Health care talks appear to be headed nowhere fast as lawmakers squabble amongst each other — and with the White House — less than a month before a critical batch of Affordable Care Act subsidies expires.
And there are serious questions about whether those talks would die out once subsidies are already long gone.
“My assumption is that by next week, when we have to have that vote, that we might not be far enough along on the bipartisan discussions,” Senate Majority Leader John Thune said Monday.
He added: “I think that the conversations are still active on a solution. Whether that originates with the White House or folks working up here remains to be seen.”
Trending
Increasingly, few on Capitol Hill think current talks will actually result in a bipartisan deal prior to Dec. 31, when the ACA subsidies are set to end, causing premiums to skyrocket. There’s no tangible plan as of yet and there’s little time to strike one. Congress has only two-and-a-half weeks of scheduled session left, and other agenda items like government funding and defense spending are still outstanding.
A plan to extend the subsidies was briefly floated among White House insiders last week, but was quickly quashed after widespread GOP backlash.
Still, there’s a political incentive for both parties to show face on doing something. A critical mass of Senate Democrats agreed to reopen the government last month after a 43-day shutdown in exchange for a vote on health care. That group of Democrats almost immediately launched into negotiations with Republicans, insisting there was hope. Republicans are also acutely aware that polls find they are losing the messaging battle on health care heading into the 2026 midterms.
As evidence of the mounting political challenges for Republicans, Speaker Mike Johnson spent Monday evening, while votes were taking place in the House, in Tennessee campaigning for Matt Van Epps, in the special election to fill the seat formerly held by Mark Green. However, Johnson’s absence is also evidence of another problem: the lack of urgency to craft policy that would address the ACA subsidies cliff.
“If we can keep politics out of it, we can make something happen,” Republican Sen. Markwayne Mullin told NOTUS. “But politics has played its role, and hopefully we can find some way forward. But right now, it’s not on a fast track.”
Sen. Chuck Grassley said there’s “not enough” momentum yet for a deal on health care before senators head out of town. But he expects things could “pick up speed very fast” next week as the vote inches closer.
Some congressional Democrats are still trying to force a backup plan. In the House, a discharge petition that would enact a three-year extension for subsidies is circulating. House Minority Leader Hakeem Jeffries on Monday said Democrats only need “a handful of Republicans to join us” in order to hit the threshold for holding a vote on the House floor.
“It’s time for the do-nothing Republican Congress to proceed with urgency,” Jeffries wrote in a “Dear Colleague” letter. “Over the next few weeks, House Democrats will use every legislative and advocacy tool available in our fight to lower costs and address the devastating Republican healthcare crisis.”
And it’s not just Democrats. Republicans from battleground districts have been pushing for Congress to address the expiring subsidies — but they are unwilling to join Democrats in their efforts, arguing that any deal needs to include income caps and reforms that address “waste, fraud and abuse” in the ACA. Conservatives, meanwhile, aren’t interested in any extension without a more significant overhaul of the ACA.
Democratic Rep. Tom Suozzi told NOTUS he’s still pushing for a bipartisan bill that would extend ACA subsidies for two years while implementing new income caps. He is leading the bill alongside fellow Democratic Rep. Josh Gottheimer and GOP Reps. Jeff Hurd and Don Bacon. However, Suozzi would not say whether there’s any new momentum around that effort since the Thanksgiving holiday.
Separately, Republican Rep. Jeff Van Drew — who has been repeatedly urging leadership to address the expiring tax credits — said he spoke to President Donald Trump “in detail” about his efforts.
“I will be sad if at the end of the day we just let it lapse and have no answer,” Van Drew told reporters Monday evening.
He said Republicans still have time to address the policy before the end of the year, which is why he didn’t want to join Democrats’ efforts just yet.
“I don’t love the discharge petition,” he said. “I like to do it the right way. I don’t say that I will never sign on to it. I don’t say that I wouldn’t do it, but right now, I’m waiting to see if we can do this in a better way.”
The chair of the House Appropriations Committee, Rep. Tom Cole, shut down another avenue toward passing anything related to the ACA: He said that he’s not interested in using any appropriations package as a vehicle to pass a health care bill, insisting that something like a subsidy extension is not germane to the spending process.
“I have no jurisdiction, and so to me, it’s an obstacle to deal with because it can affect the impact and votes on appropriations,” Cole said. “But it’s not a problem I can solve.”
In his weekly press conference, Jeffries slammed the moderate Republicans for not joining Democrats in their effort to force a vote on extending the tax credits.
“But now it’s nothing but silence from these people, because they’re not serious about helping the American people, the hard-working American taxpayers that they purport to represent,” Jeffries said. “This is becoming painfully obvious to the American people, which is why Republicans are getting wiped out electorally all across the country.”
But even if that discharge petition passed in the House, it’s unlikely Thune would be eager to put it to a vote. The Senate majority leader told NOTUS on Monday he thinks “most Republicans are going to try and follow the regular order process over there, but we’ll see what happens.”
While many Senate Republicans insist they want to claw back the rising prices of health care premiums, there’s a lack of agreement in the conference on how to do so. What’s more, Congress doesn’t generally excel in major policy negotiations after a deadline, like the expiration, has already hit.
When NOTUS asked Thune whether there’s concern about momentum dying out if talks go past Dec.31, he replied: “I think that the issue is going to be there. And I mean, honestly, as I think you all know, we have a lot of interest on our side and a lot of good ideas that go back to trying to address what we think are some of the underlying problems with Obamacare in the first place.”
Sen. John Cornyn, who’s up for reelection in 2026, was noncommittal on whether he’d be open to an extension. But Cornyn told reporters he’s open to “a discussion and trying to find some way to remedy all the failed promises of Obamacare.”
But as to whether a deal could happen by next week?
“I don’t know,” he said. “We’ll find out.”
Authors
Contributor
