Democrats will get a Senate vote next week on their plan to extend the expiring enhanced subsidies for the Affordable Care Act, but the larger question of reducing the rising cost of health care may have to wait.

Both parties agree that the U.S. health care system is unreasonably expensive, but they are far from agreement on how to reduce costs rather than merely subsidize prices. For now, both Republicans and Democrats appear focused on the immediate problem of keeping health insurance affordable for the 24 million people who buy it through the Affordable Care Act exchange. The Affordable Care Act is former President Barack Obama’s health care law, known as Obamacare.

Here is what is happening now.

Republicans Ready for Deal on Enhanced Subsidies

Republicans had mostly resisted extending the enhanced subsidies, which Democrats created in 2021 as a response to the COVID-19 pandemic, then set to expire at the end of 2025.

Democrats now want to make the tax credits permanent. They argue that, without help from the federal government, millions of people will lose their health coverage because they simply can’t afford it.

Even those who get insurance through their employer benefit from government subsidies on health insurance premiums, Rep. Brad Schneider (D-Ill.) told reporters on Dec. 3.

“Whether you work for a company and get your insurance through your employer, the employer may pay a part or even bulk of that, and they take a [tax] deduction,“ Schneider said. ”They get support and a subsidy from the government.”

Republicans have chafed at the enhanced subsidies for years, arguing that they have caused health care inflation by funneling billions of dollars directly into insurance companies rather than to health care providers or patients.

Some in the GOP have hinted that they are open to a compromise on extending the enhanced subsidies as part of a larger effort to reform health care spending.

President Donald Trump said on Nov. 25 that he did not favor extending the enhanced subsidies but conceded, “Some kind of extension may be necessary to get something else done.”

Rep. Ralph Norman (R-S.C.), an outspoken fiscal hawk, allowed room for negotiation on an extension of the subsidies. In response to a question from The Epoch Times, Norman said a phase-down of the subsidies would probably be needed to gain buy-in from Republican senators.

Sen. Bill Cassidy (R-La.), chair of the Senate Committee on Health, Education, Labor, and Pensions, said he hopes to see a bipartisan solution to the problem of rising Obamacare premiums before they take effect next year.

“I’m hoping that we can find a bill that can get 60 votes that can fix the problem of the exchanges for Jan. 1, 2026,” Cassidy said during a Dec. 3 committee hearing.

Republicans promised to allow a Senate vote on the matter in exchange for the support of eight Democrats in ending the government shutdown in November. That vote is expected to take place sometime next week.

Republicans Undecided on Longer-Term Plan

Republicans have discussed several ideas for reducing the cost of health care, but none appear to have majority support.

Sen. John Kennedy (R-La.) likened the effort to a psychological examination in which patients react to blobs of color.

“Have you ever heard of a Rorschach test?” Kennedy asked reporters on Dec. 2. “Where [ink] is smeared all over the wall? That’s kind of what we’re doing.”

The swirling proposals do have a common aim: to allow consumers more choices rather than a list of options partially funded by the government.

Trump has proposed giving $2,000 directly to consumers to be used for either insurance premiums or medical expenses.

Sens. Rick Scott (R-Fla.) and Roger Marshall (R-Kansas) have proposed similar plans involving individual health savings accounts or flexible spending accounts, respectively.

Sen. Josh Hawley (R-Mo.) proposed allowing taxpayers to deduct all out-of-pocket medical expenses up to $25,000 per person, including those who do not itemize their deductions, and making out-of-pocket health care premiums tax-deductible.

Sen. Rand Paul (R-Ky.) proposed allowing consumers to buy association health plans through vendors such as Amazon, Costco, or Sam’s Club.

“It costs nothing and simply changes labor law to allow people to buy insurance as a group from retailers,” Paul told Trump in a text message, which the president shared on social media. In the same message, Paul asked Trump to partner with him on the idea.

Commenting on the variety of options, Norman said, “It’s a menu that we need to pick and then come together.”

Gaining that unity by next week seems unlikely.

“Democrats are going to have an opportunity to vote on a proposal of their choosing, and we will see where the Republicans come down with that conversation,” Senate Majority Leader John Thune (R-S.D.) told reporters on Dec. 2.

Democrats Decline to Reveal Their Proposal

Sen. Chuck Schumer (D-N.Y.) told reporters on Dec. 3 that all Democratic senators are united behind the plan they will present in the Senate next week.

“We are now united within the entire Senate caucus,” Schumer said.

However, when asked for details of the proposal, Schumer twice declined to provide them, saying only, “Stay tuned.”

In the House, Democrats have started a discharge petition that would force the House to vote on a clean, three-year extension of the expiring enhanced subsidies.

“All we need are four Republicans to join us, and we can prevent tens of millions of people from having dramatically increased health insurance costs,” House Minority Leader Hakeem Jeffries (D-N.Y.) said on Dec. 3.

Meanwhile, the New Democrat Coalition, a group of 116 House Democrats who describe themselves as moderates, released an outline of its own proposal on Dec. 3.

The plan includes extending the enhanced Obamacare subsidies, reversing the changes made to Medicaid by the One Big Beautiful Bill Act, and reducing medical costs through “greater efficiency, transparency, and competition.”

Jeffries did not comment on the New Democrat Coalition proposal during a news conference on health care affordability held later on Dec. 3.

Appropriations Deadline Again Looms

The health care funding drama plays out against the backdrop of a stopgap measure to temporarily fund the federal government, which expires on Jan. 30.

That makes for a crowded agenda in both chambers.

“Can we pass nine [remaining] appropriations bills, and can we come up with a health care plan?“ Norman said. ”That’s problematic at best.”

Cassidy acknowledged that larger reforms may have to take a back seat for the moment.

“If there’s going to be a big idea [to reform health care], that will not happen by January 2026,“ Cassidy said during a Dec. 3 committee hearing. ”It is something we can consider for 2027 or beyond. But I’m focused on 2026 because that’s where the immediate need is.”

Is there any chance the Senate will vote on a major health care reform bill next week?

“With some divine intervention, it’s possible,” Kennedy said.

Nathan Worcester contributed to this report.