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Trump Demands Direct Payments Over ACA Subsidy Extension Ahead of Senate Vote

Expert warnings of premium spikes and coverage losses heighten the stakes for the December Senate vote.

Overview

  • The Senate is set to vote by mid-December on whether to revive enhanced Affordable Care Act premium tax credits that expire on December 31.
  • President Trump, in an all-caps Truth Social post Tuesday, said he will only back a plan that sends money directly to people rather than to insurance companies.
  • Republicans remain split, with some moderates pushing a short extension of the enhanced credits and others drafting alternatives that route funds into HSA- or flexible-account models.
  • Analyses from KFF and the Congressional Budget Office project large premium increases on average and roughly 2 million fewer insured if the enhanced credits lapse, and experts warn shifting funds to consumers could destabilize ACA markets.
  • Democrats press for an extension or a broader package, with Sen. Bernie Sanders urging expansive reforms, while Rep. Becca Balint and other lawmakers say a bipartisan deal before the December vote is unlikely.