Senate Majority Leader John Thune, R-S.D., center, joined by Senate Majority Whip John Barrasso, R-Wyo., left, and Sen. James Lankford, R-Okla., talks to reporters after a Republican policy luncheon at the U.S. Capitol on Dec. 9, 2025, in Washington, D.C. (Photo by Heather Diehl/Getty Images)
WASHINGTON – The U.S. Senate failed in long-awaited votes Thursday to advance legislation that would address rising health insurance costs, leaving lawmakers at an impasse on how to stem an expected augment in premiums next year.
The senators voted 51-48 on a Republican bill co-sponsored by Senator Bill Cassidy of Louisiana and Idaho Senator Mike Crapo that would provide financing through health insurance savings accounts to certain people enrolled in the ACA marketplace in 2026 and 2027.
Then they voted 51-48 on a measure passed by Democrats that would extend for three years enhanced tax credits for people who buy health insurance through the Affordable Care Act’s marketplace. A group of Senate Democrats in November Agreement to end a historic government shutdown in exchange for Republicans committing to a vote to extend the increased subsidies.
Republican senators Susan Collins of Maine, Lisa Murkowski and Dan Sullivan of Alaska, and Rand Paul of Kentucky voted for the Democrats’ bill. Paul also voted against the GOP bill.
Neither bill received the 60 votes needed to pass the Senate’s legislative filibuster rule.
Senate Majority Leader John Thune, R-D., criticized the ACA marketplace and subsidies for leading to huge increases in health insurance costs.
“Under the Democrats’ plan, insurance premiums will continue to spiral and American taxpayers will be burdened with ever-increasing subsidies,” Thune said. “And don’t think that all of these payments will go to vulnerable Americans.”
Thune argued that the Democrats’ bill is merely an extension of the “status quo” of a “failed, flawed fraud program that increases costs at three times the rate of inflation.”
Thune said the Republican bill filed by Cassidy and Crapo “will help citizens with out-of-pocket costs and enable many people who have no or almost no insurance to save on later health care costs.”
Schumer calls GOP plan ‘vile and cruel’
Senate Minority Leader Chuck Schumer, D-N.Y., said the three-year extension bill is the only option to avoid skyrocketing costs for people enrolled in ACA marketplace plans.
“At my last count, Republicans currently have nine different health care proposals, and none of them give Americans what they want most – a clean, simple extension of health care tax credits,” Schumer said. “But our bill awards these credits cleanly and simply, and it’s time for Republicans to join us.”
Schumer called Cassidy-Crapo’s proposals “stingy” as well as “vile and cruel.”
“The big idea in the Republican plan is to give people about $80 a month and wish them well,” Schumer said. “And even to qualify for this check, listen to how bad it looks, Americans would be forced to rely on simple bronze plans with sky-high deductibles: $7,000 or $10,000 for an individual, tens of thousands for a couple.”
After the vote failed, Schumer outlined some of the barriers Democrats would put in place as they negotiate with their GOP colleagues.
“They want to talk about health care in general and how to make it better – we’re always open to that, but we don’t want what they want – favoring insurance companies, favoring drug companies, favoring special interests and turning our backs on the American people,” he said.
Health Savings Accounts in the GOP plan
Under the Cassidy-Crapo Act, the Department of Health and Human Services will deposit money into the health savings accounts of people enrolled in bronze or catastrophic health insurance plans purchased through the ACA marketplace in 2026 or 2027. summary bill.
Health savings accounts are tax-advantaged savings accounts that consumers can employ to cover medical expenses that will not be otherwise reimbursed. These are not health insurance products.
ACA marketplace enrollees who choose a bronze or catastrophic plan and meet up to 700% of the federal poverty level will receive $1,000 per year if they are between the ages of 18 and 49 and $1,500 per year if they are between the ages of 50 and 64.
This would mean an annual income threshold of $109,550 for one person or $225,050 for a family of four, according to the report for 2025. federal poverty guidelines. The numbers are slightly higher for residents of Alaska and Hawaii.
A summary of the Republican bill says the funds cannot be used for abortion access or gender reassignment.
Members of Congress have introduced several other health care proposals, including two bipartisan bills in the House that would, with some modifications, extend the ACA marketplace’s enhanced tax credits for at least another year.
Speaker Mike Johnson, R-LA, is reluctant to bring any of the bipartisan bills to a vote, although he may not be able to do so if application for dismissal submitted earlier this week, it collected the required 218 signatures.
Pennsylvania Republican Brian Fitzpatrick said in a statement that the legislation is “a solution that can actually be passed, not an exercise in political messaging.”
“This bill provides the urgent help families need now while giving Congress a chance to continue improving our health care system for the long term,” Fitzpatrick wrote. “Responsible management means securing 80 percent of what families need today, rather than risking 100 percent of nothing tomorrow.”
But Johnson said Wednesday he would do it put a bundle of bills on the floor of the House next week, which he says will “actually lower premiums for 100% of Americans with health insurance.” Details of these accounts were not disclosed.
Thune told reporters that if “someone manages to get a discharge petition and a bill out of the House of Representatives, we will of course look at it. But right now, as you know, our focus is on what’s going on here in the Senate, which is the parallel vote that will take place later today.”
Murkowski, R-Alaska, said lawmakers could find a compromise on health care by next week “if we believe it’s possible.”
Political costs
The issue of affordability and rising health care costs will likely be key in the November midterm elections, where Democrats hope to flip the House from red to blue and gain additional seats in the Senate.
The Democratic National Committee is not waiting to launch these campaigns, placing digital ads in hometown newspapers several Republicans up for re-election next year, including Collins of Maine and Jon Husted of Ohio.
“Today’s vote in the Senate to extend the ACA tax breaks could mean the difference between life and death for many Americans,” DNC Chairman Ken Martin said in a press release. “More than 20 million Americans will see their health care premiums skyrocket next year unless Susan Collins, John Cornyn, Jon Husted and Dan Sullivan stand with working families and vote to extend these lifesaving credits.”
White House press secretary Karoline Leavitt sharply criticized Senate Democrats’ proposal during a news conference Thursday, calling it a “political show-off vote” intended to provide cover for Democrats whom she blames for creating the problem.
Trump and Republicans “would explore creative ideas and solutions to the health care crisis that Democrats have created,” she said. “Chuck Schumer has no sincere interest in lowering the cost of health care for the American people. He’s putting this vote on the floor, knowing it will fail, so he can bring up another talking point that he can throw around without any real plan or action.”
Shauneen Miranda and Jacob Fischler contributed to this report.
