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Senate Republicans see a potential deal with Democrats on lowering health care premiums for 2026 — if President Donald Trump gets involved.
The Senate will vote by mid-December on reviving enhanced premium Obamacare tax credits set to expire by year’s end, a vote that Democrats get to choose. First, though, senators in both parties and the president need to figure out whether there will be a real bipartisan negotiation over health care premiums — or merely a political vote that is litigated in the midterms.
“I think there’s really some honest, sincere negotiations going on,” Sen. Shelley Moore Capito, R-W.Va., told Semafor.
She said a clean extension of the tax credits “would get voted down” by Republicans but added that “there could be a negotiated product. I think there’s a real possibility for that, especially if the president weighs in on this.”
Trump has said he’s open to negotiating with Democrats but has also called for dismantling the underpinnings of the Affordable Care Act and sending all of the law’s subsidies directly to consumers. However, his newfound focus on affordability could pique his interest in a deal on lowering health care costs for his voters.
The White House did not comment for this story.
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Senate Democrats haven’t devised their strategy quite yet; they’d been hoping to negotiate directly with Trump but have yet to land such a meeting. And time is running short.
A person familiar with the Senate Democratic Caucus’ dynamics called getting a result “an uphill fight” but said Democrats will welcome a debate after their shutdown gambit ended in painful divisions: “There’s a huge division in the [Republican] Party. And they’re never going to get well on it because half of them want to get rid of the ACA altogether.”
Sen. Tim Sheehy, R-Mont., told Semafor that he’s a “hard no” on any proposal that pumps “more taxpayer money into a failed health care system.” Extending the ACA subsidies as-is would cost about $35 billion per year, but that cost could be reduced by making changes to the policy.
Most Republicans want to put an income cap on who receives the enhanced subsidies, though they acknowledge privately that it’s too late to do that for 2026 rates. That leaves the most obvious deal as a straight extension for next year with changes to the subsidies in 2027. A shorter, one-year deal would risk the same shutdown fight right before the midterm elections.
And with a Thanksgiving break starting at the end of this week, some senators are skeptical anything will come together on such a tight timeline.
“We’re not going to be able to pull together bipartisan legislation in time for a December vote,” said Sen. Steve Daines, R-Mont. “I don’t think we will get something done in time for December due to the complexity of the issue.”