President Donald Trump is open to making a deal on Affordable Care Act (ACA) subsidies, which has been a key demand of Democrats in the standoff over temporary funding of the federal government.
“We are speaking with the Democrats, and some very good things could happen with respect to health care,” Trump told reporters on Oct. 6.
When asked if he would make a deal on the ACA subsidies, Trump said, “If we made the right deal, I’d make a deal, sure.”
“If Republicans are finally ready to sit down and get something done on health care for American families, Democrats will be there—ready to make it happen.”
The subsidies in question are the enhanced premium tax credits, instituted during COVID-19, which expanded use of the ACA Marketplace—instituted by former President Barack Obama’s health care law, also known as Obamacare—to middle-income Americans.
Enrollment in the ACA Marketplace rose to 24 million in 2025 from 11 million before the enhanced subsidies were introduced.
Intended to be temporary, they are set to expire at the end of 2025.
Democrats have proposed making the enhanced subsidies permanent, arguing that millions of people depend on them and that their expiration will disrupt insurance markets, raising premiums for most Americans.
Some Republicans favor a one-year extension.
However, many Republicans see the enhanced subsidies as riddled with fraud and waste.
“The key to the ACA subsidies is to get back to pre-COVID policy and work on program integrity and waste,” Sen. Thom Tillis (R-N.C.) told reporters on Oct. 3.
Sen. Mike Rounds (R-S.D.) told reporters on Oct. 3: “You got folks that are really concerned about ... the subsidies, and what they look like, and what you can do to eliminate some of the fraud that’s already been identified within the COVID-related subsidies.
“So this is not going to happen in one or two days.”
Commenting on the ACA subsidies, Trump said, “It’s billions and billions of dollars that’s being wasted, and we can have a much better health care than we have right now.”
Republicans and Democrats have been at an impasse over funding the government since the federal fiscal year ended on Sept. 30.
Republicans proposed a continuing resolution to extend funding at current levels for seven weeks while spending negotiations continue.
Democrats offered a competing resolution that included significant changes in health care funding, including making the ACA’s enhanced subsidies permanent.
Neither has passed the Senate, in which standing rules require 60 votes to end debate and bring legislation to a vote.
The ACA Marketplace was designed to make health insurance more affordable by offering tax credits for low-income people to offset the cost of premiums.
The original premium tax credit applies to those whose income is between 100 percent and 400 percent of the federal poverty level. The federal poverty level for the continental United States is $15,650 in annual income for one person. The level is adjusted annually and increases based on household size.
The enhanced premium tax credit, introduced in 2021, reduced the maximum amount enrollees would pay for premiums and opened Obamacare to people whose income is higher than 400 percent of the federal poverty level if their premium payment would be greater than 8.5 percent of their income.
“I’m glad we’re talking,” Sen. Raphael Warnock (D-Ga.) told reporters.
Rounds told reporters that “a lot of people would really like to find a path forward.”
“But it requires, first of all, to get the government open again,” he said.
