Senate Majority Leader John Thune, R-S.D., speaks to reporters en route to his office on Capitol Hill in Washington, DC on November 10, 2025 (Photo by Tom Brenner/Getty Images)
WASHINGTON — Republicans and Democrats in the Senate agree that health care costs are rising too quickly and expect to vote next week on legislation that could aid Americans.
The only catch is that party leaders hadn’t decided what to include in the bills as of Tuesday.
Senators also appeared to accept that neither proposal will receive the bipartisan support needed to move forward, leaving complicated decisions for the tens of millions of Americans who buy health insurance on the Affordable Care Act marketplace before open enrollment ends as early as Dec. 15 in some states.
ACA Marketplace plans are expected to boost by an average of 26% next year, although a failure by Congress to extend the expanded tax credits would result in monthly payments for subsidized participants increasing by an average of 114% analysis from the non-partisan health organization KFF.
“I don’t think we have a clear path forward at this point,” said Senate Majority Leader John Thune. “I don’t think Democrats have a clear path forward.”
Vote expected on Democratic bill
Thune guaranteed a miniature group of Democratic senators a vote on a health care proposal of their choice in return for their votes for the spending package that ended the government shutdown.
Democrats are widely expected to introduce a bill to expand expanded tax credits for people who buy health insurance through the Affordable Care Act Marketplace. Those subsidies are scheduled to expire at the end of the year without congressional action.
But it’s not clear whether the Democrats’ bill would extend the loans for a year or a longer period.
GOP leaders are trying to drum up support for their own health care proposal, but acknowledge it will not get the 60 votes needed to advance under the Senate’s legislative filibuster rules.
Thune said Republican senators had a “vigorous discussion” about health care issues during their closed-door lunch, where Finance Committee Chairman Mike Crapo of Idaho and Health, Education, Labor and Pensions Committee Chairman Bill Cassidy of Louisiana presented some ideas. However, no final agreements have been reached.
Thune, R-S.D., said talks would continue before next week’s vote and likely afterward.
New York Senate Minority Leader Chuck Schumer said Democrats have “a plan” but declined to say exactly what it entails.
“Stay tuned,” Schumer said. “We had a great discussion and I can tell you this: We are going to be laser-focused on getting people’s costs down.”
Looking for a solution
West Virginia Sen. Shelley Moore Capito said Republicans’ discussions on health care have been “vigorous” but that they have not yet “decided on the clear path.”
Capito said their “expectation” is that Republican senators will introduce a bill next week to reduce the cost of health insurance premiums and health care as quickly as possible, although it has not yet been finalized.
“I like the idea of people being in control of the money, as opposed to insurance companies where they take a 20% profit,” Capito said, echoing comments from President Donald Trump. “I think that has its place.”
Capito said senators did not discuss during their lunch whether open enrollment should be extended or possibly reopened next year if Congress passes a health care law that in any way regulates tax credits in the ACA market.
New Hampshire Democratic Sen. Jeanne Shaheen said there is no indication there will be a bipartisan agreement on extending expanded ACA subsidies or any other health care proposal by next week’s vote, although bipartisan talks continue.
As for the Democrats’ plan, Shaheen said it was “not clear” what legislation party leaders would put forward for a vote or when they would make that announcement.
“Pay attention to the schedule”
North Dakota Republican Sen. John Hoeven said there is “strong support” among Republican lawmakers for making changes to how the expanded ACA tax credits work before extending them for a longer period of time.
However, he said these negotiations would take more time.
“In my opinion, when we have (the vote) next week, we probably won’t be at the point where we can get a big bipartisan agreement,” Hoeven said. “They’re more likely to put something together that will fail. We’ll put something together that will fail. And hopefully we’ll continue to work toward something that can work and that’s bipartisan.”
There’s a “good chance,” he said, that this will happen in December or January, a timeline that would likely bring resolution after open enrollment closes.
Hoeven declined to say whether a deal would extend open enrollment or include a second window for Americans to choose insurance, but said Republicans were aware of the deadlines.
“We pay a lot of attention to the schedule,” Hoeven said. “So with all the things we’re talking about, it’s clear that it needs to take effect next year or this year.”
- December 4, 20255:41 p.mThis report has been clarified to reflect that ACA enrollment deadlines vary by state.
