After failure to extend health subsidies during shutdown, debate continues on potential fixes

WASHINGTON — Facing the end-of-year expiration of the Affordable Care Act subsidies that were at the heart of the record-long U.S. shutdown, a flurry of proposals to address the lapse have started to emerge, with lawmakers emphasizing the need for a bipartisan fix.

As various groups of lawmakers have been hashing out different proposals, President Donald Trump and White House aides are reportedly floating their own plan that calls for a two-year extension to the subsidies that were first approved by Congress in 2021 in response to the COVID-19 pandemic.

The White House plan, first reported by MS NOW on Sunday night, would reportedly set new income caps to qualify for the subsidies, addressing concerns aired publicly by Trump and some lawmakers that the subsidies currently cover too many people.

For any plan to pass the Republican-controlled Congress, however, it will need Democratic votes both in the U.S. Senate, where eight crossover votes are needed to meet the 60-vote threshold in that chamber, and also in the U.S. House, where Republicans hold a razor-thin majority and several fiscal-hawk Republicans have said they oppose any extension of subsidies.

"The answer here is bipartisanship and addressing what people are most concerned about, which is affordability," Rep. Tom Suozzi (D-Glen Cove) said in a phone interview. "Everything else is noise."

More than 22 million Americans qualified for the subsidies in 2025, or 93% of those who purchase their health insurance through the public marketplace, and without the subsidies, health plan costs are expected to more than double for enrollees, according to an analysis by the health nonprofit KFF.

The U.S. government was shut down for 43 days over a partisan impasse on the subsidies. The expected jump in premiums prompted congressional Democrats to withhold their support from a Republican-led short-term spending bill to fund the federal government, as they urged Republicans unsuccessfully to tie a subsidy extension to the spending package.

While congressional Democrats fell short of getting their key concession of an extension, Senate Majority Leader John Thune (R-S.D.) promised Senate Democrats a separate vote on the extension in December, and lawmakers from both parties have been scrambling ever since to craft compromise legislation, even as House Speaker Mike Johnson (R-La.) has yet to commit to holding a vote on the issue.

Bipartisan proposal

Suozzi last Friday filed a bipartisan bill, along with Democrat Rep. Josh Gottheimer of New Jersey and Republican Reps. Don Bacon of Nebraska and Jeff Hurd of Colorado, that also sets income limits for eligibility.

That bill calls for a two-year extension of the subsidies for those enrollees earning less than 600% of the federal poverty line, or about $200,000 per year for a family of four. The bill would phase out the subsidies for enrollees earning between 600% and 935% of the federal poverty line, or between $200,000 and $300,000 for a family of four, according to data provided by Suozzi’s office.

Suozzi’s bill also would extend the open enrollment period to May 15 to account for consumers who may have been discouraged from purchasing a health insurance plan over the high costs, and includes a number of provisions aimed at preventing fraud such as ensuring insurance providers are routinely checking their rolls to ensure eligibility.

"Everybody knows it's going to hurt people in their real life," Suozzi said at a news conference Friday on the steps of the U.S. Capitol to unveil the bill. "This is a real life thing, so we can't just ignore it. We have to take the steps to do something."

Rep. Laura Gillen (D-Rockville Centre) was among a group of 30 bipartisan House members who cosigned a letter to Thune and Senate Minority Leader Chuck Schumer (D-N.Y.), urging them to "include both House Democrats and Republicans in the legislative process," to ensure there is a bipartisan bill that can pass both chambers.

Gillen also was part of a group of lawmakers from both parties who met privately last week at a discussion led by Gottheimer and Rep. Jen Kiggans (R-Va.) to discuss prospective legislation.

Asked by Newsday which ideas or approach she supported, Gillen in a statement did not specify, but took aim at those House Republicans who have said they oppose an extension of subsidies.

"I've heard from many families who are worried about being priced out of their health care due to Republicans’ unwillingness to extend tax credits that bring down Long Islanders' insurance bills," Gillen wrote. "Congress must act in the best interest of the American people and preserve these critical tax breaks."

'Temporary response'

Rep. Nick LaLota (R-Amityville) said that as a member of the bipartisan House Problem Solvers Caucus, he has been involved in talks for legislation that would pair an extension with income caps and also hold insurance companies accountable for repeatedly denying claims.

LaLota said in a phone interview that while he supports a one-year extension, he takes issue with drawing out the subsidies further, noting the tax credits in question "passed without a single Republican vote years ago, were called temporary and were called pandemic-related ... and that's the reality that we all have to face."

Rep. Andrew Garbarino (R-Bayport) said in a statement that the subsidies "were a temporary response to the economic fallout of COVID-19 and were never intended to be permanent," and called for a long-term solution.

"I understand the high cost of health care that families are facing right now, and I’m committed to working toward a bipartisan solution that improves affordability and provides long-term stability," Garbarino said.

Amid the bipartisan talks, there also have been partisan proposals from both sides.

Sen. Bill Cassidy (R-La.), a physician and the chairman of the Senate Health, Education, Labor and Pensions Committee, has proposed a plan that calls for redirecting the funds used for the subsidies to flexible spending accounts that consumers can use to pay for their health insurance premiums. Cassidy has argued that the move would promote competition in the public marketplace that could lower costs.

House Minority Leader Hakeem Jeffries (D-Brooklyn) filed a measure on Nov. 12 known as a discharge petition, aimed at forcing a vote on a three-year extension to the health subsidies. The measure currently has 212 signatures — all Democrats — but needs Republican signatures to reach the necessary 218 signatures to force a floor vote.

Jeffries, appearing on CNBC last Friday to talk about the measure, said: "We want to find a bipartisan path forward."

By Laura Figueroa Hernandez

laura.figueroa@newsday.com@Laura_Figueroa

Laura Figueroa Hernandez is the White House correspondent and previously covered New York City politics and government. She joined Newsday in 2012 after covering state and local politics for The Miami Herald.