Congressional Republicans are working through how to handle the expiring Obamacare subsidies—but one thing is certain: President Donald Trump will have the final word.
Democrats tried to use the recent record-breaking shutdown to push a last-minute extension of the Biden-era subsidy increases that were added during COVID. Those costly subsidies expire at the end of the year, setting up a major healthcare fight in Washington.
Republicans Say Obamacare’s Subsidies Are Failing Americans
Many in the GOP acknowledge that rising healthcare premiums must be addressed. Americans over 50 are feeling the pressure more than anyone. But Republicans do not want to simply renew the same broken subsidies that have sent billions of dollars to major insurance companies while families see their monthly premiums climb higher and higher.
To make matters tougher, House and Senate Republicans are looking at different solutions—creating a race against the clock to strike a deal before the year ends.
Senate GOP: No Extension Without Pro-Life Protections
Senate Majority Leader John Thune (R-SD) has promised Democrats a vote on a healthcare proposal. But every Senate bill must reach 60 votes to pass, which means both parties must agree.
That’s where the big conflict begins.
Republicans insist that any new healthcare bill must include the Hyde Amendment, which blocks federal tax dollars from paying for abortions. Democrats have been resisting it for years.
Thune warned that the Hyde Amendment is central to the GOP’s position—and that Democrats must decide whether they’re willing to accept it.
Trump-Backed HSA Plan Gains Major Momentum
One reform is quickly becoming the GOP’s favorite:
Redirect the subsidy money directly into Health Savings Accounts (HSAs) instead of sending billions to insurance companies.
The plan was championed early by Sen. Rick Scott (R-FL) and has strong backing from President Trump. HSAs put control back in the hands of American families.
Scott blasted Democrats’ one-year extension proposal, calling it an insurance-company giveaway.
“They pay for abortions,” Scott told Fox News Digital. “Republicans won’t vote to make taxpayers fund abortions through Biden’s COVID subsidies.”
Sen. Bill Cassidy (R-LA) is promoting a similar idea—transferring power and funding directly to consumers. Cassidy also noted that the Hyde Amendment is non-negotiable.
But he reminded everyone of the ultimate reality:
“Any bill that becomes law must align with President Trump’s direction.”
House GOP Wants Trump’s Next ‘Big, Beautiful’ Healthcare Bill
In the House, Republicans are preparing a massive reform package through the reconciliation process—a move that allows them to bypass the Senate filibuster and pass legislation with a simple majority.
Rep. August Pfluger (R-TX) said the goal is simple and urgent:
“We want affordable, transparent, competitive healthcare. Americans deserve better.”
For older Americans on fixed incomes, healthcare inflation is crushing. GOP lawmakers argue that only structural reforms—not short-term subsidies—can fix the system.
Freedom Caucus Chairman Andy Harris (R-MD) warned that if Democrats won’t work to lower actual premiums, Republicans will have no choice but to act alone.
Harris strongly supported expanded HSAs, calling them the key to lowering costs:
“It works like a debit card. You go to any provider, and they must give you the best rate.”
Deeper Reforms Are Already Being Written
A senior House Republican revealed that the party is crafting a wide-ranging reform package targeting:
- Cost-sharing reduction (CSR) reforms
- Pharmaceutical pricing and transparency
- Pharmacy Benefit Manager (PBM) crackdowns—a major driver of soaring prescription drug costs
These reforms are designed to lower costs for American families and seniors—not to pad the pockets of insurance companies or PBM middlemen.
Still, some Republicans privately worry about passing another reconciliation bill after the political drama surrounding Trump’s first major legislative victory. Some lawmakers say they want tighter safeguards to ensure the funds go where intended.
Bottom Line: Obamacare’s Future Depends on Trump
Republicans may still be fine-tuning their strategy, but the deciding factor isn’t Congress.
It’s President Donald J. Trump.
With subsidies expiring and premiums rising, the White House will set the tone—and the direction—of America’s next chapter in healthcare reform. Millions of Americans waiting for relief will be watching every move.