Overview
- Enhanced Affordable Care Act premium aid expires Dec. 31, 2025, exposing roughly 22 million people to sharp increases, with KFF estimating average premium jumps and the CBO projecting coverage losses if Congress fails to act.
- President Donald Trump declared he will oppose a clean extension and will only back sending assistance directly to people rather than to insurers to lower premiums.
- Senate Republicans, including Bill Cassidy and Rick Scott, are drafting consumer‑directed proposals that route funds into HSAs or FSAs or provide direct payments, though details and viability remain uncertain.
- House GOP leaders signaled they will not bring a clean extension to the floor, while moderates in competitive districts push one‑ or two‑year stopgaps and bipartisan tweaks to prevent immediate premium spikes.
- A mid‑December Senate vote is pledged, the Senate Finance Committee holds a hearing Wednesday, and procedural hurdles—60‑vote requirements, reconciliation limits, and insurers’ finalized 2026 rates—complicate a near‑term deal.