The Senate on Thursday rejected a Democratic bill to extend enhanced Obamacare premium subsidies for three years and a Republican alternative to redirect that government aid into tax-exempt Health Savings Accounts.
The failed dueling votes come three weeks before Democrats’ COVID-era expansion of the Affordable Care Act premium tax credits will expire.
After the GOP bill failed, four Republicans joined Democrats in voting for the three-year extension of the enhanced subsidies, showing they are desperate for a solution that will help their constituents facing massive premium costs.
Some senators said they hope the failed exercise spurs an elusive bipartisan compromise.
“We’re continuing to discuss with any Democrat who will talk with us on what their priorities look like,” Sen. Roger Marshall, Kansas Republican, told The Washington Times. “In exchange for extending the Biden subsidies for a year, can we make some real reforms?”
The 22 million Americans on subsidized Obamacare plans will, on average, have to pay more than double for their premiums next year if they lose access to the extra subsidies. Many are expected to drop coverage.
“This is a life-and-death vote, because people who will lose their health care could face that horrible, horrible end,” said Senate Minority Leader Charles E. Schumer, New York Democrat. “This is about ensuring that working- and middle-class people can afford to see a doctor without going broke, to afford to treat illnesses like cancer, and enjoy the dignity of good health without wiping out their life’s savings.”
While Mr. Schumer claimed the vote was not political, Republicans said it was because Democrats refused to consider any changes to the enhanced tax credits, which are ripe with fraud.
“We’re talking about tens of billions of dollars in waste, fraud and abuse on a yearly basis. They don’t want to do anything about it,” said Senate Majority Leader John Thune, South Dakota Republican.
He cited a recent report from the Government Accountability Office in which the congressional watchdog agency submitted fake applications for the Obamacare subsidies and 90% of them went through.
Democrats’ bill to extend the enhanced premium tax credits for three years would have added $83 billion to the deficit but increased the number of people with health insurance in 2026 by 400,000 and more than 7 times that in the following two years, the Congressional Budget Office said.
The measure failed 51-48.
The four Republicans who joined all Democrats in supporting it were Sens. Susan Collins of Maine, Josh Hawley of Missouri, and Lisa Murkowski and Dan Sullivan of Alaska.
That vote came after the GOP alternative bill failed, also 51-48, with all Democrats and one Republican, Sen. Rand Paul of Kentucky, in opposition.
The Republican bill, led by Senate Finance Chairman Mike Crapo of Idaho and Senate Health, Education, Labor and Pension Chairman Bill Cassidy of Louisiana, offered an alternative way to deliver aid to Obamacare consumers.
Their plan would let the government make monthly deposits into a tax-exempt Health Savings Account for consumers enrolled in bronze or catastrophic Obamacare plans and earning less than 700% of the federal poverty level, currently $109,550 for an individual and $225,050 for a family of four.
The government funds, totaling $1,000 a year per person ages 18-49 and $1,500 per person ages 50-64, would be available only in 2026 and 2027.
HSA rules do not allow the money to be spent on premiums, but it can be used for deductibles, copays and other out-of-pocket expenses not covered by insurance.
Their measure also included a few other health care provisions, including ones Democrats blocked from the One Big Beautiful Bill Act by flagging as out of compliance with the Senate’s budget reconciliation process that Republicans used to enact that law on a party-line vote.
