Trump's Trials - Senate Democrats pitch plan to extend ACA subsidies, but it may not have enough votes

Episode Date: December 8, 2025

The Senate is expected to vote Thursday on a Democratic proposal to extend existing Affordable Care Act tax credits for three years. But the plan is not expected to get the votes it needs to advance.Support NPR and hear every episode of Trump's Terms sponsor-free with NPR+. Sign up at plus.npr.org.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

I'm Scott Detrow, and this is Trump's Terms from NPR. We're under invasion from within. If you're not going to protect your citizens, President Trump will. We all serve at the pleasure of the president. The golden age of America is upon us. We are in the golden age. Every episode, we bring you one of NPR's latest stories about the 47th president, and now he is trying to remake the federal government.

Today's story starts right after this. I'm Leila Faldi. And I'm Amey Martinez. The enhanced healthcare subsidies that were created during the COVID pandemic will expire at the end of the month, unless Congress acts quickly. California Republican Kevin Kiley says it's time for both parties to work together to avoid major spikes in premiums. 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 times. tax credits. 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. MPR 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? 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. Democrats are fighting to lower health care costs. Republicans are fighting with one another. Democrats' plan is not expected to get the 60 votes needed to advance in the Senate. Okay. So what do Senate Republicans want? 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 cats 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. We want to give an additional choice, one in which your premium is lower, and that you have money in an account to help pay for. 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. Okay, so what about the House? 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's 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. All right, so we've talked about the Senate and the House. What about the White House? Where is the president on this debate? 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. That's NPR's Deirdre Walsh. Hopefully those are not wolves at your door, Deirdre, just dogs. Thanks for your time. Yes. Thank you.

Before we wrap up, a reminder, you can find more coverage of the Trump administration on the NPR Politics podcast, where you can hear NPR's political reporters break down the day's biggest political news with new episodes every weekday afternoon. And thanks, as always, to our NPR Plus supporters who hear every episode of the show without sponsor messages. You can learn more at plus.npr.org. I'm Scott Detrow. for listening to Trump's terms from NPR.