Cassidy: ‘There is a deal that could be made’ on ACA subsidies by end of year

Sen. Bill Cassidy (R-La.) on Sunday expressed cautious optimism about a bipartisan compromise on extending enhanced Affordable Care Act (ACA) subsidies for a select group of Americans before the tax credits expire at the end of the year. In an interview on CNN’s “State of the Union,” the chair of the Senate Health, Education, Labor and Pensions Committee said talks are underway on a deal that would couple the GOP proposal for Health Savings Accounts (HSA) with a version of the Democratic proposal that would temporarily extend tax credits. “Republicans have pushed that we would put money in the patient’s pocket so that she has something to pay the out-of-pocket,” Cassidy told CNN’s Dana Bash, referring to the Republican proposal for HSAs. “Democrats are saying, let’s do something about premiums. I think, Dana, there is a deal that could be made. Why don’t we do both?” “Let’s go ahead and not give the profit to the insurance company, but the protection to the patient, by giving them access to an account — a wallet, a purse, a pocketbook, if you will — that would have up to, pick your family, $1,000 to $5,000 to pay those initial expenses, but also do something on the premiums with maybe a temporary extension of the enhanced premium tax credits to address it for some, those really have high expenses.” “I think there’s a deal that could be done,” he continued. Cassidy, a physician, worked on the GOP proposal that was shot down in the Senate last week. Democrats’ proposal to stave off the expiring health care subsidies also failed in the upper chamber. Cassidy, in Sunday’s interview, said Republicans are concerned about the “estimated billions of dollars in fraud” in the health insurance landscape. While Democrats are worried about the expiring ACA subsidies raising insurance premiums, Cassidy noted the high deductibles just contribute to a system that helps health insurance companies profit. Asked whether his fellow Republican senators would support any compromise that extends the enhanced ACA subsidies, Cassidy said, “It has to have reforms to cut out the fraud.” “But if you address the fraud, and particularly you address the fact that… the policies being pushed have $6,000 deductibles — again, it’s more about profit for the insurance company than protection for the patient — if we do that, I think there could be interest in a short-term extension,” he added. “I think that could be the deal.” Bash noted that there are only four legislative days on the calendar for the Senate to stave off the premium hikes expected to result from the expiring tax credits. Cassidy said he has hope that he can help people before that happens but pushed back when asked if “there is a deal in the offing.” “Well, I can’t tell you it’s in the offing. It’s something that’s being worked on, because we’ve got to do something about affordability,” Cassidy said. Cassidy said the priority has to be to address the high out-of-pocket deductible, “which is so high for so many that they just cannot get the care they need. And then after that, let’s go to the premiums.” “I think if we can meet halfway on that, we can find common ground. We can do both,” Cassidy said. “Yes, we’ve got four days, but some of this policy could be implemented over the course of the first quarter of 2026,” noting HSAs can help reimburse medical expenses.