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Senate Rejects Dueling ACA Subsidy Plans, Setting Up Jan. 1 Lapse of Expanded Premium Aid

KFF projects the average subsidized enrollee’s annual premium would jump 114% if the expansion expires.

Overview

  • On Dec. 11, senators voted down a Democratic three-year extension of the pandemic-era premium tax credits and a Republican alternative centered on temporary health savings accounts.
  • The Democratic plan, led by Chuck Schumer, carried a Congressional Budget Office estimate of roughly $83 billion added to the deficit over the next decade.
  • The Republican CassidyCrapo proposal would have provided two years of age-tiered payments ($1,000 for ages 18–49, $1,500 for 50+) usable for cost-sharing but not premiums and tied to low-cost, high-deductible plans.
  • More than 24 million marketplace enrollees could face sharply higher costs if the expanded credits end on Jan. 1, with open enrollment for Jan. 1 coverage closing Dec. 15 in most states.
  • House Republicans are weighing alternatives as Speaker Mike Johnson promises a vote next week, but no bipartisan deal has emerged after months of limited negotiations.