Washington, D.C. — Today, the Center for American Progress released new analysis showing that Senate Republicans’ response to the looming expiration of the Affordable Care Act’s (ACA) enhanced premium tax credits would leave millions of Americans paying more for far weaker coverage. Senate Republicans’ proposals are pushing a patchwork of health savings accounts (HSA) and high-deductible health plans (HDHP) that shift costs onto patients and fracture insurance markets, rather than advancing the clean extension of enhanced premium tax credits
With the enhanced premium tax credits set to lapse at the end of 2025, average premiums in 2026 are expected to more than double for the more than 20 million Americans who rely on marketplace subsidies. The leading Republican proposals—from Sens. Bill Cassidy (R-LA), Mike Crapo (R-ID), and Rick Scott (R-FL)—recycle long-rejected ideas that would increase health care costs and erode market stability.
“Replacing real premium assistance with HSA deposits would shift significant health care costs onto vulnerable Americans,” said Natasha Murphy, director of Health Policy at CAP and co-author of the analysis. “Families would face soaring premiums and higher deductibles, all while Republicans fracture the insurance market.”
CAP’s analysis finds that the leading Senate Republican proposals would:
- Make coverage more expensive by replacing robust premium tax credits with $1,000 to $1,500 HSA deposits.
- Push patients into high-deductible, low-value plans, including bronze or catastrophic options with average deductibles nearing $7,500 in 2026.
- Increase the number of uninsured Americans, with the Congressional Budget Office projecting millions more people losing coverage without the enhanced credits.
- Destabilize insurance markets by moving healthier people into low-value products and driving up premiums for everyone else.
- Redirect federal resources upward, delivering the greatest benefit to higher-income households while leaving low- and middle-income families exposed to higher costs.
The proposals also lack any workable timeline for distributing HSA funds, meaning families would face massive premium hikes on January 1, 2026, with no upfront help.
Read the analysis: “Senate Republicans’ HSA Plan Can’t Replace the Enhanced Premium Tax Credits” by Natasha Murphy, Topher Spiro, and Brian Keyser
For more information or to speak with an expert, please contact Christian Unkenholz at [email protected].