The NPR Politics Podcast Health Insurance Subsidies Expire This Month But Congress Can't Agree On A Fix
36 snips
Dec 11, 2025 
Selena Simmons-Duffin, an NPR health policy correspondent, joins the discussion to unveil the looming expiration of enhanced health insurance subsidies affecting 22 million Americans. She highlights the diverse proposals from Democrats and Republicans, touching on the tradeoffs between coverage and costs. Selena emphasizes the significant premium increases low-income and older Americans will face if no agreement is reached. Political dynamics, including the role of President Trump and the pressure on swing-district Republicans, are also explored.
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Democrats Seek Clean Three-Year Extension
- Democrats pushed a clean three-year extension of enhanced ACA subsidies to keep current premium support intact.
- Senate leaders did not expect the clean extension to advance given partisan divisions.
Republican Plan Focuses On HSAs
- Senate Republicans proposed redirecting funds into health savings accounts instead of extending subsidies.
- Their plan offered up to $1,500 per year and argued it would give money directly to patients, not insurers.
Big Cost Gap Between Proposals
- The Republican HSA proposal would cover only a portion of marketplace enrollees and cost about $10 billion.
- Democrats estimated the enhanced subsidies cost about $35 billion a year, highlighting a major funding gap.