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The Battle Over Obamacare Is Far From Over. Here’s Why.

Dec 11, 2025 11:48:00 -0500 by Anita Hamilton | #Politics

Lawmakers were still battling over how to address expiring subsidies for Affordable Healthcare Act plans. (Graeme Sloan/Bloomberg)

Key Points

The two Senate bills aimed at lowering healthcare costs for more than 20 million Americans currently enrolled in Obamacare health plans failed to advance in the Senate on Thursday, but there’s still a chance for a compromise deal that could provide at least some relief.

Even as lawmakers appeared deadlocked, two new bills that incorporate elements of the failed bills are gaining bipartisan support in the House of Representatives. Both involve shorter subsidy extensions. This is an idea that President Donald Trump was believed to be on the verge of proposing shortly before Thanksgiving.

House Speaker Mike Johnson, a Louisiana Republican, is also weighing a slate of other proposals, Politico reported. They could include beefing up health savings accounts, reforming third-party companies that manage prescription drug benefits known as pharmacy-benefit managers, and better price transparency, according to a slide on legislative options.

What’s more, Republicans who hold the majority in both chambers are continuing to weigh the risk of failing to act as the midterm elections near.

“Battleground Republicans see a subsidy extension as a necessary intervention to prevent electoral disaster in 2026,” Beacon Policy Advisors wrote in a Thursday note. “Implicit is the need to respond in some way to Democrats’ messaging on healthcare and affordability.”

Two New Proposals to Cut Healthcare Costs

While Johnson hasn’t scheduled a vote on either of the two new bills proposed by rank-and-file members, their sponsors have filed paperwork called discharge petitions that allow them to bypass Johnson and force a vote if they get enough signatures.

The newest bill, announced Wednesday by Republican Jen Kiggans of Virginia and Democrat Josh Gottheimer of New Jersey, includes a two-year extension of current subsidies along with new guardrails to prevent “ghost beneficiaries,” a longer open enrollment period, and pharmacy benefit manager reforms.

The other bill, sponsored by Republican Brian Fitzpatrick of Pennsylvania, also extends the premium subsidies through 2027, while expanding access to health savings accounts. It also tightens eligibility for the subsidies and requires a minimum monthly payment from even the lowest income participants.

Dead on Arrival

Meanwhile, Thursday’s Senate votes both failed by 51-48, short of the needed 60 votes to proceed. The Republican plan would have replaced monthly premium subsidies with direct deposits into health savings accounts, which enrollees can use to cover out-of-pocket costs.

Sen. Rand Paul of Kentucky was the sole Republican to vote against his party’s bill, which would deposit either $1,000 or $1,500 a person into the accounts a year for households with incomes of up to 700% of the federal poverty level.

Sponsored by Louisiana Sen. Bill Cassidy and Idaho Sen. Mike Crapo, the Health Care Freedom for Patients Act would have also reduced Medicaid funding for states through stricter eligibility requirements and prohibit HSA funds from being used for abortion or gender transition services.

The Democrats’ bill, which got four Republican votes, would have extended Affordable Care Act plans as is through 2028. Brought by Democratic Leader Chuck Schumer of New York, it would have also eliminated the maximum income cap of 400% of the federal poverty level that will go into effect on Jan. 1 if Congress fails to pass an alternative.

While it’s unclear how things will shake out, the flurry of proposals combined with ongoing political pressure suggest that some kind of relief from high healthcare costs is in the cards.

Write to Anita Hamilton at anita.hamilton@barrons.com