VA and pay co-pays for prescriptions, but this year (2026) I also opted into the company group plan. I don't know how that will work, but I'll try it once. It does come with an HSA so I'll add money for that to cover out of pocket dental costs and (I think) I have some gym membership benefit - things that VA doesn't cover.
We had a couple leave the office yesterday with one of those bronze plans off the marketplace with a premium of over $2K a month.
Morning Ed...and thankfully I live in a country where your life doesn't depend on the size of your bank balance...
Was just in ER Monday for a blood clot in my leg..ultra sound done $0 and tablet's for 45 days $7..
Gotta be happy with that..🐨
That's true. It is insane to have the government fund healthcare while letting health services set any kind of cost they want.
Ouch! Too rich for my blood.
In 2024 the healthcare lobby spent over $400M on both political parties.
Perhaps the only solution would be to enact Medicaid for everyone and use insurance companies to handle the billing. This at least has potential as reimbursement rates are set by the government using the ICD-10 codes and Medicaid profit is set to 1.5% by law. Insurance companies are already set up to handle the billing process and I doubt the government could set up a system itself to handle it. At a minimum it would take them many years and billions of dollars to get it up and running. And I think we all know how well government does at managing IT systems. Just look at the Air Traffic Control systems, cream of the crop 1970's technology.
Now for this to work (having witnessed this in action during the Covid pandemic) the reimbursement rates would need to be increased. We saw way too many smaller hospitals have to close their doors as the only money coming in was from Medicare/Medicaid which is too low by itself to allow hospitals to meet their bills. And we would need to raise taxes so that this program would be essentially revenue neutral.
Given the divide in the country, I doubt if this would ever happen however.
Why don’t you just to do something to get rid of the out-of-pocket costs?
HSAs sound like a TEA Party solution. How will throwing taxpayer money at different financial middlemen fix anything? Or are these TEA Party Republicans only trying to buy donors?
Democrats and Republicans are not offering any meaningful solutions. The problem is not and never has been the affordability of insurance. The rising costs of delivering medical care are putting the insurance companies in a bind now. So far the political solution seems to be kicking the can until the entire health system fails.
I'm thinking that prayer will probably be as useful as a maga healthcare plan for saving christo-fascist lives ...
Relying on prayer would leave the Godless liberal narcissists without any welfare support. Sounds like a plan.
Such a nice thing for a Christian to say
hypocritical thumpers walking around with at least one bible rammed up their ass sounds like a better plan...
Deluded grifters with a secular patriarchy rammed up their asses can't walk the talk, let alone plan anything.
trump and his administration ...
fred trump's fortune and estate stolen by his son ...
RNC and CPAC after party activities ...
not on trump's swollen cankles ...
project 2025 ...