Overview
- The Senate will vote Thursday on Democrats’ clean three-year extension of enhanced Affordable Care Act tax credits, a measure expected to fall short of the 60 votes needed in the GOP-led chamber.
- Republicans have not coalesced around an alternative, and President Trump has endorsed directing funds into health savings accounts without offering detailed operational guidance.
- House Speaker Mike Johnson says he will bring a health care proposal to the floor by year’s end but has not specified which plan, as a bipartisan group pushes “CommonGround 2025” for a one-year extension with income caps and anti-fraud provisions and seeks votes by Dec. 18.
- Swing-district Republicans are urging short-term extensions to avoid voter backlash, while conservative demands including new abortion restrictions have further complicated negotiations.
- KFF estimates average annual premiums would rise 114% from $888 in 2025 to $1,904 in 2026 if the enhancements lapse, CBO projects millions more uninsured over time, and academic researchers warn HSA-based or high-deductible alternatives could worsen health outcomes.