The Senate will vote Thursday on two rival plans to avert the expiration of ACA premium tax credits that cover roughly 21.8 million people. Democrats favor a clean extension (Schumer has proposed extending credits through 2028); Republicans support a Cassidy-Crapo plan that deposits $1,000 into HSAs for bronze/catastrophic enrollees (+$500 for ages 50–64) with usage limits. Neither bill appears to have the 60 votes needed in the Senate, leaving premiums at risk of rising sharply per KFF.
Senate To Vote Thursday As ACA Premium Subsidies Near Expiration — Competing Democratic Extension Vs. Republican HSA Plan
John Thune speaks in the Senate in Washington DC on Tuesday.Photograph: Mattie Neretin/CNP/picture alliance/Consolidated News Photos
The US Senate is scheduled to vote Thursday on two competing measures aimed at averting the imminent expiration of premium tax credits for Affordable Care Act (ACA) exchange plans. The subsidies—covering about 21.8 million people—are set to lapse at month’s end, and research group KFF warns that premiums could more than double for many enrollees if the credits expire.
What’s at Stake
The premium tax credits were created by the Affordable Care Act and were temporarily expanded by the Biden administration’s pandemic-era relief measures. The credits help lower monthly insurance premiums for millions who buy coverage on ACA exchanges; letting them lapse could dramatically raise out-of-pocket costs and shrink access to care.
The Two Competing Bills
Democratic Proposal: Senate Democrats, led by Senate Minority Leader Chuck Schumer, back a straightforward extension of the current premium tax credits. Schumer has filed legislation that would extend the subsidies through 2028 (and other Democratic proposals would extend for three years).
Republican Proposal: Senators Bill Cassidy and Mike Crapo have introduced a plan supported by Republican leaders that would deposit $1,000 into health savings accounts (HSAs) for people enrolled in bronze or catastrophic exchange plans, with an additional $500 for individuals aged 50–64. That proposal also includes restrictions on using the payments for abortions or gender-affirming care.
Political Dynamics And Reactions
“The Democrat proposal, which is a three-year extension of the status quo, is an attempt to disguise the real impact of Obamacare’s spiraling healthcare costs,” Republican leader John Thune said on the Senate floor.
Senate Democrats counter that a clean extension is the simplest way to prevent sudden premium spikes.
said Schumer.“The bottom line is that the Republicans do not have a serious plan to fix our healthcare problems. But we Democrats do – a clean, simple extension to prevent premiums from going up,”
Senator Bernie Sanders, the ranking member on the Senate health committee, criticized the GOP plan, saying it would push people toward high-deductible plans and would not stop premiums from soaring or address long-term issues like high drug prices and provider costs.
Former President Donald Trump told Politico he favors giving money directly to people rather than to insurers and signaled support for the HSA approach, though he has previously indicated he might accept a limited extension as a temporary measure.
Legislative Outlook
Both bills face steep procedural hurdles. To advance in the Senate they would likely need some bipartisan support to meet a 60-vote cloture threshold — a bar neither bill appears to have cleared yet. Even if one passes the Senate, it would still need approval from the Republican-controlled House, where Speaker Mike Johnson has expressed opposition to the premium tax credits and said the House GOP will unveil its own proposals to address affordability.
A bipartisan group of moderate House lawmakers has also proposed extending credits through 2027 with new income caps and anti-fraud measures, underscoring the possibility of a compromise — but time is short.
Bottom Line
The Thursday votes will clarify political positions, but absent swift bipartisan agreement the risk remains that premium tax credits will lapse — a move that experts warn could trigger large premium increases for millions of Americans.
