These are the new GOP health bills

Modern Healthcare – Tuesday, December 9, 2025
By Michael McAuliff

Less than a month before enhanced subsidies for health insurance plans expire, congressional Republicans have started rolling out their plans for healthcare costs.

The leading Senate Republican bill would not, however, actually extend the subsidies. The upper chamber is slated to vote Thursday on Democratic legislation to renew the enhanced premium tax credits for three years and the new GOP plan, which instead offers deposits into health savings accounts for people with high-deductible health plans.

Alternative Republican and bipartisan plans would temporarily extend the subsidies while also imposing new income caps and making other changes to the exchanges.

Senate Majority Leader John Thune (R-S.D.) is backing the HSAs measure from Finance Committee Chair Mike Crapo (R-Idaho) and Health, Education, Labor and Pensions Committee Chair Dr. Bill Cassidy (R-La.). House Speaker Mike Johnson (R-La.) has not said what the lower chamber may do and is holding a party meeting on the issue Wednesday.

Crapo and Cassidy’s Health Care Freedom for Patients Act of 2025 would fund health savings accounts for people who earn up to 700% of the federal poverty level, which is $109,550 for a single person in the continental U.S. and higher in Alaska and Hawaii. Those aged 18-49 would get $1,000 and those aged 50-64 would get $1,500.

The measure would also fund cost-sharing reductions for exchange plans. While this would reduce Silver plan premiums, it also would shrink financial assistance for exchange enrollees because the value of the subsidy is linked to the price of the second-lowest-cost Silver policy — known as the benchmark plan — in each geographic market.

The bill also includes new restrictions on benefits for immigrants and healthcare for transgender people and a ban on abortion coverage in exchange plans.

“It actually does make health insurance premiums more affordable. It drives down — according to the Congressional Budget Office — premiums by double-digit levels,” Thune said Tuesday. “It delivers the benefit directly to the patient, not to the insurance company.”

The Democratic bill simply extends the tax credits for three years, which the minority party argues is the only real option so late in the day, and which they say will buy Congress time to consider how to deal with broader healthcare questions going forward.

Senate Minority Leader Chuck Schumer (D-N.Y.) said the Cassidy-Crapo bill offers “junk insurance” and has no chance of passing since it does not stave off the sticker shock millions of Americans will face when enhanced subsidies expire and is loaded with “poison pills,” such as the abortion restrictions.

“Republicans have 48 hours to choose: Join Democrats and stop the spike, or stick millions of Americans with higher costs,” Schumer said Tuesday. “The burden is on 13 Republicans to vote with us.”

Neither Schumer nor Thune seemed to believe either measure could meet the 60-vote threshold needed to prevent a filibuster. “If neither proposal gets 60, then we’ll see where it goes from there,” Thune said.

Republicans have struggled to come up with their own plans, while President Donald Trump has sent mixed signals over whether he wants the subsidies extended and, if so, what other policies should be included in legislation. Thune and Johnson have largely deferred to the chairs of the major healthcare committees.

That hasn’t stopped other Republicans from pitching ideas that include subsidy extensions, including some crafted in conjunction with Democrats.

Here are some notable proposals:

Sens. Bernie Moreno (R-Ohio) and Susan Collins (R-Maine)

“Make America Great Again”-aligned Moreno and centrist Collins unveiled a simple, three-part framework for a bill on Wednesday.

The Consumer Affordability and Responsibility Enhancement Act of 2025 would extend the enhanced subsidies for two years, limit them to households with incomes below $200,000 and require a minimum $25 monthly premium.

Reps. Jeff Hurd (R-Colo.), Tom Suozzi (D-N.Y.) et al.

House lawmakers introduced the Bipartisan Healthcare Optimization, Protection, and Extension Act of 2025 last month. It would maintain subsidies for households earning up the 935% of the poverty level, require nominal premiums, and include penalties for brokers and others who fraudulently enroll people. It also includes new restrictions on pharmacy benefit managers similar to plans Congress has considered for three years. It would extend the 2026 open enrollment period, which ends Jan. 15 in most states, until March.

Reps. Jen Kiggans (R-Va.), Josh Gottheimer (D-N.J.) et al.

These centrists and 33 other House members offered a framework last week to extend the credits for two years, phase in income caps, address fraudulent enrollments and regulate PBMs.

Rep. Brian Fitzpatrick (R-Pa.) et al.

Fitzpatrick and others including Suozzi and Rep. Jared Golden (D-Maine) offered the Bipartisan Health Insurance Affordability Act of 2025 on Tuesday. It would extend the enhanced subsidies for two years, establish income caps, regulate PBMs and expand HSAs.

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