Breaking News

House juggles options for extending ACA subsidies

December 16, 2025
john-wilkerson-avatar-teal
Washington Correspondent, D.C. Diagnosis Writer

Since the election, Cheryl Hines hasn't spoken to Larry David, her on-screen husband of 24 years who introduced her to RFK Jr. And she feels sorry for Kennedy family members who harshly criticized her husband. Send news tips and advice for surviving awkward family holiday gatherings to John.Wilkerson@statnews.com or John_Wilkerson.07 on Signal.

Congress

House GOP unveils another health care bill

House Republicans introduced health care legislation aimed at countering Democrats' calls to extend enhanced Affordable Care Act premium subsidies. But the bill wouldn't extend those subsidies. 

And it doesn't even include funding for health savings accounts that are in the Senate GOP proposal we told you about last week.

The House bill is expected to receive a vote later this week.

It would expand access to association health plans by allowing employers and self-employed individuals to band together across industries to buy insurance that is less regulated. Republicans say the bill would lower health care premiums, increase health care access, and give people more health insurance choices. Association health plans don't have to cover essential health benefits, and Democrats say they would raise premiums for ACA marketplace plan enrollees.

Another measure would override state limits on stop-loss insurance so that smaller companies can self insure. 

It also would fund cost-sharing reductions for low-income enrollees in the Affordable Care Act marketplace. When Republicans proposed that measure in their tax bill earlier this year, the nonpartisan Congressional Budget Office (CBO) estimated it would reduce the deficit by $31 billion over a decade and increase the number of people without health insurance by 300,000

When the government funds cost-sharing reductions, it lowers gross premiums for silver plans. Because ACA subsidies are based on the cost of a silver plan, that lowers the amount of tax credits available to buy any plan. The bill would not include the pandemic-era enhanced premium tax credits that Democrats seek, so it would only help silver plan enrollees who already didn't qualify for the subsidies. Individuals enrolled in gold and bronze plans would likely pay more for their insurance, due to the reduced subsidies.


aca

Democrats keep their powder dry

House Democrats could force a vote on legislation to extend the ACA credits. 

Supporters of extending the extra subsidies have filed two bipartisan discharge petitions, both of which already have enough Republican support to force a vote if nearly all Democrats were to sign on to either of them.

A measure by Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.) pairs a one-year extension of subsidies and moderate anti-fraud reforms. It would require a vote by July 1 in both chambers on extending the subsidies another year, along with more significant reforms.

The other measure, by Reps. Brian Fitzpatrick (R-Pa.) and Jared Golden (D-Maine), would extend subsidies for two years, but with more policy reforms than the Kiggans/Gottheimer proposal. The Fitzpatrick/Golden proposal would let enrollees choose between using subsidies to lower their monthly premiums or to fund health savings accounts. It also includes new income eligibility limits and the elimination of no-premium plans.

But House Minority Leader Hakeem Jeffries (D-N.Y.) has yet to weigh in, allowing divisions among Republicans to play out in the hopes of eventually getting enough Republican votes to pass a third discharge petition that would extend the credits for three years, without reforms.   

"All we need is four House Republicans to join us," Jeffries said Monday evening.

A bipartisan group of senators on Monday restarted negotiations over the credits after the Senate failed to extend the credits last week, but it's not clear whether they made much progress.

Yesterday was the last day to sign up for ACA marketplace plans that start on Jan. 1. In other words, millions of people have already picked their insurance plans (or decided to go without) when facing a higher price tag. 

The debate could easily slip into January, but Congress could reopen enrollment if the two parties were to strike a deal.



medicare advantage

Influencing policy with selective research

Remember when my colleagues told you about how UnitedHealth Group uses research to try to influence the policy debate around Medicare Advantage? Well, they're out with a new story about how Humana does something similar.

Casey Ross and Tara Bannow got a hold of company research shared internally in 2022 that showed Humana's primary care clinics for Medicare Advantage members were performing poorly relative to their peers. Six weeks later, company executives shared a different set of numbers in an investor presentation that showed the clinics were excelling at keeping patients out of hospitals.

The story gets into Humana's broader research strategy, too. Former employees described how Humana would only pursue research questions that were likely to reflect well on the company and would sometimes choose not to publish unflattering results.

Read more.


research

Bending NIH research to Trump's will

NIH leadership has issued new staff guidance on how to align its $39 billion research award portfolio with the Trump administration's priorities, Anil Oza scoops

The NIH has faced legal challenges to its previous grant termination attempts, often for being "arbitrary and capricious." The new guidance will both help the NIH justify grant terminations and provide grant recipients grounds for pushing back on them, according to outside experts.

Read more.


More around STAT
Check out more exclusive coverage with a STAT+ subscription
Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

  • The AI industry wants to turn the routine mammogram into a powerful multitool, STAT
  • How the pandemic lockdowns changed a songbird's beak, The New York Times
  • Child's sudden death unnerves a promising area of gene therapy research, STAT
  • What happened when Dr. Oz took charge of a wonky health agency, The Washington Post
  • Experts assess Trump's declaration of fentanyl as weapon of mass destruction, STAT

Thanks for reading! More next time,


Enjoying D.C. Diagnosis? Tell us about your experience
Continue reading the latest health & science news with the STAT app
Download on the App Store or get it on Google Play
STAT
STAT, 1 Exchange Place, Boston, MA
©2025, All Rights Reserved.

No comments