On 8 November 2025, Senate Republican leaders spent a weekend session debating how to end the government shutdown and address rising health costs, while President Donald Trump, from his West Palm Beach golf course and later Mar-a-Lago, urged a return to repealing the Affordable Care Act (ACA). Republican senators including Lindsey Graham, Rick Scott and Bill Cassidy publicly embraced the idea of replacing ACA subsidies with health savings account–style payments to individuals. The shutdown — the longest in U.S. history at more than a month — continued to affect federal pay, forced airline cancellations and left Supplemental Nutrition Assistance Program (SNAP) benefits delayed for roughly 42 million Americans. Negotiations recessed without a deal; Republican proposals to scrap the ACA face steep political and procedural hurdles in the evenly divided Senate.
Key takeaways
- Senate convened on 8 November 2025 to seek a shutdown resolution; talks produced no agreement and recessed without reopening government.
- President Trump used Truth Social from his West Palm Beach golf course to propose redirecting federal subsidy dollars into individual health savings accounts (HSAs), a suggestion publicly praised by Senators Lindsey Graham, Rick Scott and Bill Cassidy.
- SNAP distributions for about 42 million people were delayed during the shutdown; federal employees continued to go unpaid and airlines reported cancellations.
- Republican leaders floated repeal-and-replace language similar to the failed 2017 Graham–Cassidy approach; that effort previously lacked the votes to pass the Senate.
- Senate Republicans would need the support of at least eight Democrats to pass legislation tied to reopening the government — a political barrier to a partisan repeal of the ACA.
- Health-policy experts warned the HSA-centric plan could undermine protections for people with pre-existing conditions and destabilize the ACA insurance pools, potentially raising premiums for many enrollees.
- Moderate Democrats, led in talks by Senator Jeanne Shaheen, proposed a temporary extension of ACA tax credits as a path to end the shutdown; Senate Democratic leader Chuck Schumer urged a one-year extension to avoid immediate harm to families.
- Associated Press contributed reporting; some Republican social media posts about weekend meetings were later shown to include photographs taken before the president left for Florida.
Background
The dispute sits at the intersection of two long-running political fights: how to fund the federal government and how to structure U.S. health insurance. The Affordable Care Act, signed into law in 2010, established premium tax credits for marketplace enrollees and rules requiring insurers to cover pre-existing conditions. Republicans have long sought market-based alternatives; a major push in 2017 — including proposals tied to Senators Graham and Cassidy — failed to secure the votes needed in the Senate.
The shutdown that began more than a month earlier has sharpened pressure on both parties. Federal payroll disruptions, delayed SNAP benefits for roughly 42 million recipients and operational disruptions at airports have heightened public stakes. Democrats say extending ACA tax credits for a year would immediately blunt premium spikes that have already increased costs for many marketplace enrollees; some Republicans counter that subsidies simply prop up an expensive insurance system and that direct-to-consumer payments could spur competition.
Main event
Early on 8 November, President Trump posted a proposal on Truth Social from his golf course in West Palm Beach recommending that funds currently flowing as ACA subsidies to insurers be redirected “directly to the people” so they could purchase insurance through HSA-style accounts. The post framed the move as removing money from what the president called “money-sucking insurance companies,” and triggered immediate praise from several Senate Republicans who said they would draft legislation.
Senator Lindsey Graham described the concept as akin to a previous replacement blueprint he backed in 2017 and called it “brilliant” on social media, while Senator Bill Cassidy — a co-author of the earlier plan — echoed support and stood beside a blown-up image of the president’s post on the Senate floor. Senator Rick Scott announced he was drafting a bill that would redirect taxpayer funds into accounts for individuals to purchase coverage, arguing it would increase competition and lower costs.
Critics, including Democratic senators and health-policy analysts, said the proposals gloss over key structural realities: consumers would still be buying coverage from the same insurers, and shifting subsidies into HSAs could incentivize plans that avoid covering people with expensive pre-existing conditions. Senator Elizabeth Warren and others pointed to warnings from Kaiser Family Foundation experts that a migration to underwritten plans could cause adverse selection and destabilize the ACA risk pool.
Efforts to tie a repeal-and-replace push to the immediate business of reopening the government faltered. Senate Republican leaders signaled openness to a separate, narrower deal floated by a bloc of moderates to extend ACA tax credits temporarily in exchange for a later vote on the credits’ future, but Democrats remain split on whether to accept such a trade without firm protections for enrollees.
Analysis & implications
Politically, a full repeal-and-replace built around HSAs faces low odds in the current Senate. With a 50–50 split and Vice-President tie-breaking power limited to procedural matters, Republicans would need eight Democratic defections to pass repeal measures tied to reopening the government — an unlikely margin given Democratic commitments to preserve ACA protections like coverage for pre-existing conditions.
Policy-wise, shifting subsidies into HSAs could change incentives across the insurance market. HSAs work best for consumers with predictable, low-cost care needs and who have resources to cover out-of-pocket expenses; placing low-income marketplace enrollees into minimal-benefit or high-deductible plans risks leaving vulnerable people underinsured. Health economists warn such a restructuring could cause healthier enrollees to leave the ACA marketplaces, raising average premiums and triggering the kind of adverse-selection “death spiral” opponents cite.
Budgetary and administrative complications also loom. Redirecting hundreds of billions in subsidy spending would require detailed eligibility rules, transitions for current enrollees, and oversight to prevent new forms of premium segregation. In the near term, the proposal does not resolve the immediate harms of the shutdown — unpaid federal workers and delayed benefits — which have clear, measurable impacts on households and state-administered programs.
On political messaging, the episode reinforces divisions within the GOP between lawmakers seeking a negotiated stopgap and those embracing a long-term policy fight. For Democrats, the debate creates an opening to argue that repeal would remove guarantees Americans now rely on; for Republicans, it is a chance to reframe health policy as an issue of consumer control and market competition. How voters weigh those frames could influence negotiations and midterm dynamics.
Comparison & data
| Item | Now (Nov 2025) | 2017 Graham–Cassidy |
|---|---|---|
| Senate votes required | 50 (+8 Democratic defections likely needed for partisan repeal linked to reopening) | Failed to secure majority in 2017 |
| SNAP impact | Benefits delayed for ~42 million people | Not directly comparable |
| Policy core | Proposal to redirect ACA subsidies into HSA-style accounts | Block grants and state flexibility, criticized for destabilizing risk pools |
The table shows that while the actors and rhetoric echo 2017, the political arithmetic remains the key constraint. The immediate harms of the shutdown — unpaid workers and delayed benefits for tens of millions — give urgency to a short-term fix that many moderates continue to push.
Reactions & quotes
Several Republican senators publicly aligned with the president’s social-media proposal while acknowledging the need for legislative text. Their floor statements framed the idea as consumer-focused, though they provided limited operational detail about transitions or protections for pre-existing conditions.
“I am recommending… that the money be sent directly to the people so that they can purchase their own, much better, healthcare.”
President Donald J. Trump (Truth Social post, 8 Nov 2025)
Democratic leaders warned that a move to HSA-style accounts without safeguards could erode protections central to the ACA and precipitate higher costs for many Americans. Senator Schumer pressed Republicans to accept a one-year extension of tax credits to stabilise the market while longer-term negotiations continue.
“Doing nothing is derelict because people will go bankrupt, people will lose insurance, people will get sicker.”
Senator Chuck Schumer (Senate floor speech, 8 Nov 2025)
Health-policy analysts cautioned that the plan’s contours as described in social posts were vague and could allow insurers to design plans that avoid high-cost enrollees, risking market disruption.
“It could be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans.”
Larry Levitt, Kaiser Family Foundation (health-policy executive comment)
Unconfirmed
- It is not confirmed how a redirected-subsidy plan would preserve protections for people with pre-existing conditions; public descriptions to date lack the legislative detail required to assess that outcome.
- Claims that redirecting subsidy funds would automatically produce “much better” and cheaper plans are unproven; cost and coverage impacts depend on benefit design and insurer pricing.
- Reports implying the president’s weekend Oval Office meetings occurred while he was physically present there have been complicated by social posts that used photos taken before his Florida trip.
Bottom line
The weekend’s developments made clear that Senate Republicans are willing to embrace President Trump’s public pitch to replace ACA subsidies with HSA-style payments, but they did not produce a legislative solution to end the shutdown. Political reality in a 50–50 Senate and the practical challenge of redesigning subsidies into consumer accounts mean the proposal faces steep obstacles.
In the short term, the most actionable path to blunt immediate harm remains a temporary extension of ACA tax credits that many moderates on both sides have discussed. Longer-term questions about market design, protections for pre-existing conditions and federal oversight will determine whether any replacement approach can achieve both lower costs and broad coverage without destabilising current insurance markets.