Senate Majority Leader John Thune, R-D.D., center, along with Senate Majority Leader John Barrasso, R-Wyo., left, and Sen. James Lankford, R-Okla., speak to reporters after a Republican political luncheon at the U.S. Capitol on December 9, 2025 in Washington, DC (Photo by Heather Diehl/Getty Images)
WASHINGTON – The U.S. Senate failed in much-anticipated votes Thursday to advance legislation that would have addressed the rising cost of health insurance, leaving lawmakers at a loss as to how to curb the rise in premiums expected next year.
The senators voted 51-48 on a Republican bill co-sponsored by Louisiana Sen. Bill Cassidy and Idaho Sen. Mike Crapo that would have allowed some ACA market participants to receive funding through health savings accounts in 2026 and 2027.
They then voted 51-48 to a Democratic measure that would have extended for three years expanded tax credits for people who buy health insurance through the Affordable Care Act Marketplace. A group of Senate Democrats in November agreed to end a historic government shutdown in exchange for Republicans committing to a vote on extending 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 under the Senate filibuster rule.
Senate Majority Leader John Thune, R-S.D., criticized the ACA marketplace and subsidies for leading to edged increases in health insurance costs.
“Under the Democrats’ plan, insurance premiums will continue to skyrocket and American taxpayers will face ever-increasing subsidy payments,” Thune said. “And don’t think that all of these payments are going to vulnerable Americans.”
Thune argued that the Democrats’ bill was just an extension of the “status quo” of a “failed, flawed fraud scheme that increases costs at three times the rate of inflation.”
Thune said Cassidy and Crapo’s Republican bill would “help individuals cover their out-of-pocket costs and would allow many people who have little or no use of their insurance to save for health care expenses down the road.”
Schumer calls GOP plan ‘mean and cruel’
Senate Minority Leader Chuck Schumer, D-N.Y., said the three-year extension bill is the only option to avoid a cost raise for people enrolled in ACA marketplace plans.
“At my last count, Republicans are now on nine different health care proposals and counting. And none of them give the American people what they want most – a clean, simple extension of these health care tax credits,” Schumer said. “But our bill clearly and simply extends these loans, and it’s time for Republicans to join us.”
Schumer called the Cassidy Crapo proposals “stingy” and “mean and cruel.”
“Under the Republican plan, the big idea is essentially to give people about $80 a month and wish them good luck,” Schumer said. “And even to qualify for that check, how bad that is, Americans would be forced into simple bronze plans with sky-high deductibles: $7,000 or $10,000 for an individual, tens of thousands for a couple.”
After the votes failed, Schumer outlined some of the guardrails Democrats would put in place regarding negotiations with GOP colleagues.
“They want to talk about health care in general and how to improve it – we’re always open to that, but we don’t want what they want – favoring the insurance companies, favoring the drug companies, favoring the special interests and alienating the American people,” he said.
Health savings accounts in the GOP plan
The Cassidy-Crapo bill would require the Department of Health and Human Services to deposit money into health savings accounts for people enrolled in bronze or catastrophic health insurance plans purchased on the ACA marketplace in 2026 or 2027 a summary the invoice.
Health Savings Accounts are tax-advantaged savings accounts that allow consumers to pay for medical expenses that would otherwise not be reimbursed. These are not health insurance products.
ACA Marketplace participants who choose a bronze or catastrophic plan and make up to 700% of the federal poverty level will receive $1,000 annually if they are between ages 18 and 49 and $1,500 per year if they are between ages 50 and 64.
This would set an annual income threshold of $109,550 for an individual or $225,050 for a family of four, according to 2025 Federal Poverty Guidelines. The numbers are slightly higher for residents of Alaska and Hawaii.
According to the summary of the Republican bill, the funds could not be used for access to abortion or gender reassignment surgery.
Members of Congress have introduced several other health care proposals, including two bipartisan bills in the House that would extend the expanded ACA market tax credits for at least another year, with some changes.
Speaker Mike Johnson, R-La., was hesitant to put any of the bipartisan bills up for a vote, even though he might not have the option to do so in this case a request for dismissal The application, submitted earlier this week, brings together the required 218 signatures.
Pennsylvania Republican Rep. Brian Fitzpatrick wrote in a statement that the bill represents a “solution that can actually be adopted – not a political messaging exercise.”
“This bill delivers the urgent help families need now, while giving Congress the opportunity to continue improving our health care system over the long term,” Fitzpatrick wrote. “Good governance means securing 80 percent of what families need today rather than risking 100 percent of nothing tomorrow.”
But Johnson said Wednesday he will Place a packet of bills on the House floor next week that he expects “premiums will actually be reduced for 100% of Americans with health insurance.” Details of these bills were not disclosed.
Thune told reporters: “If someone is able to get a discharge motion and a bill passed through the House, we’ll obviously take a look at it. But right now, as you know, our focus is on the action here in the Senate, which is the vote we’ll be holding in parallel later today.”
Murkowski, of Alaska, said lawmakers could reach 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 take center stage in the November midterm elections, where Democrats hope to flip the House from red to blue and gain additional Senate seats.
The Democratic National Committee is not waiting to start these campaigns, Placing digital ads in hometown newspapers Several Republicans are 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 credits could mean the difference between life and death for many Americans,” DNC Chairman Ken Martin said in a press release. “Over 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 life-saving credits.”
White House press secretary Karoline Leavitt criticized Senate Democrats’ proposal during Thursday’s news conference, calling it a “political show vote” designed to provide cover for Democrats she blamed for creating the problem.
Trump and Republicans are “unveiling creative ideas and solutions to the health crisis created by Democrats,” she said. “Chuck Schumer is not seriously interested in lowering health care costs for the American people. He is bringing this vote knowing it will fail so he can have another talking point to throw around with no real plan or action.”
Shauneen Miranda and Jacob Fischler contributed to this report.
