The subsidies expired last year and politicos fear the voters' wrath in November
Senate Republicans say they are nearing a bipartisan deal to revive expired Affordable Care Act subsidies, though abortion coverage remains a major obstacle.
The emerging framework would extend the enhanced subsidies for two years, add income caps and impose new antifraud measures.
Any agreement would need broad Republican support and buy-in from the White House to clear both chambers of Congress.
Senate Republican negotiators say they are closing in on a deal with Democrats to extend and overhaul enhanced Affordable Care Act subsidies that expired at the end of last year, as rising insurance costs add pressure on lawmakers ahead of the midterm elections.
The developing framework would extend the enhanced subsidies for two years while adding new eligibility limits, antifraud provisions and other changes designed to attract Republican support. Abortion-related language, however, remains a significant sticking point and could derail the negotiations.
Republicans outline a narrower, temporary extension
Sen. Bernie Moreno (R., Ohio), who is leading the talks alongside Sen. Susan Collins (R., Maine), said lawmakers are close to finalizing a framework and could release legislative text as early as Monday. Moreno said his goal is to craft a proposal that can win support from more than half of Senate Republicans.
Republicans have long opposed the enhanced ACA subsidies, which Democrats enacted in 2021 and allowed to expire at the end of last year. But with premiums rising sharply for millions of Americans, some GOP lawmakers have backed a short-term extension to buy time for broader healthcare changes.
Sen. Jeanne Shaheen (D., N.H.), a lead Democratic negotiator, said a draft proposal should be ready soon but declined to provide details.
House action adds urgency to Senate negotiations
The talks are intensifying as the House prepares to vote Thursday on a three-year extension of the enhanced subsidies. Four centrist Republicans crossed party lines last month to support the Democratic-backed bill, despite opposition from House Speaker Mike Johnson (R., La.).
An identical measure failed in the Senate last month, but negotiators could amend a House-passed bill if a compromise emerges. Senate negotiators are expected to meet Thursday with House members eager to strike a deal.
Abortion coverage remains a central dispute
Several Republicans warned that abortion policy remains a major hurdle. Senate Majority Leader John Thune (R., S.D.) said talks have been productive but unresolved issues remain, including whether to impose new restrictions on abortion coverage in ACA plans.
Theyre working hard trying to find something that threads those various needles, Thune said, but as of right now, Im not aware at least that theres a landing spot just yet.
Johnson has also pointed to abortion language as a deal-breaker for many Republicans, saying the GOP will not authorize taxpayer funding for abortion services. Under current law, ACA subsidies can be used to purchase plans that cover abortion, though enrollees are required to pay separately for that portion of coverage. Antiabortion groups argue that the structure still indirectly subsidizes abortion.
President Trump told House Republicans this week that they should be a little flexible on abortion policy, comments that some Democrats viewed as a positive signal. His press secretary later said Trump was urging flexibility from both parties to reach a healthcare deal, though Trump has previously opposed extending the ACA subsidies and instead favors health savings accounts.
What the proposed framework would change
About 20 million Americans benefited from the enhanced ACA subsidies before they expired. The Moreno framework would restore those subsidies for two years and extend the ACAs open enrollment period, while adding several new restrictions.
Key provisions under discussion include cutting off subsidy eligibility for households earning more than 700% of the federal poverty level roughly $225,000 for a family of four and requiring enrollees to contribute at least $5 a month toward their coverage. That contribution could take the form of a $60 annual payment.
The plan would also impose penalties on insurers that deliberately sign people up fraudulently, including fines of $100,000 per violation. In the second year of the extension, enrollees would be given the option to place subsidy funds into prefunded health savings accounts.
Requiring a minimum monthly payment would mark a significant shift. Roughly 40% of ACA enrollees currently pay nothing toward their premiums, more than double the share before Democrats expanded the subsidies in 2021.
Whether negotiators can bridge the remaining political divides particularly over abortion will determine if the effort succeeds or joins previous failed attempts to extend the subsidies.
Posted: 2026-01-12 20:52:49
















