Trump’s Proposal for Direct Payments Threatens ACA Subsidy Stability Amid Ongoing Dispute

Treasury Secretary Scott Bessent revealed on November 23 that the Trump administration is developing a strategy to lower health-care expenses in the U.S., with further information anticipated this week. This initiative arises as political tensions mount over the looming expiration of enhanced Affordable Care Act (ACA) subsidies at the end of the year, a change that could result in higher premiums for millions. "There will be an announcement about this in the coming week," Bessent stated during NBC's Meet the Press,

against prolonging the subsidies and instead supporting direct financial assistance to individuals.

President Trump has repeatedly rejected legislative attempts to extend ACA subsidies, which Democrats maintain are essential for keeping coverage affordable.

, Trump declared that "the only healthcare I will support or approve is sending the money directly back to the people," presenting his plan as a way to bypass insurance providers. Nevertheless, that such a policy shift could disrupt ACA exchanges, since it remains uncertain how individuals would secure coverage without the subsidies. Senate Republicans are also under pressure to reconcile Trump's uncompromising approach with public anxiety over escalating health-care expenses .

Bessent also discussed broader economic challenges,

of a recession in 2026, despite difficulties in the housing market and industries sensitive to interest rates. He attributed "noninflationary growth" to Trump's tax reforms and trade initiatives, and highlighted that recently passed Republican legislation—such as permanent tax cuts and expanded deductions—will stimulate consumer spending. The administration's commitment to affordability also extends to health care, where Bessent aimed at reducing costs, though he did not provide specifics.

The health-care industry has experienced varied outcomes amid these policy shifts. after Abbott Laboratories agreed to purchase the company for $21 billion, while following favorable results from its breast cancer drug trials. On the other hand, a $1.5 billion loan to reinforce its finances, reflecting ongoing financial challenges despite its long-term profit objectives. it had raised $1 million to broaden specialized dental care for people with disabilities, underscoring efforts to improve access.

The current political and economic environment remains tense.

not "wasting time" with ACA subsidies is at odds with Democratic successes in recent elections, where affordability was a major theme. As the White House targets a to finalize a health-care proposal, lawmakers are under pressure to break the deadlock. Bessent reiterated that the administration's plan centers on channeling federal support directly to consumers, the health-care system—though it remains to be seen how it will work in practice.