Republicans Propose $1,000-$1,500 Health Account Deposits to Aid ACA Enrollees

Republican senators and former President Donald Trump have proposed a plan to deposit $1,000 to $1,500 into health savings accounts (HSAs) for certain Affordable Care Act (ACA) enrollees. This initiative targets enrollees aged 18-64, with a one-time payment to assist with rising health care costs as ACA tax credits expire at the end of 2025. HSAs are tax-advantaged accounts used to pay for qualified medical expenses and are typically paired with high-deductible health plans. Contributions and earnings in these accounts are tax-free, and funds can roll over annually. The proposal, introduced by Senators Bill Cassidy and Mike Crapo, includes provisions that restrict HSA funds from being used for abortion or gender transition care. It also aims to continue ACA cost-sharing reduction payments, expand access to low-cost 'catastrophic' insurance plans, and implement cuts to Medicaid funding for states covering undocumented immigrants. These measures reflect an effort to reduce premiums and redirect funds to patients rather than insurance companies. Democrats plan to vote on extending enhanced ACA tax credits, which Republicans oppose, framing the debate as a disagreement over the approach to health care affordability and premium relief. Senate Republican Majority Leader John Thune highlighted that the GOP proposal could lower premiums by double digits and save taxpayer dollars by providing direct financial benefits to patients rather than insurers. Opposition views, including those from the Center for American Progress and Democratic leaders, argue that the Republican plan shifts financial risks to families, destabilizes insurance markets, and revives lower-value insurance products. They advocate for extending the current enhanced premium tax credits to prevent premium hikes affecting millions of Americans. The Senate is scheduled to vote on both the Democratic plan to continue ACA subsidies and the competing Republican proposal, reflecting a broader partisan impasse over managing health care costs and insurance affordability. The outcome will have significant implications for millions of ACA enrollees facing increased costs in the upcoming year and for the direction of federal health care policy.