A Democratic-sponsored Senate bill designed to extend Affordable Care Act subsidies expiring at year’s end garnered support from four Republicans but fell short of the 60-vote threshold required for passage. As part of an agreement to conclude the longest government shutdown in U.S. history, Democrats secured a Senate vote this month on extending the expiring subsidies. The proposal was defeated 51-48.
A complementary Republican bill aimed at addressing rising health insurance premiums also failed 51-48 with no Democratic backing. The Democratic measure, spearheaded by Minority Leader Chuck Schumer of New York, would have provided a three-year extension of subsidies. Democrats introduced the subsidies during the pandemic; they were initially scheduled to expire in 2022 but were extended through December 31.
The four Republicans who endorsed the bill were Senators Susan Collins of Maine, Lisa Murkowski and Dan Sullivan of Alaska, and Josh Hawley of Missouri—all of whom also supported the Republican alternative proposal. Both Collins and Sullivan are seeking re-election in 2026. Collins, who has indicated plans for a sixth term, is the sole Republican candidate in a state won by Kamala Harris in the 2024 election. Analysts note Sullivan’s congressional district may be vulnerable, though Alaska remains a consistently Republican state. Collins has historically proven difficult to defeat in Democratic campaigns.
Collins introduced legislation Monday alongside Senator Bernie Moreno of Ohio to extend subsidies for two years while restricting eligibility to households earning less than $200,000 annually. The measure would also require low-income individuals on the federal health insurance marketplace to pay at least $25 monthly. Hawley described himself as an “all-of-the-above” advocate, stating that “at this point, we must do everything possible to reduce premium costs.” He added, “We need to take votes and demonstrate our commitment to addressing these issues; if you speak with people, they will tell you their healthcare costs are unmanageable.”
House Speaker Mike Johnson of Louisiana stated Republicans plan to introduce several healthcare proposals next week that would not extend subsidies. However, some legislators view extending the subsidies as essential to avoiding widespread financial hardship for voters ahead of the 2026 midterm elections and positioning a Republican-led Congress for broader reforms.
