Overview
- Following a Nov. 19 Senate Finance hearing, Republicans were largely united against a clean renewal of enhanced ACA premium tax credits, with only Sen. Thom Tillis signaling support for a temporary extension.
- President Donald Trump declared he would only back sending money directly to people rather than insurers, bolstering GOP proposals for Health Savings Accounts or direct payments championed by Sen. Bill Cassidy.
- Experts testified that state and federal exchanges would need months to reprogram systems for major policy shifts, arguing that a simple extension is the only workable option for 2026.
- Analysts warn that allowing the enhancements to lapse on Dec. 31 would drive substantial premium increases and leave an estimated 4 million more people uninsured.
- Lawmakers face a tight calendar with a promised mid-December vote and a Dec. 15 enrollment deadline, as employers also project a 6.7% per-employee cost increase in 2026, intensifying affordability pressures.