Lawmakers hold hope for health care even with partisan Senate votes

Lia DeGroot, CQ-Roll Call on Dec 10, 2025

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WASHINGTON — As the Senate tees up a pair of partisan votes on health care Thursday, senators from both sides of the aisle said debate isn’t over regarding enhanced premium tax credits that millions of people rely on.

Majority Leader John Thune, R-S.D., told reporters Wednesday that he wasn’t ruling out finding a way to extend the tax credits that expire at the end of the year, as long as there are changes.

“I think there’s a path forward,” he said. “I mean, I think if you did something with reforms and structure this program differently so it puts downward pressure on premium instead of upward pressure, I think you could do something.”

Many lawmakers have said something similar throughout the fall, yet no compromise to address health care affordability has been reached. Republicans’ plan, led by Sens. Michael D. Crapo of Idaho and Bill Cassidy of Louisiana, would end the enhanced subsidies and provide people who use bronze-level catastrophic coverage plans with health savings accounts funded by the government with $1,000 to $1,500 monthly.

Democrats’ proposal is a three-year “clean” extension of the current subsidies, which were established in 2021 in response to the COVID-19 pandemic, and later extended through the end of this year.

Neither vote is predicted to reach the filibuster-proof 60-vote threshold.

Going forward, Thune also didn’t rule out passing some sort of health care bill through reconciliation, though he said it’s better to do something under the normal 60-vote threshold.

“If we could do something at 60, those results tend to be more durable over time, but I wouldn’t rule anything out,” he said. “I think reconciliation, of course, is always an option.”

Republicans are likely to support the Cassidy-Crapo bill, as Thune has indicated, but there could be wild cards with the side-by-side vote.

Sen. Josh Hawley, R-Mo., said he would likely support the Crapo-Cassidy proposal but he didn’t rule out voting for the Democrats’ proposal.

Sen. Rand Paul, R-Ky., said he would vote against the Republican proposal, arguing that establishing HSA accounts for ACA enrollees would simply reroute the dollars allocated for the tax credits and wouldn’t actually lower health care costs.

‘Moment of truth’

Sen. Mike Rounds, R-S.D., told reporters Wednesday that he hopes health care discussions continue if neither bill passes on Thursday.

“I think the Cassidy-Crapo product is a very good product, and it would fix this issue for now, and would give us a chance to look at more changes over the next two years,” he said. “I would hope that we could still negotiate in the near term.”

Sen. Bernie Moreno, R-Ohio., who, alongside Sen. Susan Collins, R-Maine., sponsored a proposal to extend the tax credits for two years with some guardrails, will support the Republican proposal, an aide confirmed. Collins didn’t say whether she would get behind the it, saying that she’s still negotiating.

Senate Democrats urged Republicans to align with them on an extension.

“Tomorrow is a moment of truth for the Republicans here in the Senate,” Senate Minority Leader Charles E. Schumer said at a news conference. “Are they going to bring health care costs down, or will they sit by and let premiums explode for millions of Americans?”

Further complicating the Democrats’ plan is a Congressional Budget Office score released Wednesday that found that enacting the three-year extension would increase the federal deficit by $83 billion. For that cost, millions of more people will be insured than otherwise would be, according to CBO’s estimate.

Democrats are largely avoiding the question of whether they would be prepared to shutter the government a second time if the health care issue isn’t resolved by the end of the continuing resolution deadline of Jan. 30.

Sen. Amy Klobuchar, D-Minn., said Wednesday that the party is united behind the current proposal, but noted that they were working on spending bills with Appropriations ranking member Patty Murray, D-Wash.

“We’re focused on No. 1, getting this vote and waiting,” she said. “We’ve been waiting. They said after the shutdown, they would come to us with serious proposals.”

Sen. Bernie Sanders, I-Vt., similarly shot down the question, saying that another shutdown would be “speculative” at this point.

“One day at a time,” he said.

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(Aris Folley, Sandhya Raman and Ariel Cohen contributed to this report.)