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Senate Set to Reject Dueling Health Bills as ACA Subsidy Cliff Nears

Failure in the Senate would leave days to avert steep premium hikes.

Overview

  • Senators plan Thursday votes on a Democratic three-year extension of enhanced Affordable Care Act tax credits and a Republican CassidyCrapo HSA proposal, with both measures expected to fall short of the 60 votes needed.
  • The enhanced marketplace credits expire on Dec. 31, threatening sharp cost increases and potential coverage losses for roughly 22–24 million enrollees if Congress does not act.
  • The Republican plan would let the enhanced credits lapse and deposit $1,000–$1,500 into health savings accounts for people buying bronze or catastrophic plans, with bans on using funds for abortion or gender-affirming care.
  • House Speaker Mike Johnson says the House will not bring a clean extension to the floor as moderates push short-term bipartisan extensions and consider discharge petitions to force a vote.
  • Independent analyses warn of average premium hikes above 100%, millions likely losing coverage, and a surge in uncompensated care if the enhanced subsidies are allowed to lapse.