Lawmakers on Capitol Hill are expected to vote Thursday on competing health care proposals as Affordable Care Act (ACA) subsidies near expiration at year’s end.
Without action from Congress, millions of Americans could face a roughly 26% spike in health care costs. Democrats are unified behind a plan to extend those subsidies for three years, while GOP lawmakers plan to bring a counter-proposal to the floor.
Senate Majority Leader John Thune said that Senators will vote on a proposal from Republican Sens. Bill Cassidy and Mike Crapo, while blasting Democrats’ ACA-subsidy vote as “extending the status quo."
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"Democrats' great scheme to fix health care — Obamacare — has failed," Thune said on Monday. "... They proposed a clean, three-year extension of the enhanced Obamacare subsidies. Clean, Mr. President. No reforms, no revisions."
The GOP-led "Health Care Freedom for Patients Act" proposes sending money directly to patients rather than insurance companies and lowering insurance premiums and health care costs. It also seeks to expand Health Savings Account (HSA) eligibility, which is intended to help Americans cover out-of-pocket costs.
However, one part of the proposal that is likely to draw criticism from Democratic lawmaker, is that it calls for ending taxpayer-funded abortion or transgender services. The Republican plan also calls for reducing Medicaid funding to states that provide health insurance coverage to migrants who are in the country illegally and requires states to verify citizenship or immigration status before providing Medicaid coverage.
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While 60 votes are required to pass the vast majority of legislation in the Senate, Sen. Cassidy believes he does have enough support from his colleagues to get this legislation across the finish line.
"There are some dances you can do by yourself, well passing a health care bill is not one of them," Cassidy said. "And so we've got to have [Democrats] willing to do something different. And giving all the money to the insurance plans and leaving the consumer with a policy which has a $6,000 deductible — that does not work for families."
The ACA subsidies, currently in place, are set to expire Dec. 31. Democratic leaders believe every member of their caucus will vote for the extension Thursday.
Up to this point, the lack of Republican consensus on health care has lingered, posing a political challenge as the 2026 midterm elections approach and swing district Republicans brace for possible political fallout if those ACA tax subsidies expire.
