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White House Circulates Draft to Extend ACA Subsidies for Two Years With Income Cap and Minimum Premiums

KFF and the CBO warn that letting the subsidies expire would double premiums, increasing the number of uninsured.

Overview

  • The evolving draft would cap eligibility at 700% of the federal poverty level and end zero-premium plans by requiring all enrollees to pay at least a small premium, such as 2% of income or $5 a month.
  • The framework explores allowing some assistance to flow directly to consumers through Health Savings Accounts or direct payments, with related proposals from Sens. Rick Scott and Bill Cassidy.
  • The White House says no plan is final until President Trump announces it, though aides say he is closely engaged in the talks.
  • Senate Republicans have agreed to hold a mid-December vote on an extension as part of government funding negotiations.
  • KFF projects consumer premiums would more than double next year without action, and the Congressional Budget Office estimates about 2 million more people would be uninsured in 2026 if the subsidies lapse.