As part of the deal to reopen the government last month, Senate Republicans agreed to a vote on extending the Affordable Care Act (ACA) health care subsidies set to expire at the end of the year.
But they did not promise to vote in favor of extension, and many Republicans remain opposed to the subsidies for a variety of reasons. Some claim that propping up ACA with subsidies is undesirable and that ACA has failed to substantially reduce healthcare costs, while others insist that any new language must prevent ACA funds from going to healthcare programs that fund abortions.
At issue is a legislative proposal from Sen. Chuck Shumer (D-NY), which extends the subsidies for three years and which he expects every Senate Democrat to support. But Democrats would need 13 additional votes to overcome the Senate filibuster and pass the legislation.
An alternative proposal from Sen. Roger Marshall (R-LA), nicknamed the “Marshall Plan,” was introduced Monday. This plan would only extend subsidies for one year in favor of a transition to health savings accounts, an idea supported by President Donald Trump and other Republicans. In the House, Speaker Mike Johnson (R-LA) is expected to introduce healthcare legislation which will focus on alternatives to the subsidies. Proposals from Sen. Rick Scott (R-FL) and Rep. Brian Fitzpatrick (R-PA) are also in the works.
Regardless of the outcome of the Senate vote, Republicans face immense pressure to address healthcare affordability. Political strategists believe it will be major sticking point in the 2026 midterms.
With so many competing alternatives in play and the Senate Democrats’ plan unlikely to pass, it seems the debate over healthcare affordability will continue into the new year. Those enrolled in ACA healthcare plans may see a spike in costs beginning in January.
IEC Government Affairs staff will continue to monitor legislative progress on a healthcare deal. If IEC members or their employees experience increased healthcare costs for themselves or their employees, please share this information with national staff so we can urge congressional action in line with IEC’s interests and objectives.