FILE - Pages from the U.S. Affordable Care Act health insurance website healthcare.gov are seen on a computer screen in New York, Aug. 19, 2025. (AP Photo/Patrick Sison, File)
US Senate on Thursday rejected a Democratic bill that would have extended the Affordable Care Act subsidies for three years to help Americans pay health insurance premiums.
The Democrat bill failed to attract enough Republicans and fell short of the chamber’s 60-vote threshold to advance. A Republican alternative bill that would create new federal subsidies to help Americans fund health savings accounts also failed to get 60 votes earlier on Thursday.
Affordable Care Act subsidies will end in three weeks, more than doubling the premiums for many with health coverage through the 2010 law known as “Obamacare.” The Democratic proposal on the subsidies under the ACA would have extended the COVID-era subsidies to keep insurance premiums from soaring for many.
Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries meet with reporters to speak about health care affordability at the Capitol in Washington. (AP Photo/J. Scott Applewhite, file)
Republicans have argued that Affordable Care Act plans are too expensive and need to be overhauled. The health savings accounts in the GOP bill would give money directly to consumers instead of to insurance companies, an idea that has been echoed by President Donald Trump.
The Republican bill was proposed by Senators Bill Cassidy of Louisiana and Mike Crapo of Idaho. It had proposed to send up to $1,500 to individuals earning less than 700% of the federal poverty level — about $110,000 for an individual or $225,000 for a family of four in 2025.
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Those funds could not be used for abortion or gender transition procedures and would require verification of beneficiaries’ immigration or citizenship status — provisions Democrats reject.
Senator Bill Cassidy, chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, strives for a closed-door meeting with fellow Republicans. (AP Photo/J. Scott Applewhite)
According to Reuters, the $1,500 payments in the Republican bill are meant to cover some of the out-of-pocket costs that people on lower-cost “Bronze” or “Catastrophic” Obamacare plans need to pay before their insurance kicks in.
However, it is far below the plans’ deductibles, meaning that even after that payment, a patient would be on the hook for up to $7,500 in out-of-pocket medical expenses before their insurance would start to pay for part of their care.
Those costs can rack up quickly for people with lower-cost plans, with a visit to a U.S. emergency room costing between $1,000 and $3,000, while an ambulance ride can cost anywhere from $500 to over $3,500.
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Most supported extension of subsidies
Insurance companies have warned customers of the rising premiums in the new year, and Democrats argue there isn’t enough time to do anything but a clean extension of the tax credits.
A recent Reuters/Ipsos poll found Americans back a healthcare subsidy continuation. Some 51% of respondents — including three-quarters of Democrats and a third of Republicans — said they support extending the subsidies. Only 21% said they were opposed.
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FILE - Pages from the U.S. Affordable Care Act health insurance website healthcare.gov are seen on a computer screen in New York, Aug. 19, 2025. (AP Photo/Patrick Sison, File) 
