Republicans Eye Next Big Legislative Push To Blunt Democrat Healthcare Messaging

Republicans are pushing back against Democrats’ health care demands with their own proposals that they say will shift control from insurers to individual consumers.

The impasse that fueled the record government shutdown has centered on Democrats’ refusal to budge on extending Obamacare’s enhanced premium subsidies, which they passed in 2021 without GOP support and are set to expire at the end of 2025. Republicans are developing an alternative that shifts those subsidies away from insurers — who they say have profited excessively since Obamacare’s inception — and directly toward consumers buying health coverage.

The House of Representatives is poised to approve a Senate-passed spending package to reopen the government that omits an extension of Obamacare’s enhanced premium subsidies. Senate Majority Leader John Thune has proposed a vote on a Democratic-authored Obamacare subsidy expansion bill, but the measure is likely to fail given deep opposition from Republicans.

Critics of Obamacare, formerly known as the Affordable Care Act (ACA), point to the fact that ACA premiums have increased nearly twice as fast since 2014 as employer-sponsored insurance plans, proof that the status quo pushed by Democrats isn’t working. Expanding subsidies would cost up to $350 billion over the next decade, according to the Congressional Budget Office (CBO).

“Obamacare, since its inception, has consistently seen premiums increase for individuals in the individual market, to levels that are simply not sustainable,” Thune told reporters Monday. “We need fixes. We need solutions.” (RELATED: Shutdown deal will allow senators to pursue ‘Arctic Frost’ investigation)

Senate Majority Leader John Thune (R-SD) speaks to reporters as he walks to his office November 10, 2025 on Capitol Hill in Washington, DC. (Photo by Tom Brenner/Getty Images)

Among the leading Republicans is Sen. Bill Cassidy of Louisiana, chairman of the Senate Health, Education, Labor and Pensions Committee. Cassidy proposed funneling federal funds into flexible spending accounts (FSAs), which would allow individuals to set aside pre-tax dollars for medical expenses.

“What I’m advocating for is that we redirect the grants to flexible spending accounts, and it could be the same amount of money per person, but it would be in an FSA, not to the insurance company,” Cassidy told reporters Monday. “When you send it to the insurance company, they take 20 percent of it for overhead and profit, which is a pretty high cost of ownership. You send it to the patient, almost all of it will go toward direct health care.”

Republican Sen. Rick Scott of Florida also said he was preparing a bill that would distribute federal dollars to “HSA-style accounts,” saying it would “increase competition.” [and] reduce costs.

The concept has the support of President Donald Trump, who on Sunday urged Republicans to give individuals the money that currently goes to insurance companies, warning that extending Obamacare’s increased subsidies would give insurers “another huge payday at the expense of the American people.”

No formal proposals have been approved by Republican leaders, but the Paragon Health Institute, an increasingly influential think tank in Washington, D.C., has been a proponent of subsidy reform for years. In 2022, it published a policy brief outlining a similar plan.

Paragon’s proposal calls for restoring federal funding that reimburses insurance companies for mandatory discounts they must give eligible enrollees on out-of-pocket expenses such as deductibles and copayments, also known as cost-sharing reductions (CSRs). Initially, the federal government covered these costs, but when it stopped making payments in 2017, insurers raised premiums to make up the difference, increasing federal spending on premium subsidies.

Restoring CSR funding would reverse this effect, reducing contributions and the public deficit by about $31 billion, according to the CBO.

Paragon’s plan would also give eligible enrollees the option of receiving their CSR grant as a deposit into a health savings account (HSA) rather than as a payment to insurers.

“All of these policies would lower premiums, reduce deficits and give low-income Americans more control over their health insurance,” Brian Blase, president of the Paragon Health Institute, told the Daily Caller News Foundation. “This is the best-thought-out immediate policy that can be put in place to align with the president’s vision.”

Republican Reps. Greg Steube and Kat Cammack of Florida introduced a measure in February that would allow eligible individuals to receive direct contributions to an HSA. The House version of the GOP’s One Big Beautiful Bill would have directed funding for the CSR program, but it was ultimately rejected by the Senate parliamentarian. (RELATED: Schumer shutdown becomes circular firing squad after growing number of Democrats call for his ouster)

Senate Minority Leader Chuck Schumer (DN.Y), flanked by Senators Patty Murray (D-WA) (L) and Brian Schatz (D-HI), speaks to reporters November 4, 2025 on Capitol Hill in Washington, DC. (Photo by Tom Brenner/Getty Images)

Meanwhile, Democrats have accused Republicans of trying to overhaul Obamacare.

“The future is unpredictable, but we must continue our unequivocal and relentless fight for affordable health insurance by expanding subsidies and other measures under the ACA,” Sen. Richard Blumenthal of Connecticut told reporters Monday. “Republicans have a reflexive obsession with repealing or destroying the ACA.”

However, Cassidy stressed that his proposal was “very narrow in scope.”

“What we’re talking about: It’s not about rewriting large parts of the Affordable Care Act,” Cassidy said. “We are looking very specifically at what we can do for plan year 2026.”

Blase added that broader reforms to the ACA represent an “ambitious vision of where we should be going,” but that developing policies to get there will take time and raise many complex questions.

“I’m looking at what can be done in the coming months,” he said.

Meanwhile, some Republican lawmakers appear eager to debate with Democrats on health care.

“If they don’t want to take that money away from the insurance companies and give it back to the consumer, that would be a big fight to have,” South Carolina Sen. Lindsey Graham told reporters.

Adam Pack, Andi Shae Napier and Caden Olson contributed to this report.

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