Hill November 19, 2025
Republicans are rushing to deliver an alternative to the Affordable Care Act’s (ACA) enhanced subsidies ahead of a self-imposed mid-December deadline.
President Trump wants to send ACA subsidy money directly to consumers, and Republicans are trying to find a way to make that happen.
Republicans spent weeks during the government shutdown refusing to negotiate with Democrats on health care and now are considering their own ideas to replace the subsidies, despite the political danger of letting them expire.
The ideas are vague, and many health experts warn a direct cash proposal could create a “death spiral” in the marketplace where healthy people would drop coverage and use the subsidy cash to pay their limited out-of-pocket costs, leaving sicker and expensive...
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