Overview
- Trump again demanded Congress send subsidy dollars directly to individuals rather than insurers, a position he has framed as checks to consumers in recent posts on Truth Social.
- Senate leaders pledged a mid-December vote on the expiring enhanced premium tax credits, but key lawmakers in both parties say the compressed timeline makes a bipartisan deal unlikely.
- Republicans are split between a short extension with changes and redesigns that move funds into consumer accounts, with proposals circulating for HSA- or FSA-style options from Sens. Rick Scott and Bill Cassidy.
- Policy experts warn that shifting subsidies to consumers or letting the enhanced credits lapse could pull healthier people from ACA plans, fuel steep premium increases, and reduce coverage, with KFF and CBO projecting sharp hikes and millions fewer insured.
- GOP negotiators are pressing for a crackdown on alleged marketplace fraud, citing figures as high as $27 billion a year, even as Democrats push for a clean extension and House moderates seek near-term relief.