Time running out for Trump, lawmakers to fix soaring health care costs

WASHINGTON – As millions of Americans brace for their health care costs to skyrocket next year, President Donald Trump and the Republican-controlled Congress remain deadlocked over what to do about it.

Time is running out.

The White House and lawmakers have just a matter of weeks before federal subsidies are set to expire, potentially kicking roughly 5 million Americans off their health insurance, according to some estimates . The subsidies, which come in the form of tax credits, are part of the Affordable Care Act, commonly known as Obamacare.

Read more: ACA health insurance tax credits could end in December. How will you be affected?

Just before Thanksgiving, the Trump administration was gearing up to intervene and possibly resolve the crux of the issue before the end-of-year holidays. Multiple news outlets reported that Trump planned to propose prolonging the subsidies for two years, but the president pumped the brakes amid opposition from congressional Republicans.

"Something's going to happen" to address the problem, Trump said in a Cabinet meeting Dec. 2, though he suggested "it's probably not going to be easy."

A deal or a midterm message?

Partisan politics are one big challenge in resolving the standoff. With the subsidies' expiration looming by year's end, Democrats have vowed to make them – and health care more broadly – a cornerstone of their 2026 midterm election messaging strategy.

They're hoping to springboard off the national attention they drew to rising health care costs during the government shutdown as they seek to wrestle back control of Congress next November.

"We're going to get this done," said Sen. Amy Klobuchar, a Minnesota Democrat who ran for president in 2020. "We're going to get it done by getting it on some piece of legislation, or we're going to get it done by marching through into the midterms and winning."

Though the Senate is expected to vote next week on a bill to address the problem, it's not clear exactly what legislation lawmakers will consider. Senate Minority Leader Chuck Schumer, D-New York, said Dec. 2 that whatever the measure is, it'll focus on lowering costs.

Regardless, serious challenges exist for any bill winning enough support to become law, given the Senate's 60-vote threshold to overcome a filibuster. Also standing in the way of a possible Senate compromise: the Republican-controlled House of Representatives.

Read more: These people have found their health care at the center of a shutdown showdown

Though a bipartisan group of lawmakers is pushing for an extension of the health care subsidies, many House Republicans oppose Obamacare generally and wouldn't support any plan that survives the Senate.

Absent a last-minute breakthrough, some lawmakers are already warning the next Senate vote could end up being nothing more than a partisan exercise.

"I'm afraid that's a real risk," said Sen. Thom Tillis, R-North Carolina. Tillis, who's retiring next year, is among a group of Republicans who have voiced support for extending the premium tax credits at least while Congress figures out a bigger solution to problems with Obamacare.

"I honestly believe if we don't come up with an outcome before Christmas, it's not going to happen," he said.

Senate Republicans met Dec. 2 to discuss their health care policy fixes, including a new plan from Louisiana Sen. Bill Cassidy. Legislation written by Cassidy, who's a physician, would replace the expiring subsidies with funding that would go directly into Americans' health savings accounts, or HSAs.

Senate Majority Leader John Thune, R-South Dakota, said afterward that lawmakers didn't emerge from the talks with a consensus.

"I don't think, at this point, we have a clear path forward," he told reporters.

Read more: Millions could go without health care coverage in 2026. Here’s why.

Shutdown promise could fall flat

The impending Senate health care vote stems from a promise Republicans made to their Democratic colleagues in exchange for their support in November to bring an end to the longest-ever government shutdown .

During the funding crisis, the biggest sticking point centered on the expiring tax credits. Though there had been concern for months on both sides about how to extend them, a solution continued to elude lawmakers as the shutdown dragged on. Republicans wanted more restrictions on the subsidies; Democrats largely pushed for an extension without new strings.

Bipartisan talks sputtered for weeks. Finally, after more than a month, a group of Senate Democrats agreed to end the shutdown . In return, Republicans guaranteed them a vote on health care by mid-December. Progressives castigated their colleagues for caving without any more tangible concessions.

One of the architects of the shutdown deal was Sen. Jeanne Shaheen, D-New Hampshire. Asked a week before the big health care vote whether lawmakers were any closer to a bipartisan compromise, she replied, "I think we're not."

Zachary Schermele is a congressional reporter for USA TODAY. You can reach him by email at zschermele@usatoday.com. Follow him on X at @ZachSchermele and Bluesky at @zachschermele.bsky.social .

This article originally appeared on USA TODAY: It's crunch time for lawmakers to keep health care costs from soaring