Selina Simmons-Duffin

It says hospitals that provide this care would be cut off from all Medicare or Medicaid funding for everything.

And because federal funding represents so much of hospital budgets, that rule could shut down all gender-affirming care for youth at hospitals.

Partly Republicans don't like the Affordable Care Act, and they don't want to vote to shore it up.

They say the enhanced subsidies are just papering over the high cost of health insurance.

Also, they say that it's a really small portion of the population that relies on these plans, only about 7% of Americans.

Most people get their insurance through their jobs or through Medicaid or Medicare.

So Republicans seem to be making the calculation that even if some of their voters are on the hook for these higher premiums, it might not be enough to hurt the party politically.

24 million people were enrolled in these Obamacare plans this year, and almost all of them got these generous federal subsidies that came in during the pandemic to help keep their premium costs really affordable, like $10 a month for many people.

Those enhanced subsidies expire in a matter of weeks.

So many people are looking at way higher premium costs.

24 million people enrolled in Obamacare this year, mostly small business owners and workers, farmers, ranchers.

Nearly all of them got enhanced subsidies to help with monthly premium costs.

Now those enhanced subsidies are expiring and costs are going up dramatically.

Ellen Allen's premium costs are quadrupling.

She's 64, lives in West Virginia, and has pre-existing conditions.

The Bronze Plan without Vision and Dental

Senate Democrats' bill would put those enhanced subsidies back for three years.

The Republican bill would put money in health savings accounts, but would not bring down the higher premium costs.

Selina Simmons-Duffin, NPR News, Washington.

24 million people enrolled in Obamacare this year, mostly small business owners and workers, farmers, ranchers.