President Donald Trump urged Congress on Tuesday to send federal assistance directly to consumers as health care premiums could skyrocket for roughly 22 million Americans in six weeks.
Enhanced Affordable Care Act subsidies are set to expire at the end of the year, after the longest-ever federal government shutdown concluded without an extension of the tax credits, which emerged as a key demand of Democrats amid weeks of negotiations. The Senate will instead hold a vote on extending the subsidies by mid-December — a promise made to eight Democrats who bucked party leadership to reopen the government, though there is no guarantee it will advance.
In a post on his Truth Social platform, Trump doubled down on his proposal to redirect payments to consumers rather than health insurers.
“THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH,” Trump wrote in all caps. “THE PEOPLE WILL BE ALLOWED TO NEGOTIATE & BUY THEIR OWN, MUCH BETTER, INSURANCE. POWER TO THE PEOPLE!”
He added: “This is the only way to have great Healthcare in America!!! GET IT DONE, NOW.”
Trump’s plea, first introduced earlier this month, came as he said Sunday that he has begun discussions with Democrats about a direct health care payment plan. While speaking to reporters, Trump praised his proposal to replace federal tax credits with equivalent payments for people to cover their own health-care costs.
“People love it,” Trump said, without naming the Democrats he has spoken to about the payment plan.
“If it gets approved, we’re going to take the money, we’re going to pay it back to the people of our country to go out and buy health insurance,” Trump said. “Now, they can put it in a health account. We can do it a lot of different ways. But they’d buy their own health insurance. They can negotiate price.”
Trump said the money would be “locked,” meaning recipients “can’t go out and buy a Cadillac,” but “they can go out and buy health insurance.” He also railed against insurance companies, saying they are “making a fortune.”
“They are taking in hundreds of billions of dollars, and they’re not really putting it back, certainly not like they should,” Trump said.
According to POLITICO, Republicans on the House Ways and Means Committee have floated legislation that would align with Trump’s proposal. The bill would allow individuals enrolled in Affordable Care Act insurance exchanges to receive a portion of assistance from insurers directly through their tax-advantaged health savings accounts, in lieu of subsidies at the back-end of out-of-pocket costs.
On Monday, Sen. Bill Cassidy (R-La.) laid out another proposal that is in line with the president, which would deposit money directly into an individual’s health savings account. It would also encourage individuals enrolled in Obamacare plans to switch to bronze-level plans, POLITICO reported.
Meanwhile, critics of Trump’s plan say that it could have a major impact on how much Americans pay for health care and what type of coverage they receive. ACA enrollees will see their premiums rise by an average of 114% in 2026 if the enhanced ACA tax credits expire, according to KFF, a nonpartisan health policy research group.
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