December 12, 2025 | Vol. MMXXV | Issue 141

In this edition:

• Healthcare

• Department of Health and Human Services

• New Legislation

• AUCD Materials

• Words to Know

Healthcare

The Affordable Care Act (ACA) tax credits will expire at the end of the year. If Congress doesn't take action to extend them, many Americans will see their healthcare premiums more than double in January.

On Thursday, the Senate voted on two healthcare bills. One was a proposal from Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Bill Cassidy (R-LA) and Senate Finance Committee Chairman Mike Crapo (R-ID) to direct the federal government to deposit money directly into Americans' health savings accounts (HSAs) to make higher out-of-pocket health care costs more affordable. The plan would require ACA enrollees to switch to bronze-level plans. It wouldn't address ACA premium costs that will spike at the end of the year because money in an HSA cannot be used to pay premiums. Many Republicans say that HSAs offer people more flexibility and cut out insurance company middlemen, while Democrats argue that they don't address the needs of people with more costly healthcare needs. The other bill was Senate Democrats' proposal to extend the ACA tax credits by three years. Neither measure had enough votes to pass. Republican Senators Susan Collins (ME), Josh Hawley (MO), Lisa Murkowski (AK), and Dan Sullivan (AK) voted to advance the Democrats' healthcare bill.

Key Takeaways

It is not looking likely that Congress will pass an extension of the ACA tax credits before they expire. While most Democrats have been pushing for an extension, Republicans have been more interested in alternative proposals to save money on healthcare, with some interest in letting the tax credits expire. There are some Republicans pushing legislation to extend the tax credits, including Representative Brian Fitzpatrick (PA), who led a discharge petition to force a vote on his bill with Jared Golden (D-ME). Representative Jen Kiggans (VA) also has a discharge petition with bipartisan support to force a vote on her bill with Rep. Josh Gottheimer (D-NJ). Senators Susan Collins (ME) and Bernie Moreno (OH) have a bill to extend the tax credits as well. But, without support from the President or Republican leadership, these proposals may not go anywhere.

Plain Language

On Thursday, the Senate voted on two healthcare bills. There were not enough votes for either bill to pass.

One bill was from Senator Bill Cassidy (R-Louisiana) and Senator Mike Crapo (R-Idaho). Senator Cassidy is the Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, which works on health issues. Senator Crapo is the Chairman of the Senate Finance Committee, which works on ways for the government to spend money or save money. Their bill would make the federal government send money to a special fund that some people have called a health savings account. This is a special account where people can put money that they want to use on healthcare. Not everyone has one, and it depends on what kind of healthcare you have. You can use it to pay for some healthcare needs. You can read more about this plan in this past issue of Disability Policy News.

The other bill was from Senate Democrats, led by Senator Chuck Schumer (D-New York). This bill would help people keep using something called healthcare tax credits. Many people are able to pay less for healthcare every month because of tax credits. A tax credit is an amount of money that people can save when they file their taxes. Usually, they are a reward from the federal government. For example, if the federal government wants more people to get health insurance, they might offer a tax credit to people who get health insurance. The Affordable Care Act has special tax credits that will end on December 31, 2025. Democrats want to make sure that people can still use these tax credits in the future so they can save money and afford healthcare.

Republicans in Congress are not as supportive of these tax credits, and they want to try different ideas to save money on healthcare. However, there were a few Republicans who voted for the Democrats' bill: Senators Susan Collins (Maine), Josh Hawley (Missouri), Lisa Murkowski (Alaska), and Dan Sullivan (Alaska).

Democrats say that the plan from Senator Cassidy and Senator Crapo won't help people who have healthcare needs that cost more money. Because so many Members of Congress disagree on the tax credits, it might not be possible for Congress to pass a bill so that people can still use the tax credits before time runs out. Republican leaders in Congress and President Trump have not said they are supportive of the tax credit bills.

There are some Republicans who are interested in working on a deal so that some people can still use the healthcare tax credits. We talk about this more in the "New Legislation" section later in this newsletter.

Department of Health and Human Services

Centers for Disease Control and Prevention (CDC) – On December 5, President Trump released a memo titled "Aligning United States Core Childhood Vaccine Recommendations with Best Practices from Peer, Developed Countries." He directs the Health and Human Services (HHS) Secretary and CDC Director to review the U.S. childhood vaccine schedule and use best practices from other developed countries to mirror. The memo recommends that the U.S. update its childhood vaccine schedule to reflect the recommendations of other countries listed, including Denmark, Germany, and Japan.

Centers for Medicare & Medicaid Services (CMS) – On December 8, CMS released an informational bulletin that provides an overview of the new community engagement requirements—also known as work requirements—passed into law through H.R.1 (the One Big Beautiful Bill). The memo defines who is subject to the work requirements, what the requirements are, which individuals are excluded from the requirements, verification guidelines, consequences of non-compliance, and financial resources available for states to implement these requirements.

Key Takeaways

CDC – The countries referenced in the President's memo recommend fewer vaccinations for children, a key policy goal for the President and HHS Secretary Kennedy. Public health experts warn that these nations are smaller and typically provide universal health care, making the U.S. an incompatible comparison.

CMS – The passage of new work requirements in H.R.1 is expected to result in 5.3 million people losing their Medicaid. Based on previous experience in Arkansas and Georgia, work requirements cost millions of dollars in expensive administrative tracking systems, create administrative barriers, and result in many people—including older adults, people with disabilities, and caregivers—falling between the cracks and losing their healthcare coverage. Advocates have been preparing for these consequences and are planning state-level advocacy to prevent as much harm as possible. You can find a deeper dive into the work requirements provisions from KFF here.

Plain Language

The Department of Health and Human Services is also called HHS.

Centers for Disease Control and Prevention (CDC) – The CDC makes decisions about vaccines, which are shots to keep people from getting sick. On December 5, President Trump released a memo. This memo told the CDC that the President wants the people in charge of HHS and the CDC to look at the list of vaccines that children get. This list is called the childhood vaccine schedule. The list tells doctors, parents, and healthcare officials which vaccines children need to get and when in their lives they should get them. The President said that there are other countries that are similar to the U.S., like Denmark, Germany, and Japan. He said those other countries give children fewer vaccines. He thinks the U.S. should be more similar to those countries and give children fewer vaccines. Some public health experts say that the countries listed in the President's memo are smaller and they usually have healthcare available for everyone. This means that the U.S. might be very different from those countries, so we might not be able to do things their way while still protecting children against diseases.

Centers for Medicare & Medicaid Services (CMS) – On December 8, CMS released a memo about something called "community engagement requirements." These are rules that people have to follow to get benefits. It is also called work requirements because people have to have a job and work a certain number of hours to get their benefits. In July, Congress passed H.R.1 (also called the One Big Beautiful Bill), which made a lot of cuts to Medicaid and included these new work requirements. Now, people will have to prove they are working in order to get Medicaid. The memo has information about how to prove to the government that you are working, and which people are allowed to NOT work. It also has information about what will happen if you don't prove that you are working.

A lot of people tried to stop H.R.1 from becoming a law because it included a lot of parts that will take Medicaid away from people. Work requirements will mean that about 5.3 million people will probably lose their Medicaid. Work requirements are hard for states, because they have to figure out new systems to track people and make sure they are working. These systems can be really expensive and they don't always work well. People will have to do more paperwork and take more steps to get their healthcare. They will need to tell the government how many hours they work per month, which can be hard to figure out. Because states all have different Medicaid programs, advocates in different states now have to educate and advocate to their state lawmakers and healthcare officials to make it as easy as possible for people with disabilities to keep their Medicaid. Having healthcare helps people with disabilities get jobs. Medicaid helps people work by giving them the healthcare and services they need.

You can watch this video from Disability Policy for All with Liz on Medicaid work requirements.

New Legislation

• The ADA 30 Days to Comply Act (H.R.6453)

  • Introduced by Representative Mike Lawler (R-NY)

  • Would amend the Americans with Disabilities Act (ADA) to allow businesses a 30-day remediation window to address ACA violations or show progress

  • You can read Representative Lawler's press release here.
    
    

• The Keeping All Students Safe Act (S.3448)

  • Introduced by Senator Chris Murphy (D-CT)

  • Would prohibit and prevent seclusion and restraint in schools
    
    

• The Consumer Affordability and Responsibility Enhancement (CARE) Act

  • Introduced by Senator Bernie Moreno (R-OH)

  • Would extend the ACA tax credits for two years with income caps

  • You can read Senator Moreno's press release here.
    
    

• The Lower Health Care Costs Act (S.3385)

  • Introduced by Senator Chuck Schumer (D-NY)

  • Would extend the expanded ACA tax credits for three years
    
    

• The Health Care Freedom for Patients Act (S.3386)

  • Introduced by Senators Mike Crapo (R-ID) and Bill Cassidy (R-LA)

  • Would provide a health savings account contribution to certain enrollees to reduce health care costs

  • You can read the press release from Senators Crapo and Cassidy here.
    
    

• The Lowering Healthcare Costs for Americans Act (S.3389)

  • Introduced by Senator Roger Marshall (R-KS)

  • Would extend the ACA premium tax credits for 2026, require ID verification for ACA enrollees, and implement price transparency reforms

  • You can read Senator Marshall's press release here.
    
    

• The Accountability for Better Care (ABC) Act (S.3391)

  • Introduced by Senator Jon Husted (R-OH)

  • Would extend the ACA enhanced premium tax credits by two years with income caps

  • You can read Senator Husted's press release here.
    
    

• The Bipartisan Health Insurance Affordability Act (H.R.6501)

  • Introduced by Representative Brian Fitzpatrick (R-PA)

  • Would extend the ACA enhanced premium tax credits through 2027 and expand access to health savings accounts

  • You can read Representative Fitzpatrick's press release here.
    
    

• The CommonGround for Affordable Health Care Act (H.R.6575)

  • Introduced by Representative Jen Kiggans (R-VA)

  • Would extend the ACA enhanced premium tax credits for two years and implement new guardrails to prevent fraud

  • You can read Representative Kiggans' press release here.
    
    

• H.R.6516

  • Introduced by Representative Tim Burchett (R-TN)

  • Would amend the Affordable Care Act to identify people dually enrolled in Medicaid or CHIP and an ACA exchange plan
    
    

• H.R.6494

  • Introduced by Delegate Stacey Plaskett (D-VI)

  • Would make improvements to the treatment of the United States territories under the Medicare and Medicaid programs
    
    

• The Domestic Workers Bill of Rights Act (S.3396)

  • Introduced by Senator Kirsten Gillibrand (D-NY)

  • Would provide overtime, leave, and civil rights protections to domestic workers

  • You can read Senator Gillibrand's press release here.

Plain Language

There are a few new bills this week.

• The ADA 30 Days to Comply Act would change a part of the Americans with Disabilities Act (ADA) that tells businesses how long they have to fix something if it is not accessible. This bill would give businesses 30 days to make changes or show that they are working on making something accessible.
  
  

• The Keeping All Students Safe Act would stop restraint and seclusion in schools. Restraint is when someone stops you from moving your arms, legs, or body. Seclusion is when you are put in a separate place, away from other people. Restraint and seclusion affect a lot of students with disabilities.
  
  

• The Domestic Workers Bill of Rights Act would make sure direct care workers get paid fairly and have benefits like sick leave and family leave.
  
  

• A bill to make sure people don't have a healthcare plan through the Affordable Care Act AND a healthcare plan through Medicaid or the Children's Health Insurance Program (CHIP).
  
  

• A bill to improve Medicaid and Medicare services for people who live in the United States territories. The territories are places that the U.S. is in charge of, but they are not states.

There are a few bills that are specifically about the Affordable Care Act special tax credits. As we mentioned in the "Healthcare" section above, there are Members of Congress who want people to be able to use the tax credits for longer. Not everyone agrees on how much longer people should be able to use them, because they cost money. Some bills would make the tax credits available for two or three years. Some bills would make the tax credits available to people who make a low income (amount of money) every year. Here is the list of these bills:

The Lower Health Care Costs Act

Senator Chuck Schumer (D-New York)

The Lowering Healthcare Costs for Americans Act

Senator Roger Marshall (R-Kansas)

The Accountability for Better Care (ABC) Act

Senator Jon Husted (R-Ohio)

The Bipartisan Health Insurance Affordability Act

Representative Brian Fitzpatrick (R-Pennsylvania)

The CommonGround for Affordable Health Care Act

Representative Jen Kiggans (R-Virginia)

The Consumer Affordability and Responsibility Enhancement (CARE) Act

Senator Bernie Moreno (R-Ohio)

AUCD Story Collection

AUCD is collecting stories from the Network on a variety of topics to amplify the effects of this Administration on real people and our programs. If you have a story, we want to hear it. 

We are interested in stories about: 

• Medicaid and its impact on people's lives 

• The impact of dismantling ACL 

• The important work of UCEDDs, LENDs, IDDRCs, PNS’s, DD Councils, P&As

• The impact of zeroing out UCEDDs, LENDs, IDDRCs, PNS’s, DD Councils, P&As  

• Impact of grants that are being cut

• Stories responding to RFK Jr.’s claims about autism or the autism registry 

You can use this link to provide information and let us know if you are comfortable sharing your story with Members of Congress and their staff. 

AUCD Policy Blog

AUCD invites Network members to fill out this form if you’re interested in writing for the AUCD policy blog. We are open to a variety of issues areas, and we will follow up with you as relevant issues come up that we’d like you to write about. 

This month, we are honoring the life and legacy of disability justice activist and leader Alice Wong with a blog post from three contributors in the AUCD Network: Honoring the Life of Alice Wong

Disability Policy for All with Liz

Join Liz on Instagram Reels, where she provides plain language updates on policy, highlighting current issues and hot topics in federal disability policy.

Liz Weintraub is AUCD's Senior Advocacy Specialist and the host of "Disability Policy for All with Liz." She has extensive experience practicing leadership in self-advocacy and has held many board and advisory positions at state and national organizations, including the Council on Quality & Leadership (CQL) and the Maryland Developmental Disabilities Council.

Watch Liz's most recent video interviewing AUCD’s Interim Director, Sandy Root-Elledge.

Words to Know

Tax Credit

This is an amount of money that people can save when they file their taxes. Usually, they are a reward from the federal government. For example, if the federal government wants more people to get health insurance, they might offer a tax credit to people who get health insurance. These might also be called subsidies.

Community Engagement Requirements

These are rules about what someone has to do to get certain benefits. The law might say that you have to work and have a job in order to get supports, services, or money from the government. If you can’t get a job, the law might say you have to do something else to get those benefits, like go to school or volunteer.