Overview
- President Trump urged ending the enhanced Affordable Care Act premium tax credits and sending equivalent cash directly to individuals for health care.
- Republican negotiators Bill Cassidy and Roger Marshall propose keeping the original ACA credits but routing the extra pandemic‑era amounts into consumer health accounts, with differing views on rollover features.
- The White House describes its work on alternatives as an early ideation effort, and Republicans have not coalesced around a single plan.
- A shutdown deal guaranteed a December Senate vote on renewing the enhanced subsidies, heightening pressure as open enrollment proceeds and 2026 prices are set to take effect on January 1.
- Health‑policy experts warn that cash or non‑ACA purchases could destabilize marketplaces and raise costs, while conservative analysts advance options such as HRAs, HSAs, reinsurance, and short‑term plans.