Both procedural votes fell largely along party lines.
WASHINGTON—The Senate on Dec. 11 rejected a pair of competing health care measures aimed at addressing expiring Obamacare subsidies.
Both procedural votes ran largely along party lines, with neither proposal gaining the 60 votes needed to advance in the chamber.
The GOP plan, pitched as an alternative to the expiring subsidies, failed to advance in a 51–48 vote. Sen. Rand Paul (R-Ky.) was the lone Republican who voted against the measure.
The Democratic plan to extend the expiring subsidies for three years was similarly rejected in a 51–48 vote. Four Republicans—Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), Dan Sullivan (R-Alaska), and Josh Hawley (R-Mo.)—voted for the Democratic bill.
The subsidies, officially known as enhanced premium tax credits, were created as a temporary measure in 2021 to blunt the economic impact of the COVID-19 national health emergency. They have been in place for five years.
Republicans proposed a plan to replace the enhanced subsidies with a cash payment to eligible enrollees, to be placed in a Health Savings Account. The original Obamacare subsidies, distinct from the enhanced subsidies, would remain in place.
Democrats, fearing that allowing the subsidies to expire now would cause financial hardship and cause millions of Americans to drop their health coverage, have proposed another three-year extension.
Republicans, saying that the billions spent on these additional subsidies have contributed to rapidly rising insurance premiums and have given rise to opportunities for fraud, oppose an extension that does not address those issues.
Enhanced Subsidies
The enhanced subsidies enacted in 2021 expanded eligibility for Obamacare, offering subsidies for wage earners well into the middle class.
The original Obamacare subsidies are open to people making between 100 percent and 400 percent of the federal poverty level. That equates to a household income of between $32,150 and $128,600 for a family of four.
The enhanced subsidies increased the amount of the subsidies, removed the income limit, and capped out-of-pocket premium payments at 8.5 percent of household income. Some low-income enrollees are eligible for plans with no premium payment under the coverage expansion.
Obamacare enrollment more than doubled after the enhanced subsidies were introduced.
Standoff
Democrats pushed for a permanent extension of the enhanced subsidies early in the fall, refusing to authorize continued spending to fund the government until Republicans agreed to negotiate over this and other health-care-related proposals.
Republicans refused to consider the extension during the shutdown.
The government shutdown, which lasted for 43 days, ended when eight Democratic Senators voted with Republicans to approve stopgap funding to reopen the government, but on the condition that their party be given a vote this month on extending the subsidies.
Senate Minority Leader Chuck Schumer (D-N.Y.) revealed the Democrats’ proposal for a three-year extension on Dec. 4.
Sens. Mike Crapo (R-Idaho) and Bill Cassidy (R-La.) released their plan on Dec. 8, and Republicans elected to present it for a vote alongside the Schumer plan on Dec. 11.
Other plans have been proposed by Senate Republicans, by bipartisan groups of House members, and by the House New Democrat Alliance.
By Lawrence Wilson and Nathan Worcester
