Senators rejected a proposal Thursday from Republican Sens. Bill Cassidy and Mike Crapo that proposed sending money directly to patients rather than insurance companies and lowering insurance premiums and health care costs. It also seeks to expand Health Savings Account (HSA) eligibility, which is intended to help Americans cover out-of-pocket costs.
The vote had just 51 votes in favor, when it needed 60 to pass.
The Senate is next expected to reject legislation on Thursday that would extend Affordable Care Act tax credits for millions of Americans. The subsidies expire Jan. 1, meaning many people who buy health insurance on ACA marketplaces could face steep cost increases at the start of the year.
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Part of the Republicans' proposal that drew criticism from Democratic lawmakers is that it calls for ending taxpayer-funded abortion or transgender services. The Republican plan also calls for reducing Medicaid funding to states that provide health insurance coverage to migrants who are in the country illegally and requires states to verify citizenship or immigration status before providing Medicaid coverage.
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Up to this point, the lack of Republican consensus on health care has lingered, posing a political challenge as the 2026 midterm elections approach and swing district Republicans brace for possible political fallout if those ACA tax subsidies expire.
