A MARTÍNEZ, HOST:
The enhanced health care subsidies that were created during the COVID pandemic will expire at the end of the month unless Congress acts quickly.
LEILA FADEL, HOST:
California Republican Kevin Kiley says it's time for both parties to work together to avoid major spikes in premiums.
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KEVIN KILEY: There is perhaps no single question that has greater stakes for affordability in America in the coming year than doing something about the expiration of these tax credits.
FADEL: In a few minutes, we'll hear from people across the country who are facing higher insurance costs next month on the tough decisions they're facing, and we'll look at the data on who is expected to have to pay the most. But we start with what the parties in Congress have done in the past few weeks to address these expiring subsidies.
MARTÍNEZ: NPR congressional correspondent Deirdre Walsh has been watching. So, Deirdre, as part of the deal to end the shutdown last month, Democrats were promised a Senate vote on health care. What will they be presenting?
DEIRDRE WALSH, BYLINE: Well, there is no bipartisan deal, so Democrats rolled out their own plan last week, which is a three-year extension of the existing tax credits, and there's going to be a vote on Thursday on that. Senate Minority Leader Chuck Schumer says all Democrats are going to vote for that. He says Republicans can't agree on any plan of their own, and the only option on the table right now is to pass this straight extension.
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CHUCK SCHUMER: Democrats are fighting to lower health care costs. Republicans are fighting with one another.
WALSH: But the Democrats' plan is not expected to get the 60 votes needed to advance in the Senate.
MARTÍNEZ: OK. So what do Senate Republicans want?
WALSH: Well, they're split. Some Republicans do back extending the subsidies. You know, 24 million people currently rely on them. But GOP lawmakers say there needs to be some kind of income caps to limit who gets these subsidies and some reforms. Senate Majority Leader John Thune dismissed the three-year extension that Democrats are proposing. He says it's not a serious proposal. Louisiana Republican Bill Cassidy is pushing Thune and Republican leaders to allow a vote on his proposal. That would redirect money the government spends to subsidize ACA plans and instead give them directly to consumers and set up health care savings accounts. Cassidy talked about this on "Fox News Sunday."
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BILL CASSIDY: We want to give an additional choice, one in which your premium is lower and that you have money in an account that'll pay for it.
WALSH: So Thune hasn't decided if the Republicans are even going to put up an alternative for a vote. Even if Republicans do move forward with something like Cassidy's plan, that doesn't have the votes to advance in the Senate either. You know, these are shaping up to be messaging votes. Right now, there's not an effort to get agreement on something that can actually become law.
MARTÍNEZ: OK. So what about the house?
WALSH: Well, House Speaker Mike Johnson is planning to release a health care bill this week. He's promising a vote this month, but we don't have any details on what's going to be in it, and he's not negotiating with any Democrats. Like Senate Republicans, House Republicans are also divided. Some like the health savings account approach Cassidy is talking about. But there are other House Republicans from swing districts who are teaming up with Democrats to push bills. They call for one- or two-year extensions of these subsidies with some reforms.
MARTÍNEZ: All right. So we've talked about the Senate and the House. What about the White House? Where is the president on this debate?
WALSH: Well, the president has mostly been on the sidelines. You know, some Republicans from competitive districts I talked to last week say they've reached out to him and the White House to talk about the policy and the politics about the need to extend these subsidies in some form. But President Trump has not endorsed any legislation. Members of both parties agree on one thing. If Trump doesn't get involved to negotiate some kind of deal soon, these major increases in health care premiums are going to happen in January, and they will definitely be a major issue in the 2026 midterms.
MARTÍNEZ: That's NPR's Deirdre Walsh. Hopefully, those are not wolves at your door, Deirdre, just dogs.
WALSH: Yes.
MARTÍNEZ: Thanks for your time.
WALSH: Thank you. Transcript provided by NPR, Copyright NPR.
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