A Bold Question Looms Over ACA Costs as the Senate Takes Up Competing Health-Care Proposals
With Affordable Care Act subsidies set to lapse for millions at month’s end, the Senate is poised to vote on two health-care bills on Thursday. Yet both measures are widely expected to fail, preserving the status quo as the clock runs down on subsidies that many Americans rely on.
In a political bargain tied to reopening the government after the longest shutdown in U.S. history, Senate Republicans agreed to let Democrats bring a bill to the floor extending the subsidies. Democrats want a three-year extension, arguing that without it, health-care premiums could surge at the start of 2026.
Even though both sides acknowledge the need to curb health-care costs, the Democratic proposal lacks enough GOP support to pass. Republicans argue that extending subsidies would perpetuate what they call Obamacare waste, fraud, and abuse, while enriching insurance companies.
Senator Bill Cassidy, R-La., criticized the Democratic plan on the Senate floor, saying, “There is nothing in their bill that stops billions of dollars in fraudulent spending.”
On the other side, Cassidy and Sen. Mike Crapo, R-Idaho, have pitched a GOP alternative that would send up to $1,500 per year directly to health savings accounts for Americans earning less than 700 percent of the federal poverty level. The idea is to empower patients rather than fund insurers, they contend.
But the Cassidy-Crapo proposal doesn’t renew the ACA tax credits, and the money wouldn’t be usable for Premium payments. Deductibles in the relevant plans average about $7,000, according to data from the nonpartisan health-policy group KFF. Proponents emphasize that the approach puts money in patients’ hands and could reduce overall costs for taxpayers, but critics note gaps in coverage and affordability.
Democrats dismissed the GOP bill as insufficient, arguing it would fail to stabilize rising costs. Senate Minority Leader Chuck Schumer asserted that the Crapo-Cassidy framework would not extend the ACA tax credits for even a single day, a shortcoming, he says, driving prices higher without addressing the underlying issue.
Democrats also criticized the Republicans’ timing. After weeks of internal debate on a different health-care plan, Republicans finally introduced their proposal only this week.
Sen. Jack Reed, D-R.I., condemned the late unveiling, stressing that 24 million Americans risk losing subsidies by year’s end. He urged the GOP to extend the ACA tax credits now and consider later tweaks to substitutes rather than waiting until the eleventh hour.
Schumer framed unwavering Democratic unity around extending the ACA subsidies, while Thune suggested not all Republicans may back the Cassidy-Crapo approach. The upcoming votes thus promise a test of both parties’ resolve and the policy choices facing millions who depend on subsidies to help pay for health care.
