Challenges Pile Up with 2026 Around the Corner

End-of-Year Healthcare Fight Comes into View

Despite being the focus of the longest shutdown in U.S. history, Republicans have still not designed a counterproposal to address expiring Affordable Care Act enhanced tax credits when a forced vote in the Senate comes up on Thursday on Senate Democrats’ plan for a three-year extension. This week, Senator Lisa Murkowski (R-AK) admitted, “I don’t think we have coalesced as a conference around a plan…I’m hoping that we actually have something we can get 60 [votes] for.” 

House Democrats have filed a discharge petition to force a vote on a clean three-year extension, though it is not expected to reach the floor. Instead, House Republicans are putting pressure on Speaker Mike Johnson (R-LA) to put forward a Republican alternative. As of now, Johnson is promising to release healthcare legislation or a package of healthcare bills next week, including expanding Health Savings Accounts (an idea also put forward by Senate HELP Chair Bill Cassidy) and other alternatives to subsidizing the ACA marketplace. Yet, in the absence of leadership from the White House, many Republicans remain skeptical that any legislation will pass before the end of the year. 

As these challenges grow, so has members’ frustration. After Johnson kept the House out of session for more than 50 days, refusing to negotiate on the issue, House Republicans are growing weary of the prospect of returning to their districts for the holidays with little to show for their work. 

Appropriations leaders meet without agreement on path forward

While healthcare takes center stage, progress on fiscal year 2026 appropriations also continues to hit roadblocks. Previous reporting had indicated that Leader John Thune (R-SD) was looking to pass up to five appropriations bills (Labor-HHSCommerce-Justice-Science, Transportation-HUD, Defense, and possibly Interior-Environment) on the Senate floor before going to conference. However, as Congress works through the details, negotiations on Labor-HHS and Defense have stalled, particularly following the Trump Administration’s efforts to dismantle the Department of Education. 

Notably, appropriators in both chambers have yet to reach an agreement on top-line spending, hamstringing progress on any of the remaining bills and increasing the likelihood that lawmakers will be forced to pass another year-long CR at the end of January.