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On Thursday (December 11), the Republican-controlled Senate voted against health care bills from both parties, setting the stage for significant premium hikes for millions of Americans. The failure to pass either bill means that enhanced subsidies under the Affordable Care Act (ACA), implemented in 2021, are likely to expire at the end of the year. This could result in premiums doubling on average for approximately 22 million Americans who currently benefit from these subsidies.
The Republican proposal, led by Senate Finance Chair Mike Crapo and Senate Health, Education, Labor, and Pensions Chair Bill Cassidy, aimed to replace ACA tax credits with health savings accounts (HSAs). The plan would allow individuals with "bronze" or "catastrophic" plans to receive up to $1,500 annually in an HSA. However, the proposal included restrictions on using these funds for abortion or gender transition procedures. Democrats criticized the plan, arguing it would not adequately address premium increases and labeled it as promoting "junk insurance." Senate Minority Leader Chuck Schumer called the Republican bill a "nonstarter," emphasizing that it would not extend ACA tax credits for even a single day.
The Democratic bill sought a three-year extension of the ACA subsidies to prevent premium spikes, but it also failed to secure the necessary 60 votes for passage. The looming expiration of subsidies at the end of December has heightened tensions, with Republicans facing pressure to offer a viable alternative. President Donald Trump expressed support for the concept of the Republican plan but stopped short of fully endorsing it. As the deadline approaches, the lack of consensus on a solution raises concerns about the financial impact on millions of Americans who rely on ACA subsidies for affordable health care coverage.