Republicans Think They Have A Deal
Sen. Bill Cassidy (R-La.) signaled Sunday that a limited bipartisan agreement on health insurance policy could still be possible before the end of the year—but only if it includes reforms aimed at reducing fraud and lowering out-of-pocket costs for patients.
Cassidy, who chairs the Senate Health, Education, Labor and Pensions Committee, discussed the issue during an appearance on CNN’s State of the Union as lawmakers face a looming deadline. Enhanced Affordable Care Act (ACA) tax credits are set to expire, potentially leading to higher insurance premiums for some Americans in 2026.
Republicans Push Patient Control, Not Insurance Company Profits
According to Cassidy, Republicans want any agreement to focus on giving patients more direct control over their health care spending. He pointed to health savings accounts (HSAs) as a way to help families manage rising deductibles and medical bills.
“Our position has been to put money directly into the patient’s pocket,” Cassidy said. “That way families can actually pay their out-of-pocket costs instead of everything going to insurance companies.”
Cassidy noted that Democrats have largely focused on keeping premiums lower, while Republicans want to address deductibles that often reach thousands of dollars—even for families with insurance coverage.
“I think there’s a way to do both,” he said.
Short-Term Extension Possible—But Only With Reforms
Cassidy outlined a potential compromise that would allow families access to HSAs funded with amounts ranging from $1,000 to $5,000, helping cover initial medical expenses. At the same time, he said Congress could consider a temporary extension of enhanced ACA subsidies for individuals facing the highest insurance costs.
The Louisiana senator stressed that any extension must be short-term and paired with meaningful reforms.
“This has to be about protecting patients, not padding insurance company profits,” Cassidy said.
Fraud Concerns Remain a Major Obstacle
Cassidy, a physician, has repeatedly raised concerns about what he describes as billions of dollars in estimated fraud within the current health insurance system. He warned that extending subsidies without addressing waste and abuse would only worsen existing problems.
“Plans with $6,000 deductibles are not about care—they’re about profit,” Cassidy said. “That’s what has to change.”
Both Republican and Democratic health care proposals failed to advance in the Senate last week, increasing pressure on lawmakers as the expiration deadline approaches.
Limited Time, Uncertain Outcome
CNN host Dana Bash noted that the Senate has just four legislative days remaining to act before the tax credits expire. Cassidy acknowledged the challenge but said discussions are still ongoing.
“I can’t say a deal is finalized,” he said. “But affordability is a real concern, and doing nothing isn’t acceptable.”
Cassidy emphasized that reducing high deductibles should come before addressing premiums, arguing that many Americans delay or avoid care altogether because of upfront costs.
“If we can meet halfway, there’s room for agreement,” he said. “Some policies could be implemented in early 2026, and HSAs can begin helping families right away.”
