Bill Cassidy is at the center of an escalating congressional fight over how to prevent rising health care costs from spiking when enhanced Affordable Care Act subsidies expire, as lawmakers juggle short-term extensions and deeper structural changes to coverage. After the Senate rejected competing Democratic and Republican plans, Republicans in both chambers are pushing blueprints that would expand health savings accounts and cost-sharing reductions to put cash directly in patients’ pockets, while many Democrats such as Mark Warner and Hakeem Jeffries insist on first renewing subsidies for roughly 22 million Americans. The impasse has sharpened partisan tensions among figures like Chuck Schumer, John Thune, Jon Ossoff, Mike Johnson and Brian Fitzpatrick, with both parties trading blame for the stalled negotiations even as pressure mounts to reach a bipartisan compromise that protects millions of insured people from higher premiums and out-of-pocket bills.