Senate to Vote on Two Health Care Bills

The Senate is expected to vote soon on two health care bills ahead of the expiration of the enhanced Affordable Care Act (ACA) subsidies at the end of this year. The proposal offered by the Democratic leadership, the “Lower Health Care Costs Act,” would include a clean extension of the expiring subsidies for three years, at an estimated cost of $83 billion over a decade. The proposal offered by the Republicans, the “Health Care Freedom for Patients Act of 2025,” would replace enhanced subsidies with Health Savings Account contributions for those up to 700% of the federal poverty limit, with funds ranging from $1,000 to $1,500 for the years 2026 and 2027, while directly funding cost-sharing reduction (CSR) payments and making other reforms. We estimate that this proposal will modestly increase deficits in the short term and modestly decrease deficits over a decade.

See our tracker comparing ACA extension proposals here.  

The following is a statement from Maya MacGuineas, president of the Committee for a Responsible Federal Budget: 

Given America’s unsustainable fiscal path, with deficits nearing $2 trillion a year and debt on course to reach record levels in short order, the Senate should not be approving any deficit-financed extension of the expiring ACA subsidies.  

The Democratic proposal for a three-year extension of the enhanced subsidies would increase deficits by $83 billion. The Republican plan does not yet have a score. While it appears to be deficit-reducing over the long run, it would likely add to deficits in the near-term when new subsidies are in effect and may continue to if they are extended; lawmakers should wait for an official score before voting on fiscally significant legislation.

Debate over issues as complex as health care policy is a part of the democratic process and can affect the lives of millions of Americans. But these dueling plans appear more of a messaging war, rather than serious fiscally responsible legislating.

There are more than enough offsets available to pay for whatever new health spending is proposed. Lawmakers should include enough of these offsets to pay for the legislation twice-over, ideally, adhering to  “Super-PAYGO.” We cannot keep adding more to the national credit card.  

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For more information, please contact Matt Klucher, Assistant Director for Media Relations, at klucher@crfb.org.