On December 9, 2025, President Trump of the United States expressed his opinion that government funds should be directly distributed to individuals, allowing them to purchase the medical insurance they need. At the same time, the Democratic Party is pushing for a three-year extension of the expiring Affordable Care Act subsidies.
Trump made these remarks during an event at the White House, emphasizing his desire to provide the money directly to the people so they can buy health insurance for themselves rather than paying it to insurance companies. He pointed out that many insurance companies’ stock prices have risen 17 times in a short period, attributing it to the Democratic Party’s introduction of the Obamacare, which he claims enriches insurance companies. Trump stated that the Republican goal is to ensure funds flow to policyholders in a more transparent and direct manner.
“We want to give money to the people so they can buy health insurance themselves. This is what we want to do, and what the Republican Party wants to do,” he said.
Meanwhile, Democratic senators are preparing for a vote on Thursday to extend the subsidies during the COVID-19 pandemic. However, due to lack of adequate support from Republicans, the proposal is expected to face difficulties in passing.
These subsidies aim to offset the premium costs of the Affordable Care Act, which are set to expire at the end of this year. If not extended, it could affect up to 24 million people who rely on this program.
A recent survey by healthcare research institute KFF showed that if the subsidies expire and premiums double, around a quarter of Obamacare enrollees may drop their health insurance by 2026. The survey also indicated that a majority of beneficiaries hope Congress extends these subsidies.
Based on the agreement reached last month to end the record-breaking 43-day government shutdown, Republicans have committed to holding a vote on the subsidy arrangements to respond to the Democratic demands.
On Monday evening, Republican senators Bill Cassidy from Louisiana and Mike Crapo from Idaho, who respectively chair two key healthcare committees in the Senate, unveiled a legislative proposal as an alternative to the Democratic Party’s three-year subsidy extension plan.
According to the summary provided by the two senators, the bill would provide up to $1,500 directly into health savings accounts for individuals earning below 700% of the federal poverty line. The legislation also stipulates that this funding cannot be used for abortion or gender transition services.
The proposal also includes a provision that aims to lower insurance premiums by 11% in 2027 and reduce federal Medicaid funding for states providing medical insurance to “undocumented immigrants.”
It is unclear whether the Cassidy-Crapo bill can garner widespread support from the 53 Republican senators in the Senate. The Republican caucus is expected to discuss this bill and other proposals during a closed-door lunch meeting on Tuesday, but strong opposition from the Democrats is anticipated.
As a physician and chairman of the Senate Health, Education, Labor, and Pensions Committee, Cassidy believes that this approach would give patients more control over their healthcare expenses.
Critics argue that this proposal may benefit high-income groups the most and force low-income Americans to switch to short-term or high-deductible insurance plans. They are concerned that many low-income individuals who currently pay minimal premiums may face significantly increased out-of-pocket expenses if the subsidies are terminated. Under current regulations, Obamacare participants’ premium expenditures do not exceed 8.5% of their income; however, if Congress does not extend the subsidies, this protection limit will cease to exist.