Affordable Care Act

WASHINGTON — There’s bipartisan support in Congress for extending tax credits that have made health insurance more affordable for millions of people since the COVID-19 pandemic. But the credits are in danger of expiring as Republicans and Democrats clash over how to do it.

Democrats are threatening to vote to shut down the government at the end of the month if Republicans don’t extend the subsidies, which were put in place in 2021 and extended a year later when Democrats controlled Congress and the White House. The tax credits, which are due to expire at the end of the year, go to low- and middle-income people who purchase health insurance through the Affordable Care Act.

Some Republicans who have opposed the healthcare law, known as Obamacare, since it was enacted in 2010 are suddenly open to keeping the tax credits. They acknowledge that many of their constituents could see steep hikes in coverage if the subsidies are allowed to lapse.

But the two sides are far apart. Republicans are divided, with many firmly opposed. GOP leaders in the House and Senate have been open but noncommittal on the extension, and many of those Republicans who say they support it argue that the tax credits should be reworked — potentially opening up a new healthcare debate that could take months to resolve.

Democrats would be unlikely to agree to any changes in the subsidies, increasing the chances of a standoff and mounting uncertainty for health insurers, hospitals, state governments and the people who receive them.

“In just a few weeks, unless Congress acts, millions of Americans will start getting letters in the mail telling them their health insurance costs are about to go through the roof — hundreds of dollars, thousands in some cases,” Senate Democratic leader Chuck Schumer (D-N.Y.) said last week.

Surging enrollment

Enrollment in Affordable Care Act plans has surged to a record 24 million people in large part due to the billions of dollars in subsidies that have lowered costs for many people. The expanded subsidies allowed some lower-income enrollees to access health plans with no premiums and capped the amount higher earners pay for premiums to 8.5% of their income. It also expanded eligibility for middle-class earners.

With expiration just a few months away, some of those people have already gotten notices that their monthly premiums are poised to surge next year. Insurers have sent out notices in nearly every state, with some proposing premium increases of as much as 50%.

Lawmakers are facing pressure to act from some of the country’s biggest industries, including the insurers that cover people on the marketplace and hospital executives who say they’re already going to be squeezed by the Medicaid cuts in President Trump’s massive spending and tax bill enacted this summer.

“There’s broad awareness that there’s a real spike in premiums coming right around the corner, both Republicans and Democrats,” said David Merritt, senior vice president of external affairs at Blue Cross Blue Shield. “It’s certainly lining up for Congress to have an opportunity to head off this problem.”

Companies have said they’ll need to raise premiums without the subsidies because healthier and younger people are more likely to opt out of coverage when it gets more expensive, leaving insurers to cover older and sicker patients.

In Iowa last month, the state’s insurance commissioner weighed increases ranging from 3% to 37% against a stream of angry public comments. One woman who runs a garden center in Cedar Falls said she was considering dropping her health insurance.

“I am already living as frugally as I possibly can while working as hard as I possibly can, putting in as many hours as I am allowed to at my job, never missing a day of work,” the woman, LuAnn, wrote in a public comment published to the commissioner’s website.

Feud over Obamacare

On Capitol Hill, the issue has become entangled in a larger fight over government funding as the threat of a shutdown looms at the end of the month. Schumer and House Minority Leader Hakeem Jeffries (D-N.Y.) have said Democrats will not vote to keep the government open unless an extension of the healthcare tax credits is part of the deal. Republicans have said that they want more time to look at the subsidies and potentially scale them back. They will also have to wait for a signal from Trump, who has not yet weighed in.

Jeffries said last week that “we will not support a partisan Republican spending bill that continues to rip away healthcare from the American people.”

Republican leaders are eyeing a potential stopgap bill that would keep the government open for a few weeks, but they are unlikely, for now, to include the extension. GOP leaders in both the House and Senate are also under pressure from some members who worry that premium increases will be a political liability before next year’s midterm elections.

Senate Majority Leader John Thune (R-S.D.) has said he wants to see a proposal from Democrats on how to extend the subsidies since they are pushing the issue. “Maybe there is something we can do in the middle as a solution,” he said in a Punchbowl News interview Thursday, adding that his members are divided on the issue.

Still, Thune has ruled out quick action, even as he noted that premium notices will go out soon. He has said a short-term spending measure to fund the government for several weeks while Congress finishes its budget bills is not likely to include an extension of the benefits,

House Speaker Mike Johnson (R-La.) has said that many of his members would oppose an extension, but he has not ruled it out.

In recent days, 15 House Republicans in competitive political districts introduced legislation to extend the tax credits for one year. “While the enhanced premium tax credit created during the pandemic was meant to be temporary, we should not let it expire without a plan in place,” said Rep. Jen Kiggans (R-Va.), who led the effort with Rep. Tom Suozzi (D-N.Y.).

Middle-class and small-business owners, including many in Kiggans’ coastal Virginia district, will be especially vulnerable to big health insurance hikes if the subsidies are not extended.

Several Senate Republicans also said they’d favor an extension. Sen. Josh Hawley of Missouri said that if Congress doesn’t act, some premiums will “skyrocket, and not by a little bit. We’re looking at massive increases. People will not be able to afford it.”

Sen. John Cornyn (R-Texas) said he thinks Congress should scale back the subsidies for the highest-income people who receive them. “I think we all know that access to healthcare is important and we take it very seriously,” he said.

Senate Finance Committee Chairman Mike Crapo (R-Idaho), whose panel has jurisdiction over the tax credits, said he’s working with his colleagues to find a solution. “There are a lot of ideas being thrown out there,” he said. “I’m trying to find a solution; I’m not telling you what the solution is.”

Others were firmly against it. “It’s costing us billions of dollars,” Sen. Ron Johnson (R-Wis.) said.

Open enrollment begins Nov. 1, and people will begin to see “real sticker shock” as Affordable Care Act plan prices are posted next month, Sen. Tammy Baldwin (D-Wis.) said.

“Timing is important,” she said.

Jalonick and Seitz write for the Associated Press. AP writers Lisa Mascaro in Washington and Hannah Fingerhut in Des Moines contributed to this report.

June 27 (UPI) — The Supreme Court is slated to hand down its final rulings of its current term Friday, some of which could be landmark decisions.

It’s expected the Court will decide on whether President Donald Trump may enforce his executive order that would limit birthright citizenship. Trump had put out the order in January that alleged the 14th Amendment, which says every person born in the United States is a U.S. citizen., doesn’t actually apply to babies born to one or more parents who aren’t legally in the country.

The Court will also resolve whether or not the U.S. Preventive Services Task Force, an Affordable Care Act feature that recommends preventive care services that insurers must cover at no cost to patients, infringes the Constitution’s appointments clause as its members are not nominated by the president and confirmed by the Senate.

Another major decision likely to be made Friday would decide if parents in Montgomery County, Md., had their religious rights violated because the Board of Education there hasn’t provided an opt-out for their children to avoid reading material that includes gay and transgender characters.

A First Amendment lawsuit that concerns a Texas law that requires people to verify their age before viewing online pornography is also on the docket, as is the fate of a Federal Communications Commission program that covers the cost of telecommunications services in rural and low-income areas.

A lawsuit that accuses Louisiana of gerrymandering congressional districts, in violation of the Voting Rights Act is also expected to be settled Friday.

The Court usually breaks for the summer until the new term starts in October, but they will still have to act on any emergency cases that might arise.

June 26 (UPI) — President Donald Trump held a “One Big, Beautiful Event” rally on Thursday afternoon to garner support for the federal budget bill that he wants passed before Independence Day.

Trump was backed by dozens of supporters who represented many occupations while addressing attendees at the event held in the East Room of the White House.

“We’re cutting $1.7 trillion in this bill, and you’re not going to feel any of it,” Trump told media and other event attendees.

“Your Medicaid is left alone. It’s the same,” Trump said. “Your Medicare and your Social Security are strengthened.”

He said Democrats would cut Medicare and Medicaid benefits in half and asked people to contact their senators and representatives to support the budget bill.

“Almost every major promise made in the 2024 campaign already will have become a promise kept,” Trump said. “That’s very important.”

He said the budget bill would eliminate federal income taxes on tips, overtime pay or Social Security.

A reconciliation bill before the Senate would limit the income tax deduction on tips to the first $25,000, though.

The president also said a trade deal has been reached with China and another might be coming with India, but he did not elaborate on them.

House Speaker Mike Johnson, R-La., and several members of Trump’s Cabinet attended the event, including Treasury Secretary Scott Bessent, Attorney General Pam Bondi and Agriculture Secretary Brooke Rollins.

Trump held the rally after the Senate parliamentarian earlier ruled several provisions in the Senate reconciliation bill violate Senate rules.

Senate Parliamentarian Elizabeth MacDonough nixed provisions that would have limited the use of healthcare provider taxes by states that recently expanded Medicaid coverage but did not increase Medicaid under the provisions of the Affordable Care Act.

Those proposed changes would cost states more to provide Medicaid coverage.

MacDonough is still reviewing the Senate reconciliation bill and might issue more objections to proposed measures.

The House already passed the bill, but the Senate is trying to hammer out a reconciliation package that would pass both chambers and be ready for signing by the Fourth of July.

Rep. Majorie Taylor Greene, R-Ga., already has said she intends to vote against the reconciliation bill, The Hill reported.

New York Republican Rep. Nick LaLota also is skeptical of the package and a potential limit on state and local tax deductions for taxpayers.

He said changes being made in the Senate reconciliation package make it impossible for a reconciliation bill to win approval in the House.

May 20 (UPI) — The U.S. House Rules Committee, after 22 hours of proceedings, late Wednesday advanced President Donald Trump‘s legislative agenda that experts say would add $3 trillion to the federal deficit and negatively affect the poorest of Americans.

Debate on the full House floor began early Thursday.

The House Rules Committee adopted the bill in an 8-4 vote along party lines. They first met shortly after 1 a.m. Wednesday to consider the 1,116-page budget that is roughly $7 trillion

The Finance Committee late Sunday approved the legislation 17-16 along party lines with four Republicans who rejected the bill the first time on Friday voting present: Ralph Norman of Oklagoa, Chip Roy of Texas, Andrew Clyde of Georgia and Josh Brecheen of Oklahoma.

“What the hell are you guys so scared of, that you guys are holding this hearing at 1 in the morning?” Rules Committee Ranking Member Jim McGovern, D-Mass., said. “If Republicans are so proud of what is in this bill, then why are you trying to ram it through in the dead of the night?”

The full House must also vote to adopt the rule first before taking up the underlying bill. Republicans hope to move the House bill, with no support from Democrats, to the Senate by Memorial Day on Monday.

With the GOP holding a slim majority of 220-212, House Speaker Mike Johnson can afford to lose more than three GOP votes. Party hardliners and moderates from vulnerable districts have failed to agree on key issues that include Medicaid, federal clean energy programs and tax breaks to states.

Three House seats were held by Democrats who died, including Gerry Connolly of Virginia on Wednesday.

At least five House GOP members considered vulnerable in the 2026 midterm elections — including Rep. Mike Lawler, R-N.Y. — have vowed to vote against the bill unless it ups the proposed state and local tax deduction from the current proposed $30,000.

The bill contains a massive overhaul of the tax code and deep spending cuts.

An amendment included speeding up work requirements for Medicaid to the end of 2026 rather than 2029.

It also tightens the definition of a “qualified alien” eligible for the program.

There is a new incentive for states that hadn’t expanded Medicaid under Obamacare. It allows those states to pay 110% of Medicare rates for state directed payments as a way to finance Medicaid.

The Center on Budget and Policies Priorities estimates 36 million Medicaid enrollees could be at risk of losing coverage because of potential work requirements and other factors.

In December, there were 78,532,341 on Medicaid and the Children’s Health Insurance Program, or CHIP.

Also, the bill formalizes the so-called SALT cap, which would allow people to deduct state and local income taxes up to $40,000 for certain income groups. GOP leaders initially wanted cap of $30,000 but key New York, New Jersey and California Republicans vulnerable in the 2026 election, had refused to support it.

Republicans opted to phase out Biden energy tax credits sooner than planned. New projects must break ground within 60 days or be “in service” by the end of 2028 to qualify for the credits.

Earlier, Rep. Chip Roy of Texas,, a holdout, told CNN’s Manu Raju he was “still looking to review more provisions and have more conversations.”

“Yeah, I’m going to vote for it,” Rep. Andy Biggs ,of Arizona, told CNN.

Medicaid changes and a $4 trillion debt limit increase, among other provisions.

The bill includes a $4 trillion debt limit.

Budget plan’s analysis

The nonpartisan Congressional Budget Office released data Tuesday that the House Republican’s budget proposal and its tax provisions would cut federal revenue by around 10% of America’s current national debt over the next decade.

The GOP bill proposal could cost American taxpayers $3.8 trillion over the next 10 years, according to a report this month by the Joint Committee on Taxation, which looked at the effect of tax policies versus spending cuts.

“This bill does not add to the deficit,” White House press secretary Karoline Leavitt claimed Monday during a press briefing.

On Friday, Moody’s Ratings downgraded the U.S. debt citing the GOP proposal that Moody’s says will tack on $4 trillion to the national debt over the next 10 years.

As proposed, the bill would extend Trump’s tax cuts largely to the wealthiest Americans and cut personal income tax rates. It also establishes fresh tax reductions on tips, Social Security, overtime payments and loan interest on automobiles produced in the United States.

An analysis Monday by the University of Pennsylvania’s Penn Wharton school projects that under the Republican plan, the lowest-income American citizens would end up paying more.

Leavitt said the Trump administration’s Council of Economic Advisers claim that there’s $1.6 trillion worth of savings in the GOP bill.

“That’s the largest saving for any legislation that has ever passed Capitol Hill in our nation’s history,” Leavitt continued.

On Tuesday, the president was on Capitol Hill to meet with Johnson and lawmakers in order to push his legislative agenda.

“While I respect President Trump and understand the importance of passing this legislation, I will not do so at the expense of my district,” Lawler posted on X Tuesday afternoon.

Lawler noted that his district was one of only three kept by a Republican that then-Vice President Kamala Harris had won in November’s presidential election in a heavily-taxed Congressional district.

“For over two years, I have been abundantly clear to everyone from the President to House Leadership about the importance of lifting the cap on SALT,” he said about state and local tax deduction caps.

May 14 (UPI) — Health and Human Services Secretary Robert Kennedy Jr. defended proposed 2026 budget reductions during separate House and Senate committee budget hearings on Wednesday.

Kennedy started the morning by fielding questions from members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies.

Chairman Rep. Robert Aderholt, R-Ala., opened the hearing by acknowledging President Donald Trump‘s efforts to enforce the border and its effect on community health and safety.

“The president’s success in securing our border directly benefits public health by reducing the incoming flow of illicit drugs, like fentanyl, which has fallen by 54% since this time last year,” Aderholt said. “That’s no small thing.”

He also commended the Trump administration for reducing the number of unaccompanied minors crossing the border and said he wants to hear Kennedy’s ideas for reforming the Department of Health and Human Services and its sub-agencies.

‘Disastrous’ program funding reductions

Ranking Member Rep. Rose DeLauro, D-Conn., was less conciliatory and referred to the Trump administration’s budget request for the Department of Health and Human Services as “disastrous.”

DeLauro said the proposed budget would reduce funding for health programs by $33 billion.

The proposed HHS budget for the 2026 fiscal year is $93.8 billion, which is a 26.2% reduction from the current budget and includes funding reductions across most programs.

“I view it as a disgrace,” DeLauro said. “Under your budget proposal, Americans would die needless and preventable deaths.”

DeLauro cited funding cuts to the Centers for Disease Control and Prevention and accused Kennedy and the Department of Government Efficiency Director Elon Musk of “eliminating entire divisions without consideration for what is being lost.”

The cuts “affect families and communities” and “are dangerous,” DeLauro said.

Kennedy said his goal is to make America healthy again by focusing on the “chronic disease epidemic.”

HHS also seeks to deliver more effective and efficient services for Americans who rely on Medicaid, Medicare and other programs while reducing costs for taxpayers, Kennedy said.

During the Senate Health, Education, Labor and Pensions Committee budget hearing Wednesday afternoon, Kennedy said states and localities can do a better job of responding to disasters at the state and local levels than the federal government.

He cited Florida’s success in handling hurricanes Helene and Milton last year, with no lives lost there, as an example and said the federal government should focus on national disasters.

Drug prices and healthcare as a human right

Sen. Bernie Sanders, D-Vt., asked Kennedy if he is willing to work to make drug prices in the United States the lowest in the world, to which Kennedy said he is.

Sanders then asked Kennedy if healthcare is a “human right.”

Kennedy said healthcare is not part of the rights enumerated in the Constitution and called it more of a philosophical matter.

Sanders responded by saying “every other country guarantees healthcare” as a right and said Americans don’t want the choice to be uninsured or not have the ability to see a doctor.

Kennedy said “Obamacare” is not working and he and President Trump want to enable everyone to be insured and have access to quality healthcare.

Sanders then cited proposed cuts to programs that serve middle-class and poor Americans and claimed they would end healthcare coverage for 13 million Americans.

Kennedy said the cuts only are for waste and denied they would affect coverage for Americans.

Sen. Rand Paul, R-Ky., followed Sanders and cited examples of wasteful programs that the proposed budget would eliminate.

They include a recent study on the effects of cocaine on lab rats and another study that showed about half of biological males who medically transition to female believe they can get pregnant, the senator said.

Gain-of-function research and COVID-19

Paul also said bipartisan support exists for better controlling gain-of-function research on Ebola, avian flu and other infectious diseases and the potential dangers they pose to Americans.

The senator cited a research study that would put Ebola in an aerosol as a potential biological weapon, which he said could be potentially very dangerous to the general public.

Paul asked Kennedy if HHS would be transparent in gain-of-function research regulations and protect Americans from potentially deadly outbreaks.

Kennedy said HHS would be “absolutely transparent” in regulating gain-of-function research and “bring the public in on the debate.”

He also said National Institutes of Health research “almost certainly” caused the COVID-19 pandemic through gain-of-function research.

Lack of access to critical care

Sen. Patty Murray, D-Wash., said she opposes staffing reductions at the NIH and cited a constituent with stage-four cancer who recently was told her treatment would be delayed by four weeks due to staffing shortages.

Kennedy offered to intervene on that person’s behalf and ensure she receives needed care right away.

Sen. Tammy Baldwin, D-Wis., accused Kennedy of “hiding information” from the American people and asked if he believes lead poisoning is a problem.

Kennedy said he thinks it’s a very serious problem, but Baldwin said “the entire lead-poisoning program staff has been fired.”

She asked if Kennedy intends to eliminate the program that helps communities address lead poisoning, which he said will not happen.

She also said HHS has provided about $1 billion less in Head Start program funding and asked why there are funding delays.

“There should not be any delays,” Kennedy said. “The funding is there.”

He suggested staffers who want to make the Trump administration look bad are slowing down disbursements for Head Start and similar programs.

The House and Senate hearings were held before a vote on a proposed 2026 federal government budget measure that Trump has referred to as “one big, beautiful bill.”

Protesters arrested for disrupting hearing

While the Senate hearing was underway, Ben & Jerry’s co-owner and co-founder Ben Cohen and six others were arrested for disrupting the hearing, Axios reported.

Cohen and the others were protesting the United States’ support of Israel in its war with Hamas in Gaza.

The protesters yelled, “RFK kills people with hate!” before Capitol Police escorted them from the room.

They were arrested and charged with crowding, obstructing proceedings or incommoding.

Some protesters also were charged with assaulting a police officer or resisting arrest, but Cohen was not among those so charged.

May 14 (UPI) — The House Ways and Means Committee approved the Republican tax package Wednesday, which followed an all-night hearing during which GOP members rejected attempts by Democrats to alter the plan.

The bill was approved on 26-19 party line, which will next move to the chamber’s Budget Committee, where it will be blended with legislation from other committees and presented as part of what President Donald Trump has dubbed the “One, Big, Beautiful Bill.”

“We are in hour 14 of a markup where Democrats are fighting tooth and nail,” posted Ways and Means Chairman Jason Smith, R- Mo. to X at 4:29 a.m. EDT Wednesday,” which followed previous update posts at 2:37 a.m. EDT Wednesday and 11:56 p.m. EDT Tuesday. The hearing began at 2:30 p.m. EDT Tuesday.

Democrats saw all their proposed amendments, which covered items like the expansion of health care coverage under the Affordable Care Act, and green energy, turned down, while also having stumped against the current tax plan, which it called a giveaway to the wealthy.

Democrats also put forth amendments that would have impacted Trump’s tariffs, blocked tax cuts for high earners and expanded child-care incentives among other suggestions, but none were adopted.

The entire package is projected to cost $3.8 trillion, but could still address state and local tax, or SALT, deductions. The Joint Committee on Taxation reported Tuesday that average earners would see their tax bills decrease by double-digit percentages in 2027 under the plan as it stands.

Democrats have also pointed out that under the plan, taxpayers who earn over $500,000 would see a cumulative tax cut of around $170 billion in 2027, while those who will earn between $30,000 and $80,000 that year would only see a collective $59 billion.

The bill is targeted to pass through the enter chamber by Memorial Day, then on to the Senate which is expected to combine the tax laws with the rest of Trump’s “Beautiful” bill, which together would both extend the life of previously set tax cuts and enable Trump’s financial requests.