WASHINGTON – As millions of Americansbrace for their health care costs to skyrocketnext year, PresidentDonald Trumpand the Republican-controlled Congressremain deadlockedover what to do about it.
Time is running out.
The White House and lawmakers have just a matter of weeks before federal subsidies are set to expire, potentially kicking roughly five million Americans off their health insurance,per some estimates. The subsidies, which come in the form of tax credits, are part of the Affordable Care Act, also known as Obamacare.
Read more:ACA health insurance tax credits could end in December. How will you be affected?
Just before Thanksgiving, the Trump administration was gearing up to intervene, potentially resolving the crux of the issue before the end-of-year holidays.Multiplenews outlets reported that Trump planned to propose prolonging the subsidies for two year, but the president pumped the breaks amid opposition from congressional Republicans.
"Something's going to happen" to address the problem, Trump said during a Dec. 2 Cabinet meeting, though the president also signaled "it's probably not going to be easy."
A deal or a midterm message?
Partisan politics are one big challenge in resolving the standoff. With the subsidies' expiration looming by year's end, Democrats have vowed to make them – and health care more broadly – a cornerstone of their 2026 midterm messaging strategy.
They're hoping to springboard off the national attention they drew to rising health care costs during the recent government shutdown in order to wrestle back control of Congress next November.
"We're going to get this done," said Sen. Amy Klobuchar, a Minnesota Democrat who ran for president in 2020. "We're going to get it done by getting it on some piece of legislation, or we're going to get it done by marching through into the midterms and winning."
Though the Senate is expected to vote next week on a bill to address the problem, it's not clear exactly what legislation they'll consider. Senate Minority Leader Chuck Schumer, D-New York, said Dec. 2 that whatever the measure is, it'll focus on lowering costs.
Regardless, serious challenges exist for any bill winning enough support to become law considering the Senate's 60-vote threshold to overcome a filibuster. Also standing in the way of any potential Senate compromise: the GOP-controlled House of Representatives.
Read more:These people have found their health care at the center of a shutdown showdown
Though there's a bipartisan group of lawmakers pushing for an extension of the health care subsidies, many House Republicans have big issues with Obamacare generally and wouldn't support any plan that survives the Senate.
Absent a last-minute breakthrough, some lawmakers are already warning the next Senate vote could end up being nothing more than a partisan exercise.
"I'm afraid that's a real risk," said Sen. Thom Tillis, R-North Carolina. Tillis, who's retiring next year, is among a group of Republicanswho have voiced supportfor extending the premium tax credits at least in the short term while Congress figures out a bigger solution to problems with Obamacare.
"I honestly believe if we don't come up with an outcome before Christmas, it's not going to happen," he said.
Senate Republicans met Dec. 2 to discuss their health care policy fixes, including a new plan from Louisiana Sen. Bill Cassidy. Legislation authored by Cassidy, who himself is a doctor, would replace the expiring subsidies with funding that would go directly into Americans' health savings accounts, or HSAs.
Senate Majority Leader John Thune, R-South Dakota, said afterward that lawmakers didn't emerge from the talks with a consensus.
"I don't think, at this point, we have a clear path forward," he told reporters.
Read more:Millions could go without health care coverage in 2026. Here's why.
Shutdown promise could fall flat
The impending Senate health care vote stems from a key promise that Republicans made to their Democratic colleagues in exchange for their support in November to bring an end to thelongest-ever government shutdown.
During the funding crisis, the biggest sticking point centered around the expiring tax credits. Though there was concern for months on both sides of the aisle about how to extend them, a solution continued to elude lawmakers as the shutdown dragged on. Republicans wanted more restrictions on the subsidies. Democrats largely pushed for an extension without new strings.
Bipartisan talks sputtered for weeks. Finally, after more than a month, a group of Senate Democratsagreed to end the shutdown. In return, Republicans guaranteed them a vote on health care by mid-December. Progressives castigated their colleagues for caving without any more tangible concessions.
One of the architects of the shutdown deal was Sen. Jeanne Shaheen, D-New Hampshire. Asked a week before the big health care vote whether lawmakers were any closer to a bipartisan compromise, she replied, "I think we're not."
Zachary Schermele is a congressional reporter for USA TODAY. You can reach him by email at zschermele@usatoday.com. Follow him on X at @ZachSchermele and Bluesky at @zachschermele.bsky.social.
This article originally appeared on USA TODAY:It's crunch time for lawmakers to keep health care costs from soaring