Trump’s push for health care plan stalls ahead of looming subsidy expiration

By Adam Cancryn, CNN

(CNN) — President Donald Trump’s push for a new health care plan has stalled, amid disagreements within the GOP over the extension of key enhanced Affordable Care Act subsidies, three people familiar with the matter told CNN.

The dispute has slowed the administration’s efforts to avert a looming spike in health insurance premiums, raising doubts about whether it will have any proposal ready in time for a Senate vote as early as next week on the fate of the ACA subsidies relied on by roughly 22 million people.

The White House initially expected to roll out a plan last week that paired an extension of the subsidies with a range of conservative reforms meant to limit their scope. But that was scrapped following sharp backlash from Republican lawmakers who were blindsided by the framework and deeply opposed to its core elements.

Trump officials attempting to rework the proposal are now unlikely to finalize a new plan this week, the people familiar with the matter said, raising the odds that Senate Republicans will be left without a Trump-endorsed proposal to counter Democrats’ call for passing a simple extension of the ACA subsidies before the funding expires at the end of the year.

The White House declined to comment.

Trump has continued to push aides to develop a health care plan over worries that voters will blame him for rising premiums should he fail to present an alternative, and the administration could still reach a sudden breakthrough, the people familiar with the matter cautioned.

Republicans in Congress, too, have been privately ramping up pressure on the administration to get behind a plan that averts steep price hikes in 2026 — a critical midterm year that could endanger their own seats.

“I encouraged the president to continue on this path of trying to move forward with a temporary extension,” said GOP Rep. Nicole Malliotakis of New York, who added that Congress would still need to overhaul the underlying structure of the ACA subsidies. “We have to do our best to protect American people and consumers.”

If the Biden-era subsidies expire, the premiums people pay are expected to more than double next year, according to KFF, a nonpartisan health policy research group. Plus, an estimated 2 million more people will be uninsured next year, the Congressional Budget Office found.

Still, the administration’s initial stumbles underscore the steep challenge that the White House faces in winning consensus within the GOP on any major health care proposal — much less one that has a shot at garnering enough support from Democrats to make it into law.

Senate Republicans agreed to hold a vote this month on extending the ACA subsidies as part of a deal with Democrats to fund the government and end a record-long shutdown. Most Republican lawmakers are staunchly opposed to a simple extension.

“The bottom line is, let them expire,” GOP Rep. Keith Self of Texas said Tuesday when asked about his preferred plan for addressing the looming cliff.

Trump has similarly signaled his opposition to a simple extension, calling instead for a plan that would send federal funding directly to consumers, rather than paying it to insurance companies to subsidize health care premiums.

The White House’s original framework would have extended the subsidies for two years, but set new income limits and required that all enrollees pay a minimum monthly premium. It also proposed incentivizing people to pick lower-tier plans by allowing them to funnel some federal aid into health savings accounts.

Yet many conservatives on Capitol Hill rejected the idea of voting to continue part of a health care law they’ve opposed for more than a decade. That division over continuing the subsidies in any form, or allowing them to expire, has prevented the party from coalescing behind a single proposal.

Roughly 22 million people benefit from the enhanced tax credits, which polling shows are broadly popular with voters. That has raised fears among some Trump advisers and Republican lawmakers about the political ramifications of letting them run out, which would push premiums higher at a moment when much of the electorate is already unhappy with the cost of living.

“I think we need to do something,” said Rep. Nick LaLota of New York, a battleground Republican who has been a vocal supporter of preventing those health care price hikes, while working to fix what he calls a broken system.

Asked whether anything can be done before the end-of-the-year expiration of funding for the enhanced subsidies, LaLota pointed to Congress’ tendency to act only ahead of key deadlines: “Time winds up becoming a pressure cooker.”

Trump administration officials in recent days have sought to resolve lawmakers’ concerns over continuing the subsidies, the people familiar with the matter said, including exploring ways to maintain the funding through some alternate program that members might be more willing to support.

They are also grappling with demands that any plan including so-called Hyde protections prohibiting the use of federal funds for abortion — a key GOP priority, yet one that would complicate any prospect of winning Democratic support.

But with the Senate poised to vote as soon as next week, the prospect of striking a deal ahead of that deadline has grown exceedingly dim.

Some Republicans, like Malliotakis, have been in private talks with rank-and-file Democrats for weeks to find a path forward that can win support in both chambers.

“This is not a problem that Republicans created, and so Republicans on their own will not be able to resolve it,” Malliotakis said. “This needs to be a bipartisan solution.”

CNN’s Sarah Ferris and Tami Luhby contributed to this report.

The-CNN-Wire
™ & © 2025 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.