Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing, or another hot-button matter.
On November 12, the House of Representatives voted 222-209 to reopen the government. President Trump signed the bill shortly thereafter. The agreement, first approved by the Senate on a 60-40 vote on November 10, provides a continuing resolution to fund most federal agencies through January 30 in exchange for a promised Senate vote to extend enhanced Advance Premium Tax Credits (“APTCs”) in December. The bill also includes three full-year spending bills funding military construction, the Departments of Agriculture and Veterans Affairs, and the legislative branch through September 30, 2026; appropriations to fund Supplemental Nutrition Assistance Program (“SNAP”) benefits through September 30, 2026; the reversal of certain layoffs during the shutdown (and blocking any new layoffs through January 30, 2026); and the guarantee of back pay for federal employees who have been furloughed or working without pay during the shutdown. The longest shutdown in history lasted 43 days.
Leading up to the December Senate vote to extend the enhanced APTCs, various groups of lawmakers are beginning to stake out their positions. Republicans generally do not support extending the advanced APTCs, but one bipartisan group of senators reportedly has been meeting on policies related to the extension. Meanwhile, some Republican senators have been exploring other, alternative health reform proposals related to President Trump’s statements in favor of the subsidies going directly to individuals instead of to insurance companies. Last week, President Trump posted on Truth Social, “We want a health care system where we pay the money to the people instead of the insurance companies, and I tell you, we’re going to be working on that very hard over the next short period of time — where the people get the money.” Although the exact policy proposal the President is calling for is unclear, some Republicans have interpreted it to encompass ACA-related health insurance subsidies being redirected to consumer-directed benefit accounts. Senate Health, Education, Labor, and Pensions (“HELP”) Committee Chairman Bill Cassidy (R-LA) is working on a proposal to deposit enhanced APTC subsidies in health flexible spending accounts, while Senator Roger Marshall (R-KS) has said he favors sending APTC amounts to health savings accounts (“HSAs”). The Senate Finance Committee is holding a hearing this Wednesday at which these individual account proposals and the extension of enhanced APTCs are likely to be discussed.
Though a group of House moderates has pressed him to help negotiate a deal on extending the enhanced APTCs, House Speaker Mike Johnson has not promised a vote even if an extension passes in the Senate. That said, Ways and Means Republicans are reportedly working on legislation based on the President’s proposal that would redirect health insurance subsidies to HSAs. One proposal being evaluated is a bill, H.R. 1157, the ACCESS Act, introduced by Reps. Greg Steube (R-FL) and Kat Cammack (R-FL) in February that would allow individuals to elect to receive HSA contributions in lieu of ACA cost-sharing reduction amounts. Meanwhile, other Republican committee chairs will reportedly hold listening sessions with their members this week as leadership works through which policies to pursue to lower healthcare costs.
