The U.S. Capitol building after the U.S. Senate advances a bill to end the government shutdown in Washington, D.C., U.S., November 10, 2025. REUTERS/Evelyn Hockstein
U.S. Senate Majority Leader John Thune (R-SD) holds a press conference following the GOP weekly policy lunch on Capitol Hill in Washington, D.C., U.S., December 9, 2025. REUTERS/Annabelle Gordon
U.S. Senate Minority leader Chuck Schumer (D-NY) holds a press conference following the Democratic weekly policy lunch on Capitol Hill in Washington, D.C., U.S., December 9, 2025. REUTERS/Annabelle Gordon

By Richard Cowan and Katharine Jackson

WASHINGTON, Dec 9 (Reuters) - The U.S. Senate will vote on Thursday on rival healthcare plans from Republicans and Democrats, Senate Majority Leader John Thune said on Tuesday, as Congress struggles to address a fast-approaching surge in health insurance premiums for up to 24 million Americans.

Democrats continued to push for a three-year extension of expiring Affordable Care Act subsidies, while Thune said he will present a bill to replace those subsidies with direct payments to individuals. Democrats have criticized those payments as insufficient, and neither approach is expected to get enough support to pass.

The COVID-era subsidies, which help to offset premium costs for the plans, also known as Obamacare, are set to expire at year end for up to 24 million people who rely on the program.

Speaking to reporters following a closed meeting of his fellow Republicans, Thune indicated that some in his 53-member conference have differing ideas on how to deal with the looming rise in healthcare premiums. Some have expressed support for extending the current subsidy program, but with new restrictions.

Asked what will happen if neither party's bills win enough support for passage, Thune said: "We'll see where we go from there." He made no mention of whether there would be negotiations toward a compromise measure.

REPUBLICANS PROPOSE $1,500 FOR HEALTH SAVINGS ACCOUNTS

Late on Monday, Republican Senators Bill Cassidy of Louisiana and Mike Crapo of Idaho, who chair committees with oversight of healthcare, unveiled legislation offering an alternative to the Democrats' plan.

Their bill would authorize up to $1,500 for health savings accounts for individuals earning less than 700% of the federal poverty level. It also would bar the funds from being used for abortion or "gender transition services," according to a summary released by the two senators.

They said the measure also would lower insurance premiums by 11% in 2027 and reduce federal Medicaid funding to states that provide healthcare coverage to "illegal immigrants."

Senate Democratic Leader Chuck Schumer dismissed the Republican bill, calling it "junk insurance," while Republicans have criticized the high cost of Democrats' proposed extension of the existing subsidy and say it has contributed to rising healthcare costs.

The bill's $1,500 payment is meant to cover deductible costs for lower-priced Obamacare plans, although it is far below those deductibles and could leave patients on the hook for up to $7,500 in out-of-pocket expenses before their insurance kicks in. Medical expenses can add up quickly, with a visit to a U.S. emergency room costing between $1,000 and $3,000.

On Monday, President Donald Trump embraced the Cassidy-Crapo approach, backing the payment of federal funds directly to individuals instead of to insurers, as provided by the Obamacare subsidy.

(Reporting by Richard Cowan and Katharine Jackson; Additional reporting by Ahmed Aboulenein; Editing by David Gregorio and Edmund Klamann)