由议长迈克·约翰逊领导的众议院共和党人星期五公布了一个狭窄的医疗保健一揽子计划，以解决不断上涨的费用，但是该计划没有延长即将到期的加强平价医疗法案补贴。
共和党的提案将在下周的某个时候在众议院进行投票，这将扩大协会健康计划和所谓的“选择安排”;对药房福利经理实施新的透明度要求，以降低药品成本;并拨出资金用于降低成本分摊，以降低单个市场的保费。
协会健康计划允许雇主联合起来购买保险。
值得注意的是，长达111页的措施不会将额外的资金注入健康储蓄账户。
越来越多的众议院共和党人人签署努力强行表决ACA补贴-藐视议长约翰逊
“虽然民主党人要求纳税人给保险公司开出更大的支票，以掩盖他们失败的法律的成本，但众议院共和党人正在解决医疗费用的真正驱动因素，以提供负担得起的医疗服务，增加获得和选择的机会，并为所有美国人恢复我们国家医疗保健系统的完整性，”约翰逊周五在一份声明中说。
共和党人是也讨论对延长ACA补贴的医疗保健方案修正案进行投票。据共和党领导人的助手称，修正案的细节仍在讨论中。
规则委员会计划在周二下午2点对该法案进行评分。然后，众议院将不得不对一项与延长补贴相关的修正案进行投票，然后对基础法案进行投票，然后将其提交给参议院。
美国总统唐纳德·特朗普(Donald Trump)周五对记者表示，他希望有一个直接向患者提供援助的医疗保健计划，并补充说，应该通过保险账户向人们提供医疗保健资金。
特朗普说:“我认为大多数共和党人希望看到的——也是我希望看到的，我把它留给他们，希望他们会在这张桌子上提出伟大的立法:我们希望看到所有被浪费并给了保险公司的钱，因为奥巴马医改是可怕的医疗保险。”
他补充说，“我们希望钱到人民手中。它们会以保险账户、医疗账户或我们可以用许多不同的形式创建的任何其他形式存在。我们想把钱给人民，让人民购买他们自己的伟大的医疗保健，他们将节省很多钱，这将是伟大的，”他继续说。
但特朗普也对延长ACA税收抵免敞开了大门，表示他将“研究”这样做的可能性，并保证延长协议将附带一些共和党人想要的警告。
众议院共和党领导人的助手希望下周通过医疗保健一揽子计划-预计众议院将在2025年的最后一个立法周开会。
特朗普直接给美国人支付医疗费用的想法可能吗?
“降低所有美国人的医疗保险费法案将实际上提供负担得起的医疗保健-我们期待着在众议院推进它，”约翰逊说。
即使该措施在众议院获得通过，参议院也不太可能在下周对医疗保健采取任何进一步的重大行动，从而使这些增加的保费补贴几乎肯定会失效。
众议院民主党领袖哈基姆·杰弗里斯(Hakeem Jeffries)称共和党的提议是“有毒的立法”，没有解决即将到来的ACA保费上涨问题。
杰弗里斯在一份声明中说:“众议院共和党人对结束他们在这个国家引发的医疗危机并不认真。”。“在承诺立法数月后，这一最后时刻的措施未能延长数千万美国人赖以支付医疗保健的患者保护与平价医疗法案税收抵免。”
杰弗里斯说，民主党人愿意与共和党人合作延长补贴，他说:“我们准备好与过道另一边希望阻止患者保护与平价医疗法案税收抵免在本月底到期的任何人真诚合作。”
在这项措施于周五出台之前，近12名众议院共和党人人试图强行就延长即将到期的补贴进行投票，公开挑战约翰逊。
截至周四，11名共和党人签署了两份出院申请一份由共和党人提交，另一份由民主党人提交，这将延长补贴。
在参议院，两个相互竞争的医疗保健提案旨在解决预期的保费飙升，一个由民主党人倡导，另一个由共和党人倡导未能前进本周早些时候。
House Republicans unveil health care package that does not extend ACA subsidies ahead of next week's vote
House Republicans -- led by Speaker Mike Johnson -- unveiled Friday a narrow health care package to address rising costs, but the plan does not extend the expiring enhanced Affordable Care Act subsidies.
The GOP proposal -- which will receive a vote on the House floor sometime next week -- would expand the availability ofassociation health plans and what are known as "CHOICE arrangements"; impose new transparency requirements on pharmacy benefit managers to lower drug costs; and appropriate money for cost-sharing reductions to reduce premiums in the individual market.
Association health plans allow employers to band together to purchase coverage.
Notably, the 111-pagemeasurewould not funnel additional money into health savings accounts.
Growing number of House Republicans sign on to effort to force vote on ACA subsidies -- defying Speaker Johnson
"While Democrats demand that taxpayers write bigger checks to insurance companies to hide the cost of their failed law, House Republicans are tackling the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation's health care system for all Americans," Johnson said in a statement Friday.
Republicans arealsodiscussing staging a vote on an amendment to the health care package that would extend the ACA subsidies. The specifics of the amendment are still being discussed, according to GOP leadership aides.
The Rules Committee plans to mark up the bill at 2 p.m. on Tuesday. The House would then have to vote on an amendment related to extending the subsidies and then the underlying bill before sending it over to the Senate.
Senate back to square one on health care after both bills fail
Speaking to reporters on Friday, President Donald Trump said he wants a health care plan that would directly funnel aid to patients, adding that money should be given to people for health care through an insurance account.
"I think what most Republicans want to see– what is what I want to see, and I leave it to them, and hopefully they're going to put great legislation on this desk right here: we want to see all of the money that's been squandered and given to insurance companies because Obamacare is horrible health insurance," Trump said.
He added, "And we want the money to go to the people. They'll go in the form of an insurance account, health care account, or any other form that we can create with a lot of different forms. We want to give the money to the people and let the people buy their own great health care, and they'll save a lot of money, and it'll be great," he continued.
But Trump also kept the door open, slightly, on extending ACA tax credits, saying he was going to "look into" the possibility of doing so with the assurance that an extension deal would come with some caveats that Republicans want.
House GOP leadership aides hope to pass the health care package next week -- the last legislative week of 2025 that the House is expected to be in session for.
U.S. President Donald Trump points on the day he signs a bill to award congressional gold medals to members of the 1980 U.S. Olympic men's hockey team, who went on to win gold after defeating a heavily-favored Soviet Union team in their "Miracle on Ice" medal-round match, in the Oval Office at the White House in Washington, D.C., U.S. December 12, 2025.
Jonathan Ernst/Reuters
Is Trump's idea to pay Americans directly for health care possible?
"The Lower Health Care Premiums for All Americans Act will actually deliver affordable health care -- and we look forward to advancing it through the House," Johnson said.
Even if the measure does clear the House, the Senate is not likely to take any further major action on health care next week, leaving those enhanced premium subsidies all but certain to lapse.
House Democratic Leader Hakeem Jeffries called the Republican proposal "toxic legislation" that doesn't address the coming hike in ACA premiums.
"House Republicans are not serious about ending the healthcare crisis they have unleashed in this country," Jeffries said in a statement. "After promising legislation for months, this 11th hour measure fails to extend the Affordable Care Act tax credits that tens of millions of Americans rely on to afford their healthcare."
Jeffries said Democrats are willing to work with Republicans on extending the subsidies, saying: "We are ready to work with anyone in good faith on the other side of the aisle who wants to prevent the Affordable Care Act tax credits from expiring at the end of the month."
Ahead of the measure being introduced Friday, nearly a dozen House Republicans had publicly defied Johnson by trying to force a vote on extending the expiring subsidies.
As of Thursday, 11 Republicans hadsigned on to two discharge petitions-- one filed by a Republican and the other by a Democrat -- that would extend the subsidies.
In the Senate, two competing health care proposals aimed at addressing the expected premium spikes -- one championed by Democrats and the other by Republicans --failed to advanceearlier this week.
