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ACA Subsidy Cliff Nears as Senate Sets December Vote and GOP Divisions Complicate Path

Nonpartisan analyses project sharp premium increases with coverage losses if the enhanced tax credits lapse on December 31.

Overview

  • Lawmakers return Dec. 1 with less than three weeks to act, and the Senate has pledged a mid‑December vote on an extension while House prospects remain uncertain.
  • President Donald Trump says he would rather not extend the subsidies but acknowledges some short‑term extension may be necessary, as Speaker Mike Johnson signals broad GOP resistance to a straight renewal.
  • Several Republicans insist any deal include new abortion‑related restrictions, drawing firm Democratic opposition and adding a major hurdle to passage.
  • The Congressional Budget Office estimates roughly 2 million more uninsured if the credits expire, while KFF finds premiums for a 60‑year‑old at 401% of poverty would at least double in 46 states and triple in 19, with the largest dollar hikes in Wyoming, West Virginia and Alaska.
  • Republicans promote alternatives such as directing funds to HSAs/FSAs and advancing price‑transparency legislation like the bipartisan Patients Deserve Price Tags Act, as consumers face open enrollment choices amid insurer notices of potential premium spikes.