Overview
- Congress left for the holiday break without action, with a Senate vote on health legislation promised for mid-December and no guaranteed House vote.
- Trump declared he will not accept retaining the current subsidy structure and told Republicans to deliver solutions by Jan. 30 that send funds directly to individuals.
- Republican proposals center on HSA-style or prepaid accounts championed by Sen. Bill Cassidy and newly introduced by Sen. Rick Scott, while moderates float short extensions with guardrails.
- Marketplace officials and policy experts say such overhauls cannot be built in time for Jan. 1, warning that a clean extension is the only practical step to avert immediate disruption.
- If the enhancements lapse, analyses project sharp premium hikes for roughly 22–24 million ACA enrollees and potentially millions more uninsured, a dynamic both parties see as a 2026 campaign flashpoint.