Negotiations seeking to strike a compromise in the elimination of enhanced subsidies for lower-income purchasers of  health plans sold on Affordable Care Act insurance exchanges appear to have died a quiet death.

Talks between Democratic and Republican negotiators focused on a one- or two-year extension of those subsidies, but once the subsidies ended at the close of 2025 and then Congress enacted an FY 2026 funding bill for the Department of Health and Human Services, those talks appeared to collapse.

The demise of the premium subsidies will be especially harmful for community safety-net hospitals, which are located in generally low-income areas whose residents are more dependent on financial assistance to obtain health insurance than those in the typical American community.  The residents of the communities these hospitals serve will still need tertiary care, and when they do, community safety-net hospitals will continue to care for them – but often with little or no compensation for their efforts, which could become financially troubling over time in light of the large numbers of uninsured and Medicaid-covered patients these hospitals already serve.

Learn more about the issues that negotiators stumbled over and how those talks faltered and ultimately failed from the Wall Street Journal article “Negotiators Say Talks to Restore ACA Subsidies Likely Dead” and The Hill report “Senate talks to revive ACA tax credits appear to be fizzling out.”