WASHINGTON — U.S. senators began debating strategies to reduce health care costs for Americans during a Senate Finance Committee hearing on Wednesday, where experts offered differing recommendations and lawmakers’ comments underscored the challenges ahead.
Republicans on the committee criticised the Affordable Care Act (ACA), also known as Obamacare, arguing it has driven up individual health insurance costs that should no longer be offset by tax credits. Democrats, however, called for extending the enhanced subsidies for at least another year to allow Congress more time to address broader, systemic issues within the U.S. health insurance and health care systems.
Committee Chairman Mike Crapo (R-Idaho) described the hearing as “the first step in building the foundation for” health care reform. He stressed the need for both short-term and long-term solutions. “In the short term, we cannot simply throw good money after bad policy. If we keep advancing a system that drives up premiums, we will make this problem even harder to solve,” he said. Crapo suggested that financial assistance could be provided directly to consumers through health savings accounts (HSAs), rather than giving billions of taxpayer dollars to insurers.
HSAs are tax-advantaged accounts that allow individuals to save for medical expenses, generally paired with high-deductible insurance plans. The Congressional Research Service notes that HSAs “are trust/custodial accounts and are not health insurance.”
Signed into law in 2010 by President Barack Obama, the ACA aimed to reduce uninsured rates and curb discriminatory insurance practices. It expanded Medicaid and created health insurance marketplaces. According to the Kaiser Family Foundation (KFF), the uninsured rate fell from roughly 14–16% before the law to a record low of 7.7% in 2023.
Experts Split on Next Steps
| Expert | Affiliation | Key Recommendation |
|---|---|---|
| Douglas Holtz-Eakin | American Action Forum | Rethink health care policy; rationalise insurance subsidies; focus on Medicare costs |
| Jason Levitis | Urban Institute | Extend enhanced ACA tax credits for 2026; simplify insurance marketplace |
| Brian Blase | Paragon Health Institute | Reject ACA subsidy extension; reduce insurer influence and regulation |
Senator Ron Wyden (D-Oregon) criticised Republicans for focusing on other policies rather than improving health care. He expressed willingness to collaborate with GOP senators on tackling insurance company practices but remained sceptical that meaningful legislation would pass.
Douglas Holtz-Eakin warned that the ACA remains “a troubling construct” and that Congress has “very little it can do” to change the outlook for 2026. He urged reforms to Medicare and insurance subsidies. Jason Levitis advocated for a clean extension of current ACA tax credits, citing marketplace readiness.
Former Trump adviser Brian Blase criticised the ACA as inefficient, arguing that taxpayer-funded subsidies fuel insurance company profits and inflate premiums. Senate Majority Leader John Thune (R-S.D.) highlighted GOP unity on the need for reform to reduce premiums, while former President Donald Trump called for sending funds directly to Americans, bypassing insurance companies.
The hearing highlighted deep partisan divisions, but lawmakers agreed that reform is urgently needed to curb rising health care costs and improve accessibility for millions of Americans.