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Trump Rejects ACA Subsidy Extension as GOP Splits Over HSA-Style Alternatives

The president’s stance leaves Republicans divided between short extensions and consumer accounts ahead of a mid-December Senate vote.

Overview

  • Enhanced Affordable Care Act premium credits expire Dec. 31, risking steep premium hikes for roughly 22 million people, with KFF and CBO warning of higher costs and fewer insured.
  • Trump declared he will only back sending assistance directly to individuals rather than insurers, a position GOP leaders echoed as they draft HSA- or FSA-based proposals.
  • Republican senators Bill Cassidy and Rick Scott are developing plans to route funds into consumer-controlled accounts, changes that would require new law and run up against current HSA rules.
  • Moderate Republicans, including Reps. Jen Kiggans and Don Bacon, are pressing for short-term extensions, but party leaders say a clean renewal will not reach the House floor.
  • Senate leaders pledged a mid-December vote, the Finance Committee holds a hearing Wednesday, and analysts warn that redirecting funds could destabilize ACA markets while procedural hurdles limit fast action.