By Anita Hamilton

Two bills aimed at lowering healthcare costs for more than 20 million Americans currently enrolled in Obamacare health plans are expected to fail in the Senate on Thursday. But there's more movement behind the scenes that could eventually provide some relief.

The first vote will be on a Republican plan aimed at replacing monthly premium subsidies with direct deposits into health savings accounts, which enrollees can use to cover out-of-pocket costs.

Brought by Louisiana Sen. Bill Cassidy and Idaho Sen. Mike Crapo, the Health Care Freedom for Patients Act would deposit either $1,000 or $1,500 in the accounts per person for households with incomes of up to 700% of the federal poverty level. It also reduces Medicaid funding for states through stricter eligibility requirements and prohibits HSA funds from being used for abortion or gender transition services.

The second vote will be on the Democrats' proposal to extend Affordable Care Act plans as is through 2028. Brought by Democratic leader Chuck Schumer of New York, it also eliminates the maximum income cap of 400% of the federal poverty level that will go into effect in 2026 if Congress fails to pass another bill.

Because both bills require a supermajority of 60 votes to pass, and neither party has that many members, they are widely expected to fail. But there is still a chance that some sort of compromise could be worked out.

Meanwhile, two separate bills in the House are gaining support. While House Speaker Mike Johnson of Louisiana, a Republican, hasn't scheduled a vote on either, both bills' sponsors have filed discharge petitions that could bypass Johnson and force a vote if they get enough signatures.

The newest bill, announced Wednesday by Republican Jen Kiggans of Virginia and Democrat Josh Gottheimer of New Jersey, includes a two-year extension of current subsidies along with new guardrails to prevent "ghost beneficiaries," a longer open enrollment period, and reforms of the third-party companies that manage prescription drug benefits, known as pharmacy-benefit managers or PBMs.

The other bill, sponsored by Republican Brian Fitzpatrick of Pennsylvania, also extends the premium subsidies through 2027, while tightening eligibility and requiring a minimum monthly payment from all enrollees.

President Donald Trump was thought to be on the verge of proposing a temporary extension of the Obamacare subsidies shortly before Thanksgiving, but reportedly shelved the proposal after Republican Party pushback.

"Battleground Republicans see a subsidy extension as a necessary intervention to prevent electoral disaster in 2026," Beacon Policy Advisors wrote in a Thursday note. "Implicit is the need to respond in some way to Democrats' messaging on healthcare and affordability."

How that shapes up is yet to be seen, but the flurry of proposals in both chambers of Congress indicates that some kind of relief from high healthcare costs is in the cards.

Write to Anita Hamilton at anita.hamilton@barrons.com

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December 11, 2025 11:50 ET (16:50 GMT)

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