Originally broadcast December 11, 2025

Congress is scrambling to find a solution to the enhanced Affordable Care Act subsidies that expire at the end of the year. Without action, premiums are set to rise sharply for millions of Americans, creating a major health care cliff as 2026 approaches.

Congressional reporters Sandhya Raman (CQ Roll Call) and Robert King (Politico) join hosts Mark Masselli and Margaret Flinter to help make sense of the fast-moving negotiations and what is likely to happen next.

King captures the mood inside Congress as competing proposals circulate without leadership support. As he explains, “But right now, there has not been any indication from Speaker Johnson that he is going to be advocating for any of the compromise legislation that is being discussed in the House.” 

Raman looks ahead to the broader forces that will shape the policy debate over the next year. She says, “I think affordability and the forms of that will be a big thing, whether or not we get any sort of deal on ACA or some of the other things that have been in the mix. Congress has been very interested in PBM reform and things like that to bring down health costs. So I think going into next year, regardless of what happens in the next couple weeks, that will be definitely something big to watch here.” 

Together, their insights offer a timely look at why the subsidy cliff is proving so hard to solve, why the Senate’s competing plans are unlikely to pass, and how issues like abortion coverage and health savings account proposals are adding new complications to an already crowded landscape.

They also share their predictions for the top health care story of 2026, including the trends they believe will shape the year ahead for patients, providers, and policymakers.

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