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Senate Sets Dueling Votes on ACA Aid as Clock Runs Out

Failure to act before December 31 would end enhanced tax credits, triggering sharp premium hikes with widespread coverage losses.

Overview

  • Democrats force a floor vote on a clean three-year extension of enhanced ACA premium tax credits, a measure unlikely to clear the 60-vote threshold.
  • Republicans advance the Crapo–Cassidy plan to replace the expiring aid with direct HSA deposits of $1,000 for ages 18–49 and $1,500 for ages 50–64 tied to bronze or catastrophic plans, a proposal backed by President Trump.
  • Independent estimates say roughly 22 million subsidized enrollees face average premium increases near 114% with millions projected to lose coverage, with Covered California warning of steep county-level hikes and disproportionate impacts on Latino and Black enrollees.
  • A GAO undercover review found 23 of 24 fictitious applications approved for subsidized coverage, fueling GOP calls for program-integrity changes as House Republicans debate options that exclude an extension.
  • State and market officials caution that a lapse could raise costs beyond the exchanges, including small-business plans in states like Maine and broader premiums as uncompensated care grows.