The Senate failed to advance both Democrats' three-year extension of Affordable Care Act subsidies and Republicans' HSA-focused plan, creating urgency ahead of a Jan. 1 deadline. Mutual distrust between parties has complicated negotiations, though a two-year Collins-Moreno subsidy extension with income caps could attract some Democratic support. Some senators urge combining elements from multiple proposals, but the Senate's imminent adjournment compresses the window for a solution.
After the Senate Health Vote Collapses: Is There a Viable Plan B?
The Senate staged what many lawmakers called "failure theater" today as competing health proposals sputtered. Democrats' three-year extension of expiring Affordable Care Act (ACA) subsidies and Republicans' health savings account (HSA)-focused alternative both failed to attract the votes needed, leaving uncertainty ahead of a looming Jan. 1 deadline.
What’s At Stake
If lawmakers do not agree on a short-term fix, premium subsidies that help millions afford ACA plans could lapse on Jan. 1. The Senate is scheduled to adjourn at the end of next week, compressing the timeline for any emergency legislation.
Why The Votes Broke Down
Underlying the procedural fights is deep mutual distrust. Democrats say many Republicans are ideologically opposed to bolstering Obamacare; Republicans accuse Democrats of prioritizing campaign messaging over workable solutions.
“I guess we have to demonstrate our failures first before we can apply our successes,” said Sen. Lisa Murkowski (R-Alaska), one of the more optimistic voices about finding common ground.
Sen. Jacky Rosen (D-Nev.) blasted the GOP HSA proposal as “the most partisan thing you’ve ever seen,” while Sen. Bill Cassidy (R-La.), a co-author of the Republican plan, expressed skepticism about Democratic willingness to negotiate: “We need to see if they want to deal. I don’t know if they want to.”
Possible Compromises
Republicans have circulated several alternatives in recent weeks. One that could attract some Democratic support is a two-year extension of ACA subsidies with income caps offered by Sens. Susan Collins (R-Maine) and Bernie Moreno (R-Ohio). But several senators say the Collins-Moreno approach looks like a last-minute effort without enough GOP backing to be workable.
“It would have been in the ballpark, but it sounds like it’s more of them doing a last-minute effort without being able to bring enough votes from the Republican side to make it workable,” said Sen. Ruben Gallego (D-Ariz.).
Murkowski argued there are overlapping ideas across the various proposals and urged lawmakers to take components from multiple plans and “cobble [them] together into one package that makes sense.”
What Could Happen Next
To many observers, today's proceedings will look like a partisan jumble. Yet the high cost of inaction could push lawmakers back to the negotiating table. Sen. Tim Kaine (D-Va.) noted that successive failed votes can open the door to new discussions and compromise.
“There sometimes have to be votes on Democratic and Republican proposals. And if each fails, then that opens the door to other discussions,” Kaine said.
Key Players
- Sen. Lisa Murkowski (R-AK)
- Sen. Jacky Rosen (D-NV)
- Sen. Bill Cassidy (R-LA)
- Sen. Susan Collins (R-ME) and Sen. Bernie Moreno (R-OH)
- Sen. Ruben Gallego (D-AZ) and Sen. Tim Kaine (D-VA)
With time running out, the most likely near-term outcome is continued negotiation and targeted, last-minute bargaining — but whether that produces a short-term extension before Jan. 1 remains uncertain.
