(Dec. 16, 2025) - The House and Senate have convened for their last week of the 2025 regular session, with health care policy as a top priority on the Hill. Although the current budget continuing resolution doesn’t expire until the end of January, the Affordable Care Act’s enhanced premium tax credits will end at the close of the year. Negotiators in Congress and at the White House are working to find solutions for health care affordability and the United States Department of Health and Human Services budget.
Late last week, the Senate held votes on competing ACA subsidy bills. The Democrats voted on a three-year extension of the EPTCs, but it failed with a 51-48 vote, with four Republicans voting alongside all Democrats and independents present. A Republican alternative bill that would fund health savings accounts for ACA bronze plan participants also failed 51-48, with one Republican defecting to oppose the measure alongside all Democrats and Independents. In the Senate, such bills require a sixty-vote threshold to be considered for final passage.
This week, Senators are negotiating across party lines on compromises that might keep the EPTCs active into 2026, with a one-year extension as the preferred option. However, it currently seems unlikely that such a straightforward extension can clear the sixty-vote threshold.
The House is set to consider a health care policy bill aimed at addressing systematic healthcare costs, but it does not include provisions for extending the EPTCs. The bill contains language on association health plans, purchasing insurance across state lines and pharmacy benefit manager reforms, all of which have been priorities for Republicans for years. It does not include Medicare site-neutral payment schemes, which we have been calling on Kansas’ members of Congress to oppose. There are some technical amendments to H.R.1, the One Big Beautiful Bill Act, that we are monitoring, as they could make it easier for the Centers of Medicare & Medicaid Services to approve various provider tax programs and their associated grandfathering provisions.
Kansas Hospital Association staff continue working with our delegation, the Kansas Department of Health and Environment and CMS to ensure the grandfathering of both the 2025 provider tax and the state-directed payment distribution model, as well as approval of Kansas’s 2026 provider tax and SDP changes. While we are optimistic about the direction of discussions regarding Kansas’s 2025 programmatic changes, we remain vigilant about securing the same for the state’s 2026 changes. We will keep you updated as these discussions progress.