Senate Republicans blocked a bill Thursday that would have extended enhanced tax credits to help Americans afford health insurance, virtually guaranteeing that they will expire at the end of the year and cause premiums to more than double for millions of hardworking families.
The Democratic proposal included a three-year extension for the premium tax credits implemented during the Biden administration, giving Congress time to come up with a more permanent solution to lower health care costs.
Protesters stand outside of the U.S. Supreme Court to support the Affordable Care Act in March 2012.
But the bill was ultimately filibustered by a vote of 51-48, with four Republicans—Sens. Josh Hawley of Missouri, Susan Collins of Maine, and Lisa Murkowski and Dan Sullivan of Alaska—joining Democrats in voting for the bill. But that was far short of the 60 votes needed to avoid a filibuster, causing the legislation to fail.
Now it's essentially guaranteed that the Affordable Care Act subsidies will expire on Dec. 31, as both chambers of Congress are set to head out on a holiday recess next week.
That means that premiums will, on average, spike by 114% for millions of people—leaving them with the horrible choice of paying thousands more for their coverage or going uninsured.
"Senate Republicans just blocked our bill to stop health care premiums from skyrocketing," Democratic Sen. Patty Murray of Washington wrote on X. "This vote was Republicans' last chance to do something before costs jump on January 1—once again, they refused. This is health care sabotage & we will hold Republicans accountable."
Polling shows that voters overwhelmingly want Congress to extend the subsidies, and that they will blame Republicans if they expire. Now, it’s causing a number of Republicans to worry it could cost them next November.
“I don't think I'm at risk... But I am worried about all these other folks that won by 1 point, 2 pts, 3 pts," GOP Rep. Jeff Van Drew of New Jersey reportedly said. "We’ve had a lot of close elections, and that can make the difference for them.”
And GOP Sen. Jim Justice of West Virginia said that health care providers in his state are facing the risk of rising costs. Still, he did not vote to extend the ACA subsidies.
A cartoon by Clay Bennett.
"If you're not concerned, then you're living in a cave. If you're not watching the elections that are happening all the time, then you're living in a cave," Justice said.
In fact, some House Republicans in competitive districts are seeking to force a vote on extending ACA subsidies out of fear that not acting will lead them to electoral doom next November.
“If we fumble this health care ball, nothing else is going to matter,” GOP Rep. John Rutherford of Florida told Politico. “If we don’t win the majority in the midterms, then none of this matters. We can’t do anything good then. I think everybody understands that.”
But House Speaker Mike Johnson is not supportive. Instead, he said that Republicans plan to spend the first six months of 2026 on fixing health care.
"We're gonna have a vote before the end of the year for sure, and then we're going to continue to do improvements along the way. In the first quarter, second quarter, there's a lot to fix in health care, we've all acknowledged that," Johnson told Punchbowl News Tuesday.
But given that Republicans lack a consensus on how to proceed, their effort might end up being political suicide in a critical election year.
