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Senate Sets Thursday Votes on Dueling ACA Plans as Subsidy Expiration Looms

Both measures lack the 60 votes required, leaving millions at risk of steep premium increases when enhanced tax credits lapse on Dec. 31.

Overview

  • Democrats will force a vote on a clean three-year extension of the enhanced Affordable Care Act premium tax credits to keep marketplace premiums from rising.
  • Republicans have coalesced around the Crapo–Cassidy plan to let subsidies end and deposit $1,000 for adults under 50 and $1,500 for ages 50–64 into health savings accounts tied to bronze or catastrophic plans, with restrictions on abortion and gender transition care.
  • Senate leaders in both parties say neither bill is expected to clear the 60‑vote threshold, and House Democrats are pursuing a discharge petition as House Republicans debate alternatives.
  • President Donald Trump backs directing funds to individuals rather than insurers, while GOP sponsors cite fraud concerns and high-income eligibility; health policy experts warn the HSA approach would leave lower-income and sicker enrollees exposed to higher costs.
  • Nonpartisan analyses project that without action, premiums for more than 20 million ACA enrollees could roughly double starting in January, intensifying pressure on swing‑state Republicans exploring shorter, capped extensions.