The Trump administration has delayed the release of a new health care proposal after facing immediate backlash from Republican allies, casting doubt on the party’s ability to unite behind a plan to address rising health care costs. The postponement highlights internal divisions as Congress races against a year-end deadline to avert a spike in premiums for millions of Americans enrolled in Affordable Care Act plans.
The White House had developed a framework in recent weeks that sought to extend enhanced ACA subsidies for two years while incorporating conservative reforms, but details circulated among aides and allies sparked swift criticism. According to sources, the administration briefed some key lawmakers ahead of a planned rollout, but rank-and-file Republicans were caught off guard, learning about the proposal through media leaks and social media. This led to harsh blowback, prompting the delay, with a White House official stating that no announcement had been finalized and cautioning against speculation.
The proposed package included continuing the enhanced subsidies—set to expire at year’s end—but with new guardrails such as an income cap and a requirement for all enrollees to make a minimum monthly premium payment. It also aimed to allow consumers to redirect some federal aid into health savings accounts if they chose lower-tier ACA plans, fulfilling Trump’s desire to give more control to individuals. Additionally, the framework floated expanding access to plans outside the ACA exchanges and imposing restrictions on federal funding for gender-affirming care and health care for undocumented immigrants.
Republican opposition was particularly strong in the House, where Obamacare remains a contentious issue, and many lawmakers viewed the subsidy extension as an unacceptable expansion of the law. Conservatives panned the proposal, with one former senior administration official calling it “not very Trumpian,” and Michael Cannon of the Cato Institute remarking, “What this means is the Republicans will be expanding Obamacare. It’s really disheartening.” There is little expectation that such a plan could pass the House, as other GOP health care proposals exclude subsidy extensions entirely.
On the Democratic side, while Senators Jeanne Shaheen, Maggie Hassan, and Jacky Rosen expressed tentative support for good-faith negotiations, the majority rejected the proposal in favor of a clean extension of ACA subsidies. Senator Ron Wyden, the top Democrat on the Senate Finance Committee, accused Republicans of retreating to ideological crusades instead of working collaboratively to lower costs. The divide reflects longstanding partisan battles over health care, with Democrats wary of any measures that could undermine the ACA.
The political context amplifies the urgency, with midterm elections looming and voters increasingly anxious about affordability. More than 22 million Americans benefit from the enhanced subsidies, and their expiration could lead to hefty premium increases, making health care a central issue in the upcoming campaigns. A White House adviser emphasized, “The president understands this. If we can come up with something that actually gives people more choices and makes health care more affordable, that’ll be a powerful message headed into the midterms.”
Looking forward, the Senate has agreed to hold a mid-December vote on the subsidies as part of a government funding deal, but with the Thanksgiving recess, time is critical. The episode illustrates the persistent challenges in health care policy, where bipartisan compromise has often eluded lawmakers. As Cannon noted, “Obamacare sort of trapped us in this situation where anything that a Republican proposes, Democrats scream that they’re undermining Obamacare,” suggesting that finding common ground will require significant concessions from both sides.
