Cassidy–Crapo Health Care Proposal to Get a Senate Floor Vote This Week

The Senate will vote this Thursday on a GOP-drafted health savings account–focused legislative alternative to Senate Democrats’ warring Obamacare subsidy extension proposal, Senate Majority Leader John Thune (R., S.D.) confirmed to reporters on Tuesday.

The Thune-endorsed health-care proposal, drafted by Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Bill Cassidy (R., La.) and Senate Finance Committee Chairman Mike Crapo (R., Idaho), would direct the Department of Health and Human Services “to deposit payments into HSAs paired with bronze or catastrophic plans on the Obamacare exchanges in 2026 and 2027,” according to a one-page readout of the legislation.

“Eligible individuals earning less than 700 percent of the federal poverty level would receive $1,000 if aged 18 to 49 and $1,500 if aged 50 to 64,” the page reads. HSA funds could not be used to pay for gender-transition or abortion-related medical procedures under this proposal.

The bill does not extend the controversial enhanced Obamacare subsidies and instead serves as a Republican alternative to Senate Democrats’ clean three-year ACA subsidy extension, which will also hit the floor on Thursday. Conventional wisdom in Washington suggests that neither bill is likely to clear a filibuster this week, given deep party divisions on health care.

But Cassidy maintains that his bill aligns with the legislative priorities that have been laid out by the president, who will be key to any health-care proposal that Republicans put forward in the coming weeks.

“If you listened to the president’s Politico interview last night — in which he says that he wants the money to go to the patient, not to the insurance company — that is our proposal. We give the money to the patient directly,” Cassidy told National Review on Tuesday when asked where the White House is on his proposal and whether he’s been engaging with the administration in recent days on the matter.

“I think the president is exactly where we are,” the Louisiana senator and career physician added.

Speaking with Politico’s Dasha Burns this week, Trump said he wants “to give the money to the people, not to the insurance companies.”

Senate Democrats have made clear that they will not support legislation that doesn’t extend the enhanced subsidies, and that any health-care-related proposal that includes Hyde amendment abortion protections is dead on arrival with the caucus. Senate Minority Leader Chuck Schumer called the Cassidy–Crapo bill “junk insurance” that “adds tons of new abortion restrictions.”

Republicans have been all over the map on health care in recent weeks. Until Thune confirmed this afternoon that the Cassidy-Crapo bill got the green light for a floor vote this week, roughly half a dozen Senate GOP-drafted proposals were circulating on Capitol Hill, including from Senators Rick Scott (R., Fla.), Jon Husted (R., Ohio), Roger Marshall (R., Kan.), as well as a joint proposal authored by Bernie Moreno (R., Ohio) and Susan Collins (R., Maine).

As Senate Republican leaders whip support for the Cassidy–Crapo bill, House Republicans are game-planning their own health-care strategy in real time.

“We’re gonna have a vote before the end of the year for sure, and then we’re going to continue to do improvements along the way. In the first quarter, second quarter, there’s a lot to fix in health care, we’ve all acknowledged that,” Speaker Mike Johnson told Punchbowl News on Tuesday.

As we approach the December 31 expiration date on the Obamacare subsidies, keep in mind that Trump’s own pollsters, along with a small but vocal cohort of moderate House Republicans, have been sounding the alarm on the electoral consequences that may occur in 2026 if Republicans do not extend them. Most congressional Republicans are staunchly opposed to extending the Covid-era enhanced subsidies that were created and extended by Democrats, arguing that they were meant to be temporary and are rife with fraud.