U.S. Senate Faces ACA Subsidy Cliff

Proposal could be released early this week

January 12, 2026

All eyes are on the U.S. Senate this week, as lawmakers work on a last-minute solution that could prevent the expiration of enhanced premium support for Affordable Care Act (ACA) health coverage.

But any legislative compromise faces a murky path to approval. Per media reports, President Trump has not indicated support for any ACA extension and could veto legislation that reaches his desk.

Here’s what you need to know:

Happening this week

A bipartisan group of U.S. Senators are expected to release this week a proposal that would address the expiring health care subsidies.

The U.S. House last week advanced a clean three-year extension to the Senate after a 230–196 vote, with 17 Republicans joining their colleagues across the aisle to support the measure.

The vote would not have happened without three Pennsylvania Republicans— Representatives Brian Fitzpatrick, Ryan Mackenzie, and Rob Bresnahan—whose signatures on a discharge petition forced a vote in the House. 

The Senate has already rejected the three-year proposal, but the House approval provides another opportunity to address the issue. Lawmakers are working through a host of questions related to abortion coverage, addressing “no-cost” premiums, and adjustments to the income thresholds to qualify for assistance.

In Pennsylvania

The negotiations come as consumers are picking plans for 2026. In Pennsylvania, January 31 marks the end of open enrollment.

Updated figures from the Pennsylvania Insurance Department indicate monthly costs for Pennie enrollees will increase by 102 percent on average. The average increases will vary based on income.

“Due to federal changes, costs are increasing but many Pennsylvanians still qualify for financial savings and now is the time to act,” said Devon Trolley, Pennie executive director, in a statement. “Enrolling in health coverage before the deadline can ensure you are not only protecting your health in 2026 but also protecting your financial wellbeing should something unexpected occur.”

HAP continues to support the extension of enhanced premium subsides to promote access to care. For more information, contact John Myers, vice president, federal advocacy.