Republicans unveil health care plan to counter Democratic effort to extend ACA subsidies

With the deadline to address expiring enhanced Affordable Care Act tax credits fast approaching, Senate Majority Leader John Thune announced Tuesday that two competing plans — one led by Democrats and the other by Republicans — will get votes on the Senate floor on Thursday.

But neither bill is expected to have the support it needs to advance, leaving in the balance tens of millions of Americans who could see their health care costs soar at the start of the new year.

The Republican plan

Thune’s announcement on Tuesday marked the first time Senate Republicans appeared to coalesce around a single health care plan to respond to the anticipated price hikes Americans currently receiving ACA tax credits will face in 2026.

The proposal would do away with the enhanced tax credits, and instead take the extra money from those tax credits and put it into health savings accounts for those who purchase bronze-level or “catastrophic” plans on the ACA exchanges. Republicans say this will help Americans pay for out-of-pocket costs.

Under the plan, individuals earning less than 700% of the federal poverty level would receive $1,000 in HSA funding for those between age 18 and 49 and $1,500 for those age 50-64.

Republican Senate Majority Leader John Thune speaks to reporters outside his office in the US Capitol in Washington, December 3, 2025.

Jim Lo Scalzo/EPA/Shutterstock

The plan was first unveiled by Senate Health Committee Chairman Bill Cassidy and Senate Finance Committee Chairman Mike Crapo on Monday.

The senators say it would lower 2027 premiums by 11% by funding cost-sharing reductions and would empower Americans to choose the insurance plan that “fits their needs.” The proposal also requires states to verify citizenship and immigration status before coverage to avert “illegal immigrants” from accessing Medicaid. In addition, the proposal would prevent the use of the funds for abortions and gender affirming care. 

Thune said the plan represents an effort to reform the ACA and address GOP concerns that the enhanced tax credits have caused insurance premiums to rise. It also, they say, gives money directly to patients, as President Donald Trump said he wants to see happen.

President Donald Trump attends a roundtable discussion in the Cabinet Room at the White House in Washington, December 8, 2025.

Yuri Gripas/EPA/Shutterstock

“This is a failed program, and it does nothing but drive premiums up,” Thune said of the expanded tax credits that Democrats want to keep in place. “And the increase in premiums, who is that going to? That’s going to the insurance companies.”

Thune added, “So the proposal that we will put out there will bring insurance premiums down, it will be fiscally responsible, and it will get us away from the practice of giving the money all to the insurance companies and put it back in the hands of the patients.”

This plan emerged as the most popular choice for Republicans among a crowded field of GOP health care proposals that have cropped up in recent weeks. Thune said he believes the majority of his conference backs it.

“What I can tell you is as a conference, our members — and I can’t say 100%, but I think for the most part — are united behind the Crapo-Cassidy proposal which as I said, in terms of its emphasis, is about patients, not insurance companies, and about lowering premiums, not increasing them, and about getting a better return for the federal tax payer,” Thune said. 

The Democratic plan

 The Democratic-led bill would extend the expiring ACA tax credits for three years. 

The upcoming vote, which has been weeks in the making, is being granted to Democrats as part of a deal that was struck in November to end the record 43-day government shutdown. 

Democrats won no tangible health care concessions as part of the deal to fund the government. But they were promised a vote on a health care bill of their choosing, and they selected this 3-year extension. 

Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries meet with reporters about health care affordability, at the Capitol in Washington, Dec. 3, 2025.

J. Scott Applewhite/AP

“Democrats have put forward the cleanest, fastest, most realistic solution: a three-year extension of the current tax credits. No gimmicks, no poison pills,” Senate Minority Leader Chuck Schumer, the Senate’s top Democrat, said on the floor. 

Schumer’s strategy aligns with Leader Hakeem Jeffries’ proposal in the House, where Democrats have filed a discharge petition to force a vote on extending the tax credits for three years. The petition has received 214 signatures, just four shy of triggering a vote in the lower chamber. So far, no Republicans have signed on to the effort. 

Will either plan pass the Senate?

Both of these bills are all but certain to fail to get the 60 votes they need to advance in the Senate on Thursday. 

Thune has repeatedly criticized the Democratic plan for its failure to implement reforms to the ACA.

“There is no income limit, there are $0 premiums. There are millions of Americans who don’t even know they have coverage, they have decided not to do anything zero, zero reforms to this program, and so the bill that they are going to put on the floor will fail,” Thune said.

Schumer, meanwhile, dismissed the “phony” Republican plan as “dead on arrival.”

“Their bill is junk insurance. It’s been repudiated in the past. The American people will repudiate it once again because it is junk insurance that puts the burden on people,” Schumer said.

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