Senate rejects dueling ACA subsidy plans; both get 51 votes
The Senate held dueling votes on Democrats’ clean three‑year extension of enhanced ACA premium tax credits and the GOP’s Cassidy–Crapo “Health Care Freedom for Patients Act” redirecting funds into HSAs, and both measures failed in cloture votes, each receiving 51 votes — short of the 60 needed. With enhanced credits set to expire Jan. 1 and millions of marketplace enrollees facing sharply higher premiums, lawmakers said they will pivot to bipartisan negotiations to seek a short‑term or compromise fix.
📌 Key Facts
- The Senate held dueling cloture votes on rival ACA fixes — Republicans’ Cassidy–Crapo HSA alternative (branded the Health Care Freedom for Patients Act) and Democrats’ clean three‑year subsidy extension (the Lower Health Care Costs Act) — and both measures failed to reach the 60 votes needed, each receiving 51 votes.
- The GOP Cassidy–Crapo plan would redirect federal funds into Health Savings Accounts for bronze‑plan or catastrophic enrollees (seed amounts reported as $1,000/$1,500 for people up to 700% of the federal poverty level), with funds barred from paying premiums and excluding abortion and gender‑transition services; it also includes Hyde‑style restrictions and other GOP provisions (Medicaid funding limits for states covering illegal immigrants, citizenship/eligibility verification for Medicaid, and removing gender‑transition services from ACA essential benefits).
- Democrats pushed a clean, three‑year extension of the enhanced ACA premium tax credits to avoid premium spikes and coverage losses; Democrats and many advocates say the GOP HSA approach would not maintain subsidy coverage or be implementable quickly enough.
- Several Republicans crossed party lines to support the Democrats’ three‑year extension — Senators Susan Collins, Lisa Murkowski, Dan Sullivan and Josh Hawley — and Murkowski said she voted for both proposals to spur negotiations.
- Analyses and experts cited KFF and CBO estimates showing the stakes if enhanced credits expire Jan. 1: roughly 22–24 million people rely on the credits, average marketplace premiums for subsidized enrollees would rise about 114% (from $888 in 2025 to about $1,904 in 2026), and the CBO projects about 4 million people could drop coverage.
- Timing heightened pressure: enhanced credits are set to expire Jan. 1, many states’ open‑enrollment windows for Jan. 1 coverage end Dec. 15, and Congress is set to leave until the New Year, compressing the window for a fix.
- Both parties and several senators (including Thune, Cornyn, Rounds, King, Schumer and others) signaled the partisan votes were likely to fail and pushed for immediate senator‑to‑senator/bipartisan talks or a short‑term extension (six months to a year or phased approaches) as the next step; Sen. Bill Cassidy said a deal is possible and he would consider a short‑term extension tied to reforms.
- Reporting noted GOP fraud concerns (citing a GAO sting) as part of the rationale for demanding anti‑fraud measures, and polling/consumer interviews show potential political and personal impacts — a KFF poll found about half of registered‑voter enrollees say a $1,000 annual increase would affect their 2026 vote, and enrolllee testimony illustrated likely premium shocks.
📊 Analysis & Commentary (1)
The Democratic base isn’t in the mood to compromise
"An opinion piece arguing that Democratic grassroots anger and preferences make rank‑and‑file Democrats reluctant to accept GOP compromise plans—such as converting ACA subsidies to HSAs or accepting caps and riders—thereby constraining leaders and shaping the upcoming Senate votes over extending enhanced ACA premium tax credits."
📰 Sources (17)
ACA shoppers face sticker shock as Congress dithers on health care
New information:
- NPR reiterates neither Senate option reached the 60-vote threshold and places the failed vote in the context of ongoing open enrollment timelines.
- Introduces a December KFF poll showing about half of ACA enrollees who are registered voters say a $1,000 increase in annual health costs would have a major impact on their 2026 midterm vote.
- Highlights consumer uncertainty and marketplace contingency considerations during enrollment.
Sen. Cassidy says "there's a deal to be had" on health care after failed Senate votes
New information:
- Sen. Bill Cassidy said there is "a deal to be had" and he is willing to back a short-term extension of ACA premium tax credits as part of a broader compromise.
- Cassidy outlined a GOP approach to redirect funding into HSAs for bronze-plan users to help cover high deductibles, arguing Democrats must address out-of-pocket costs.
- He suggested Congress could implement a fix by the end of March because HSA users can save receipts and be reimbursed retroactively.
- Cassidy reiterated that last week’s GOP bill, which Democrats opposed, would lower premiums by shifting people to lower-tier plans while offsetting deductibles with HSA funds.
Millions of Americans could see health plan costs double as ACA credits vanish
New information:
- KFF estimates out-of-pocket premiums would rise an average 114% for ACA enrollees currently receiving enhanced credits, adding about $1,016 to annual costs; a $75,000-income family of four could face about $3,368 more without the credits.
- CBO projects about 4 million people could drop coverage if the enhanced subsidies lapse.
- CBS reports 90% of ACA enrollees rely on the enhanced credits and highlights disproportionate impacts on small business owners and the self-employed.
- Includes on‑the‑record testimony (Dec. 10) from Iowa farmer Aaron Lehman that his family’s comparable 2026 policy costs would more than double without the enhanced credits, plus consumer interviews illustrating premium shocks.
Senate mulls next steps after dueling Obamacare fixes go up in flames
New information:
- Fox News reports four Senate Republicans crossed the aisle to vote for Democrats’ three-year ACA subsidy extension.
- Sen. Lisa Murkowski says she voted for both the GOP and Democratic proposals to spur negotiations.
- Key GOP leaders (Sens. John Thune and John Barrasso) signal interest in continued talks; a short-term extension (six months to a year) is being discussed even as Republicans press for reforms.
- Growing sentiment that President Trump should weigh in more directly; he has previously signaled support for HSAs.
- Congress is set to leave at the end of next week while enhanced ACA subsidies expire at year’s end, increasing pressure for an off‑ramp.
Senate rejects plans to address sharp rise in health care premiums
New information:
- Both the Republican HSA-centered alternative and the Democrats’ three‑year extension each received 51 votes, short of the 60 needed.
- Sen. John Thune said there are senator‑to‑senator talks but no bipartisan negotiations yet; he has not given up on a path forward.
- Sen. Chuck Schumer suggested this may be it for the year, indicating limited prospects for another Senate attempt before recess.
- PBS segment underscores that House GOP leadership is not currently advancing an extension while noting a bipartisan group is trying to push action.
Some lawmakers see path for health care deal after failed Senate votes
New information:
- Identifies the four Republicans who voted with Democrats to extend subsidies: Sens. Lisa Murkowski, Susan Collins, Dan Sullivan and Josh Hawley.
- Sen. Roger Marshall says a solution is unlikely before the holiday recess and points to a potential January deal; reiterates his one‑year extension then HSA‑style transition plan.
- Sen. Thom Tillis pushes for a deal within a week, arguing Democrats see political upside in premium hikes but that rank‑and‑file support exists for an anti‑fraud‑focused extension.
- Sen. Jeanne Shaheen signals Democratic openness to post‑vote compromise talks.
- Notes Republicans’ compromise contours under discussion: temporary extension with income caps, anti‑fraud measures, and phased phase‑out of enhanced credits; cites Collins’ two‑year plan with income caps.
- Highlights scope of impact: around 22 million Americans face a subsidy cliff absent action.
Senate rejects rival Obamacare bills. Here's what that means for ACA subsidies
New information:
- The Senate rejected the Democratic three‑year extension of enhanced ACA premium tax credits in a cloture vote that failed to reach 60 votes.
- With the earlier defeat of the GOP alternative, both rival Obamacare bills failed in the Senate.
- Without congressional action, the enhanced ACA subsidies remain set to expire on January 1, increasing costs for marketplace enrollees; next steps shift to potential bipartisan talks and House maneuvers.
Senate Dems' Obamacare fix fails as Senate looks for off-ramp from healthcare cliff
New information:
- Four Republicans — Susan Collins (ME), Lisa Murkowski (AK), Dan Sullivan (AK) and Josh Hawley (MO) — voted for Democrats’ three‑year ACA subsidy extension.
- GOP offering was also blocked minutes before the Democratic plan failed, leaving no Senate solution yet.
- New on‑record quotes: Hawley said he would back 'just about anything' that lowers costs now; Majority Leader John Thune called Democrats’ plan a 'fantasy'; Schumer asserted his side’s bill had broad support.
Senate Dems block Republicans' HSA plan as Obamacare deadline nears
New information:
- Senate Democrats, joined by Sen. Rand Paul (R‑Ky.), voted down the Cassidy–Crapo HSA alternative.
- Details reiterated on the GOP plan’s structure: $1,000/$1,500 HSA seed funds up to 700% FPL, tied to purchase of bronze/catastrophic plans, with Hyde enforcement and exclusions for gender‑transition services.
- A vote on Democrats’ three‑year ACA subsidy extension is up next and is expected to fail, pushing toward bipartisan talks.
- Quote from Sen. Chuck Schumer criticizing the GOP proposal as a "fig leaf."
- Senate Majority Leader John Thune is prepared to hold a vote on another proposal next week.
WATCH LIVE: Senate expected to vote on ACA subsidies with premiums set to rise in 2026
New information:
- KFF estimates the average subsidized ACA enrollee’s annual premium payments would rise 114% if enhanced credits expire (from $888 in 2025 to $1,904 in 2026).
- KFF poll: about 1 in 4 ACA enrollees say they would be very likely to go without insurance if premiums doubled next year.
- Open enrollment timing detail: for Jan. 1 coverage, most states’ ACA sign-up window ends Dec. 15.
- Context: roughly 24 million people currently have ACA coverage; enhanced credits are set to expire Jan. 1.
Senate to vote on dueling health care bills with price hikes on the horizon
New information:
- Procedural votes set to begin at 11:30 a.m. ET Thursday, with the GOP bill up first.
- Democrats’ bill is identified as the Lower Health Care Costs Act (a clean three‑year extension).
- KFF estimate cited: annual premiums for ACA exchange enrollees would more than double without an extension.
- CBS pegs about 22 million low- and middle‑income Americans aided by the 2025 enhanced credits.
- Schumer labels the vote a 'moment of truth' for Republicans and ties the vote promise to the shutdown deal.
- Republicans cite a recent GAO sting finding fictitious applications were approved as part of their fraud concerns.
Dueling Obamacare plans set to fail as deadline nears, pushing Senate toward bipartisan talks
New information:
- Multiple senators (Thune, Cornyn, Rounds, King) say both partisan plans are expected to fail and express intent to pursue bipartisan talks immediately afterward.
- Sen. John Cornyn says a final resolution is likely to slip to January, after the enhanced subsidies expire.
- Article notes bipartisan discussions have already been occurring in the background, but both parties opted to stage partisan votes first.
- Sen. Angus King says strict Hyde Amendment enforcement sought by Republicans is 'not going to happen' with Democrats, highlighting a core negotiating hurdle.
- Timeline context: Congress leaves Washington next week until the New Year, compressing the window to act.
Senate to vote on dueling health care proposals as ACA premium hikes loom
New information:
- GOP Cassidy–Crapo plan would provide up to $1,500 per year to Health Savings Accounts for those under 700% of the federal poverty level.
- Funds in the GOP plan cannot be used to pay premiums and exclude abortion and gender‑reassignment services.
- Democrats say both votes are expected to fail, while Republicans lack certainty all GOP senators will back the Cassidy–Crapo measure (per Thune).
- Democrats argue time is too short to implement the GOP plan this year and push a clean three‑year ACA tax‑credit extension.
- KFF data cited: average deductibles around $7,000 for marketplace plans, underscoring affordability concerns.
- Quotes: Cassidy warns of 'fraudulent spending'; Schumer says GOP plan 'would not extend the ACA tax credits for a single day'; Reed says 24 million face losing subsidies at year’s end.
WATCH LIVE: Senate meets ahead of dueling health care proposal votes
New information:
- Republican senators publicly coalesced around the Cassidy–Crapo plan after a Tuesday lunch, despite prior internal differences.
- Sen. Bernie Moreno, who recently floated a two‑year extension with income caps, says he is now "hyper‑focused" on the Cassidy–Crapo bill.
- Sen. Josh Hawley said the consensus bill "isn’t perfect, but I’m willing to give it a go," adding Republicans "can’t do nothing."
- Majority Leader John Thune said Democrats’ three‑year extension "will fail" for lacking sufficient fraud controls/limits on high‑income recipients; Schumer called the GOP plan "phony" and "dead on arrival."
- Article reiterates that both bills lack the votes needed and that millions could face higher premiums when credits expire in January.
Thune says Senate GOP will bring up alternative health care bill for a vote
New information:
- Majority Leader John Thune publicly commits that Republicans will put their alternative health bill up for a vote alongside Democrats’ ACA subsidy extension.
- Names the GOP proposal as the 'Health Care Freedom for Patients Act' by Sens. Bill Cassidy and Mike Crapo.
- Policy detail: redirects funds to health savings accounts for bronze‑plan enrollees on the exchanges rather than extending enhanced tax credits.
- Thune’s framing/claim: the GOP bill lowers premiums, delivers benefits directly to patients, and saves taxpayer money.
- Sen. Chuck Schumer labels the Cassidy–Crapo plan 'junk insurance.'
- Context note: Democrats can bring their three‑year extension as part of the shutdown‑ending agreement; both measures are unlikely to reach 60 votes.
Senate Republicans land on Obamacare fix, tee up dueling vote with Dems
New information:
- Senate Majority Leader John Thune said Republicans coalesced around the Cassidy–Crapo HSA plan after a closed-door conference meeting.
- The Senate will hold dueling votes on Thursday on Democrats’ three-year subsidy extension and the GOP HSA alternative.
- The GOP bill includes additional provisions: reducing federal Medicaid funding to states that cover illegal immigrants; requiring states to verify citizenship/eligible status for Medicaid; banning federal Medicaid funding for gender transition services and removing those services from ACA essential health benefits; and applying Hyde-style abortion funding restrictions to the new HSAs.
- Direct quotes from Thune arguing Democrats’ plan benefits insurers and affluent Americans and that the GOP plan shifts benefits to patients.