WASHINGTON — The Republican-controlled Senate voted Thursday to reject health care bills offered by each party, as the U.S. barrels toward a cliff with steep premium hikes for millions of Americans set to hit next month.
The failed votes raise the likelihood that enhanced Obamacare subsidies passed in 2021 will expire at the end of this year and cause premiums to double on average for some 22 million Americans who benefit from that funding.
Neither bill achieved the 60 votes needed to advance, kicking the issue into the political arena. Democrats hope to use the issue to mobilize voters in the 2026 midterm elections if there is no outcome to prevent the cost increases.
“The Republican plan is a ‘when you get sick, you go broke’ plan,” Senate Minority Leader Chuck Schumer, D-N.Y., said Thursday on the Senate floor.
The bill offered by Democrats on Thursday would have extended the enhanced Affordable Care Act funds for another three years. The legislation failed by a vote of 51-48, with Sens. Susan Collins, R-Maine, Josh Hawley, R-Mo., and Lisa Murkowski and Dan Sullivan, both Alaska Republicans, joining Democrats to support it.
“Democrats may talk about helping Americans, but their bill is nothing more than a political messaging exercise that they hope they can use against Republicans next November,” Senate Majority Leader John Thune, R-S.D., said Thursday.
A competing bill, offered by Republicans, sought to let the ACA money expire and instead boost health savings accounts while making changes to the insurance marketplaces. It would allow adults earning under 700% of the federal poverty level to access $1,000 per year in a tax-advantaged HSA if they’re younger than 50, rising to $1,500 per year for those aged 50 to 64. And it would expand the availability of lower-tier “bronze” and “catastrophic” Obamacare insurance plans, which have lower premiums and higher out-of-pocket costs.
The bill, written by Sens. Mike Crapo, R-Idaho, and Bill Cassidy, R-La., failed by a vote of 51-48. Along with all Democrats, Sen. Rand Paul, R-Ky., voted “no.” Sen. Steve Daines, R-Mont., missed both votes.
“It delivers the benefit directly to the patient, not to the insurance company,” Thune said, saying it “saves money” for taxpayers. “That is a win-win proposal.”
President Donald Trump said he likes the “concept” of the Crapo-Cassidy bill, but stopped short of endorsing it as his preferred measure. He has not offered a plan of his own.
Democrats blasted the Republican proposal.
“Under the Republican plan, the big idea is essentially to hand people about $80 a month and wish them good luck,” Schumer said before the vote, saying the only viable plans to access that money have deductibles of $7,000 or more. “So, to get that $80 a month, you’re going to pay $7,000 off the top before you even get any health insurance. How ridiculous. How stingy. And how mean and cruel to the American people.”
Even some Republicans said their plan wasn’t enough, as it wouldn’t address the rising cost of insurance premiums.
“I think giving people more money to pay for their deductible is a great idea. I think we probably still need to do something on premiums, because you can’t use the HSAs on premiums,” Hawley said. “That’s just the law. So you know, there’s probably more to do there.”
Sen. Jeanne Shaheen, D-N.H., said Thursday she wasn't giving up on an ACA funding extension, and suggested there may be another opening in January to pass it.
House Republican leaders have said they hope to hold a vote on a health care bill next week before leaving for the holiday recess. But the party has not yet found a plan that its members will rally around, much less one that can pass the Senate before the end of the year. No vote has been scheduled yet, and some swing district Republicans have signed on to two "discharge petitions" to defy Speaker Mike Johnson, R-La., and force a vote on extending ACA money.
Many Republicans in both chambers want the enhanced ACA funds to expire on schedule at the end of this year. Congress is scheduled to leave town at the end of next week for the holidays.
