Dr. Mehmet Oz, the administrator for the Centers for Medicare and Medicaid Services (CMS), said Sunday the Trump administration is holding “discussions” on extending subsidies offered under the Affordable Care Act (ACA).
“There are discussions around extending the subsidies, if we deal with the fraud, waste and abuse that, right now, is paralyzing the system,” Oz told host Dana Bash on CNN’s “State of the Union.”
The majority of fraud Oz is referencing concerns agents, brokers, web brokers and third parties that enroll people in the ACA marketplace, according to health policy research group KFF.
The ACA subsidies, which expire at the end of this year, were a source of conflict during the 43-day government shutdown. Republicans in Congress sought to reopen the government first before negotiating on the credits, while the majority of Democrats pushed for an extension to be included in any funding bill.
The continuing resolution President Trump signed into law Wednesday did not include an extension of the subsidies, which were first offered during the COVID-19 pandemic and extended by the 2022 Inflation Reduction Act.
Senate Majority Leader John Thune (R-S.D.) has promised a December vote on an extension in the upper chamber, while House Democrats introduced a discharge petition Wednesday intended to force consideration of a three-year extension of the credits.
Health insurance premiums for 2026 are projected to be $50 per month for the lowest-cost plan, an increase of $13 relative to this year, before accounting for the potential expiration of the subsidies, according to the CMS.
In lieu of the subsidies, which the federal government pays to insurance companies, Trump has proposed sending payments directly to Americans; 4 in 5 HealthCare.gov customers were able to find health care coverage for $10 or less per month for plan year 2024 after subsidies.
“The big question is this: How do we insure people, but make it sustainable?” Oz added.