Clashing healthcare plans from Republicans and Democrats both failed to advance in the Senate on Thursday, dividing lawmakers along mostly party lines and all but ensuring that Congress will fail to address enhanced Obamacare subsidies that expire at year’s end.
A Democratic proposal for a three-year extension of the pandemic-era premium subsidies failed 51-48, and a GOP counterproposal to instead provide up to $1,500 annually to qualifying recipients for health savings accounts was shot down by the same vote tally.
As expected, both measures fell well short of the required 60 votes to advance but offered both sides their latest healthcare messaging opportunities with side-by-side votes and revealed the depths to which Republicans were able to present a mostly unified front despite deeper underlying divisions. The votes also lay out where both sides’ negotiation baseline is should a bipartisan compromise eventually be reached.
Sen. Rand Paul (R-KY) was the lone Republican to vote against the GOP plan led by Sens. Bill Cassidy (R-LA) and Mike Crapo (R-ID). Sens. Susan Collins (R-ME), Lisa Murkowski (R-AK), Dan Sullivan (R-AK), and Josh Hawley (R-MO) supported the Democratic bill. Collins is facing a battleground reelection next year. Sullivan is also up for reelection but in a safer seat.
All Democrats voted in lockstep to oppose the GOP proposal and support their party’s legislation, which was afforded a vote by Senate Majority Leader John Thune (R-SD) as part of a bipartisan deal last month to end the government shutdown.
Party leaders traded their final barbs on healthcare leading up to the votes, as Democrats seek to make the 2026 elections a referendum on affordability.
“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,” Thune said. “I hope that after today, they’ll feel like they’ve checked the messaging box and will get serious about actually doing something about the spiraling healthcare costs under Obamacare.”
Minority Leader Chuck Schumer (D-NY) called his party’s subsidy extension bill a “life and death vote” and said Republicans’ plan was the result of disunity and using “Scotch tape and glue to come up with this ridiculous proposal that can’t be taken seriously.”
Congress’s last working week of the year is next week, all but guaranteeing that the enhanced subsidies for marketplace insurance plans will lapse Dec. 31 without a response from lawmakers. With the failed votes in the rearview mirror, there is optimism among some in both parties that bipartisan talks can be rekindled in the new year.
“I think we would be better served if after we get through these votes we sit down and come to a compromise to address the real costs that people are facing in terms of healthcare, and I’m ready to do that,” said Sen. Jeanne Shaheen (D-NH), a retiring lawmaker who is not seeking reelection next year and was involved in previous negotiations.
Republicans still broadly view the Biden-era subsidies as overly generous and plagued by fraud, but centrists up for reelection are reluctant to be seen as doing nothing to extend them, given that millions are projected to lose coverage from out-of-pocket premium increases.
In the GOP-controlled House, there are efforts on multiple fronts to force Speaker Mike Johnson (R-LA) to hold votes through so-called discharge petitions on measures that would extend the subsidies.
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Prior to the Senate’s votes, Thune said that should a proposal advance from the House, “obviously, we’ll take a look at it.”
“But at the moment,” he added, “we’re focused on the action here in the Senate, which is the side-by-side vote we’re going to have later today.”
David Sivak contributed to this report.