Republican leaders are intensifying behind-the-scenes discussions on how to structure and advance an extension of key Affordable Care Act subsidies before the end of the year, despite public insistence on waiting for a government shutdown resolution. The focus remains on potential compromises, including income caps, out-of-pocket requirements, or grandfathering current enrollees, to curb the subsidies without abolishing them. The talks involve White House engagement and bipartisan efforts to craft a deal that can pass through Congress despite internal GOP resistance.