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2d ago

Senate Rejects Both ACA Subsidy Extension and GOP HSA Plan as Year-End Deadline Nears

The 60-vote barrier in the Senate plus House GOP resistance leaves an eleventh-hour rescue unlikely, raising the prospect of steep premium spikes starting Jan. 1.

Senate Minority Leader Chuck Schumer, of N.Y., right, speaks as Sen. Chris Murphy, D-Ct., left, listens during a news conference on health insurance premiums on Capitol Hill, Wednesday, Dec. 10, 2025, in Washington. (AP Photo/Mariam Zuhaib)
Speaker of the House Mike Johnson discusses affordability at a press conference on Wednesday, at the US Capitol in Washington, DC. The Republican leaders discussed healthcare plans with a vote regarding an extension of the ACA subsidies looming.
FILE - Pages from the U.S. Affordable Care Act health insurance website healthcare.gov are seen on a computer screen in New York, Aug. 19, 2025. (AP Photo/Patrick Sison, File)
Rep. Brian Fitzpatrick, R-Pa., speaks at a news conference, Jan. 31, 2023, on Capitol Hill in Washington.

Overview

  • Both measures failed to clear 60 votes: a Democratic three-year extension fell 51–48 with four Republicans in support, and the Republican Crapo–Cassidy alternative failed 51–48 with Sen. Rand Paul voting no.
  • The GOP plan would replace enhanced ACA credits with $1,000–$1,500 annual HSA deposits for people under 700% of the federal poverty level, limited to bronze and catastrophic plans, barred for abortion or gender-affirming care, and not usable for premiums.
  • Enhanced ACA tax credits are set to lapse Dec. 31, and KFF estimates premiums could more than double on average, with modeling warning that millions could lose coverage if subsidies expire.
  • House Speaker Mike Johnson opposes a clean extension as Republicans draft their own package with no consensus, while moderates pursue discharge petitions to force votes on temporary extensions.
  • President Donald Trump said he likes the concept of the Crapo–Cassidy approach, as Democrats argue there is no time to implement alternatives and push for a clean extension to avert January price hikes.