Health Insurance Debates – Not Over Till It’s Over
Just when you thought you had everything settled and you knew everything – which meant you knew nothing new might appear on the horizon regarding the One Big Beautiful Bill, healthcare, Obamacare, subsidies, health insurance and everything related you once again find the map turned upside down and you start over again – or almost. At least that is the way I felt on reading first in Modern Healthcare, a well respected publication in the healthcare field in their January 7, 2026 article, “The Narrow, Rocky Path to a Deal on Enhanced ACA Subsidies,” and then in the Morning Wire, a publication of the Associated Press, “House Takes Step Toward Extending Affordable Care Act Subsidies, Overpowering GOP Leadership,” on January 8, 2026 that we are “off to the races” again. The debate is not yet finished – or is it?
You might wonder why is this being done actually after the law has been passed and everyone has gone home. The new premium notices have already been sent for January, 2026 but using a strategy already being used regarding tariffs where the amount of the premium is indicated and then the amount of the subsidy is separately stated so consumers then can know what the difference would be. Sign up is indicated for January 15 generally although it is best to check for specifics for anything relating to requirements today if that information can actually be found.
The Burning Question is – or was – will some Republicans bond with their Democratic brethren and sisters, despite the opposition of their leadership and of the President, to pass some version of enhanced subsidies for health insurance exchange enrollees under Obamare or will that venture again fail? That action in the House of Representatives is, of course, not enough since, even if Republican Representatives, or at least some of them, shed their opposition to continued funding of this type of healthcare – healthcare currently received by large numbers of constituents in largely “red” states – Senate Republicans must as well or the entire campaign would be lost. Therefore, the reporting in common terms would go something like this “Can you believe it? Nine centrist Republican lawmakers joined with Democrats in signing a “discharge petition” to force the vote to come to the floor even though Speaker of the House Johnson previously rejected bringing it to the floor but hinted this might happen “in the New Year”…Then, seventeen Republicans joined Democrats in favor to continue the health insurance exchange subsidies for another three years to result in a vote of 230-296.
Actually, it might be a good idea to stop right here. This action is huge and unexpected although it is possible some Republicans in the House voted for it expecting it would go down in the Senate and thereby be able to say for constituents that they tried even though it did not succeed.
Despite all of this activity we should understand that “the Senate is under no requirement to take up the bill.” id . In fact some reporting suggests the plan to extend has reached the end of the road or even is dead on arrival. However it has been reported that “a small group of members from both parties is working on an alternative plan that could find support in both chambers and become law…” id. Now, what might that be? It is suggested that it might shorten the extension of the subsidies to two years and/or make other changes to the program or they could even go back to the older idea – the one I was going first to write about -which is Health Savings Accounts. Health Savings Accounts, by the way, in my opinion and others are targeted to a different audience, one that is more affluent and less concerned about serious health care coverage. HSA’s require participants to enroll in less comprehensive health care coverage (Bronze coverage) and are more useful as a tool to provide tax savings. In other words we do not know now where the health care system in America is going.
So, there you have it. In the meanwhile I have been attending as many football games as I can in between reading reports on the U.S. healthcare system. It is often refreshing and less stressful to follow current football scores! “Go <whatever team you are interested in!> Sports are easier to follow and at the end you do know who won the game -usually.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.