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U.S. President Donald Trump sharpened his criticism of insurance companies on Monday, urging that federal healthcare funds be directed to individuals rather than insurers. His remarks come as Senate Democrats push for a three-year extension of Affordable Care Act (ACA) subsidies that are set to expire at the end of the year. These enhanced subsidies, originally expanded during the COVID-19 pandemic, help reduce premiums for millions of Americans enrolled in Obamacare plans.
If Congress fails to act, up to 24 million people who rely on these subsidies could face steep premium increases in 2025. A recent KFF poll found that one in four ACA enrollees would likely drop their coverage in 2026 if premiums double, underscoring the high stakes for low- and middle-income consumers. Most surveyed beneficiaries support extending the subsidies, which currently cap premium payments at no more than 8.5% of an enrollee’s income.
Under a deal that ended a record 43-day government shutdown, Republicans agreed to hold a vote on healthcare subsidies. In response to the Democrats’ proposal, Republican Senators Bill Cassidy of Louisiana and Mike Crapo of Idaho introduced a competing plan late Monday. Their bill would direct up to $1,500 into health savings accounts for individuals earning less than 700% of the federal poverty level, while restricting the funds from being used for abortion or gender transition services. The legislation also aims to lower insurance premiums by 11% in 2027 and reduce Medicaid funding for states that provide coverage to undocumented immigrants.
Cassidy, who chairs the Senate Health Committee, argues that the GOP plan gives patients more control over their healthcare dollars. Critics counter that it could shift lower-income Americans into high-deductible or short-term plans, increasing out-of-pocket costs and reducing access to comprehensive coverage. With Republicans divided and Democrats firmly opposed, the path forward remains uncertain as the Senate prepares for a pivotal healthcare vote.
