December 5, 2025

Moderate GOPers Frustrated On Exchange Impasse

Frustration is mounting for moderate GOP lawmakers as the GOP has no defined healthcare plan, and Democrats are capitalizing on the lack of affordability in healthcare and the expiration of enhanced subsidies in the Exchange. Millions will see surging premiums as of January 1 with no action to extend the subsidies. Dozens in the GOP caucus in the House from swing districts face an uncertain future. A few GOP senators are also vulnerable. But so far, House Speaker Mike Johnson, R-LA, bolstered by opposition from conservatives, refuses to guarantee a vote in the House. In the Senate, Majority Leader John Thune, R-SD, did agree to hold a vote and Democrats are pushing a three-year extension. Sixty votes are needed to pass the bill. Democrats would need seven GOP defectors. It is a possibility but perhaps not a likelihood.

In other news, MedPage Today talks about the irony that tax-free Health Savings Accounts (HSAs) can pay for parenting workshops, bassinets, and even saunas, but cannot use the funds to pay for premiums under current law. Some Republicans want to send the enhanced subsidies in favor of funding HSAs, but many even among Republicans doubt the federal government can pull off such a swift implementation.

Additional article: https://www.medpagetoday.com/publichealthpolicy/washington-watch/118862 and https://www.fiercehealthcare.com/payers/ahip-presses-aca-subsidy-extension-further-program-integrity-measures

#exchanges #healthcare #coverage #hsas

https://thehill.com/policy/healthcare/5634256-gop-health-care-plans-frustration

Exchange Enrollment So Far Reveled

The Centers for Medicare & Medicaid Services (CMS) reported today that nearly 950,000 consumers who do not currently have healthcare coverage through the Exchanges have signed up for coverage in 2026. The deadline comes on December 15 for January 1 coverage. Over 4.8 million existing consumers have already selected a plan for 2026.

Despite the huge surge in premiums in general and especially for subsidized individuals (due to the anticipated expiration of enhancements), enrollment is not down considerably – at least so far. Last year at this time, 988,000 new enrollments had occurred, with 4.4 million returning.

We shall see what the remainder of open enrollment brings.

Additional article: https://www.cms.gov/newsroom/press-releases/nearly-988000-new-consumers-selected-affordable-health-coverage-aca-marketplace-so-far

#exchanges #healthcare #coverage #enrollment

https://www.cms.gov/newsroom/fact-sheets/marketplace-2026-open-enrollment-period-report-national-snapshot

— Marc S. Ryan

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