Overview
- Republican leaders released a House package focused on association health plans, pharmacy benefit manager transparency, expanded employer health reimbursement arrangements and restoring cost-sharing reductions starting in 2027, but it omits an extension of the enhanced ACA tax credits.
- The proposal is slated for a vote next week, and GOP leaders say a floor vote on a subsidy-related amendment could be allowed, with the House Rules Committee meeting Tuesday to determine what amendments reach the floor.
- The Senate this week failed to advance both a Democratic three-year extension of the enhanced subsidies and a Republican alternative centered on health savings accounts and direct payments, though four GOP senators voted to advance the Democratic bill.
- Centrist Republicans are joining Democrats on discharge petitions to force votes on short-term extensions, but the bipartisan efforts have not secured enough signatures to guarantee floor action and face resistance from party leaders.
- Roughly 22–24 million marketplace enrollees could face sharply higher costs in January, with KFF estimating average premium payments more than doubling and the CBO projecting about 2 million additional uninsured if the enhanced credits lapse.