Lawmakers Scramble to Hammer Out a Healthcare Package Before the Holidays

Before Congress leaves Washington for the holidays, lawmakers are scrambling to put together a healthcare bill they can pass. Politico’s Jordain Carney and Calen Razor reported that on Monday night, a bipartisan group of nearly two dozen senators gathered to work out a healthcare deal to extend Affordable Care Act (ACA) insurance subsidies set to expire at the end of this month.

At a meeting convened by Senators Susan Collins (R-Maine) and Bernie Moreno (R-Ohio), the lawmakers discussed a two-year extension of the ACA tax credits, coupled with a new income eligibility cap and fraud-prevention language, Carney and Razor wrote. “Beyond the income cap, the senators discussed further changes aimed at lowering the cost of healthcare during the second year of the extension, including cost-sharing reductions and more flexibility for health savings accounts, according to lawmakers in attendance.” However, if the group were able to reach a deal, it wouldn’t come up for a vote until January.

At the same time, House Republicans, under Speaker Mike Johnson's leadership, introduced a limited healthcare bill on Friday to tackle increasing costs. However, the plan does not include the extension of the expiring enhanced ACA subsidies. Lauren Peller reported for ABC News that the GOP would expand the availability of association health plans and what are known as "CHOICE arrangements," impose new transparency requirements on pharmacy benefit managers to lower drug costs, and allocate money for cost-sharing reductions to lower premiums in the individual market. “Association health plans allow employers to band together to purchase coverage.” Notably, Peller wrote, the 111-page measure would not increase contributions to health savings accounts.

Meanwhile, increasing reports indicate Americans are worried they may soon be unable to afford health insurance as the ACA tax credits are set to expire. Megan Marshall reported for Spectrum News 1 on the Milwaukee-based Bread of Healing Clinic, which provides free healthcare, and is preparing for a surge in new patients. “We’re just bracing for a potential floodgate of people who are going to be in the same bracket of poverty level, insurance eligibility, maybe not being able to qualify for things they used to anymore,” Erica Wright, Bread of Healing’s executive director, told Marshall.

Likewise, approximately 130,000 Alabamians could lose healthcare coverage or face much higher premiums at the beginning of 2026, Anna Barrett wrote for Alabama Reflector. Theresa Lau, senior policy counsel for the Southern Policy Law Center (SPLC), said in an interview “that ACA enrollees will not be automatically dropped from their plans, but many will opt out because of the cost of monthly premiums. She said that a 60-year-old couple making $85,000 per year in Alabama would see their premium increase from $0 per month to $1,876 per month.”

Scott Darius, the executive director of Florida Voices for Health, reiterated on Monday at a press conference that insurers are implementing a significant, one-year increase in baseline rates. “Floridians in particular have had to process and make really tough decisions about purchasing care for next year,” he said.

NPR published a piece by KFF Health News’ Julie Appleby explaining that ACA shoppers are facing sticker shock. “Meanwhile, the clock is ticking for shoppers. People needed to choose their ACA plan by Monday for coverage to begin January 1. Open enrollment continues in most states until January 15 for coverage beginning February 1.”

“The marketplaces, too, must have contingency plans in case Congress intervenes,” Appleby pointed out. “These adjustments could take days or weeks.”