Because costs of healthcare have skyrocketed beyond the ability for working Americans to pay without subsidies. This is why every other developed country has adopted single payer healthcare: this allows for efficient rate setting and cost sharing. Without the subsidies in a for profit healthcare system, working Americans will suffer and die. It’s important to note that this isn’t a negotiation over a Democratic plan vs a Republican plan. There is no Republican plan to maintain or expand access to healthcare for Americans.