By Sabrina Siddiqui and Lindsay Wise
WASHINGTON -- Millions of Americans are facing higher healthcare premiums and lingering uncertainty about whether help might still arrive, with Congress set to break for the rest of the year without renewing enhanced Affordable Care Act subsidies.
Supporters of the subsidies insist the fight isn't over. But prospects of a bipartisan deal remain slim, even as some lawmakers and people close to the Trump administration signaled that voter pressure could lead to a retroactive fix when Congress reconvenes in the new year.
"I'm not ruling anything out," Senate Majority Leader John Thune (R., S.D.) told reporters Thursday.
Lawmakers have been grappling for months with the fate of the enhanced subsidies, which benefit roughly 20 million Americans and were at the heart of this fall's record-long government shutdown. Democrats, along with some Republicans, have pushed various proposals to keep the subsidies in place. Most Republicans oppose any extension.
Hopes of a breakthrough emerged on Wednesday, as four vulnerable House Republicans broke ranks and joined Democrats in backing a petition that would force a vote on a three-year extension of the enhanced subsidies when Congress returns in January.
Republican leaders warned that the measure would be effectively dead on arrival in the GOP-controlled Senate, although some acknowledged that it would intensify pressure on party leaders to find a compromise.
For ACA enrollees, Dec. 15 was the deadline to sign up for coverage that starts Jan. 1 via the federal insurance marketplace and many state exchange s. Consumers can continue to enroll until Jan. 15 through HealthCare.gov, but plans chosen later typically take effect Feb. 1, potentially leaving them with a gap in coverage.
Insurance agents said many enrollees did choose plans for 2026, despite the uncertainty, but it isn't clear if they will actually pay to keep them if their monthly costs rise sharply due to the loss of the enhanced subsidies.
That reality has already come to pass for Brandi Sutton, an office manager for a small construction company in southern Mississippi. Sutton, 46, said she just terminated her healthcare coverage after finding out her monthly premium would rise from $126 to $600 in January.
Before qualifying for the enhanced subsidy in 2021, she was uninsured. Sutton said the coverage was crucial over the past four years, allowing her to afford treatment for a precancerous spot on her nose and other procedures.
"I'm scared to death. This could literally kill me," she said. "The politicians don't care about us. We're just numbers on a piece of paper."
Nearly two dozen senators from both parties met this week to find a way forward. Thune said Thursday that one condition for a deal would include expanding the use of tax-advantaged health savings accounts -- an idea Democrats have rejected -- as well as other changes to crack down on fraud and abuse.
Republicans have also cautioned that any agreement would need the backing of President Trump, who has largely steered clear of wading into the debate publicly.
"The most important part for most Republicans is going to be, does the president see a path forward that would be worth pursuing?" said Sen. Mike Rounds (R., S.D.), who has been part of bipartisan talks.
Trump has endorsed the idea of health savings accounts that would give money directly to people. But he hasn't pushed for a specific plan and instead has let the fight play out on Capitol Hill.
Trump has heard differing opinions on the subsidies, according to people familiar with discussions. Some of his aides have emphasized that the political fallout from letting subsidies lapse would undermine Republicans' prospects in the midterms, while others have warned against angering the president's base by supporting any part of the Obamacare law, which has long been reviled by conservatives.
Polls have suggested that most Americans support extending the subsidies, and one recent survey found that enrollees would be more likely to blame Republicans compared with Democrats if the subsidies expired and premiums skyrocketed. Democrats have already begun targeting Republicans in competitive midterm races with campaign ads focused on the subsidies and healthcare costs.
Rep. Kevin Kiley, a California Republican who supports extending the subsidies, said leaders in both parties were more focused on "creating problems that you can try to blame the other side for" than a resolution.
Some suggested Trump was the only figure capable of moving Republicans toward a compromise. " Donald Trump has not told them to cut a deal," said Sen. Elizabeth Warren (D., Mass.). "So there's no deal."
Write to Sabrina Siddiqui at sabrina.siddiqui@wsj.com and Lindsay Wise at lindsay.wise@wsj.com
(END) Dow Jones Newswires
December 19, 2025 05:00 ET (10:00 GMT)
Copyright (c) 2025 Dow Jones & Company, Inc.
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