This afternoon, the Senate held votes on two partisan health care bills that both required 60 votes to overcome procedural objections. First, the chamber voted 51-48 to reject a Republican proposal to let enhanced Affordable Care Act (ACA) premium subsidies expire and instead provide new, time-limited health savings account payments for enrollees who switch to lower-cost, high-deductible bronze or catastrophic plans. Sen. Rand Paul (R-KY) was the only Republican to vote with Democrats to oppose the bill. Senators also voted 51-48 to reject a Democratic proposal to extend the enhanced ACA subsidies for three years. GOP Sens. Susan Collins (ME), Josh Hawley (MO), Lisa Murkowski (AK), and Dan Sullivan (AK) joined Democrats in support of the bill.
Meanwhile, House Republican leadership said they will allow a vote next week on a GOP package of healthcare bills that does not include an extension of expiring ACA enhanced premium subsidies, but instead offers a package of policies ranging from expanded Health Savings Account and stricter oversight of pharmacy benefit managers to enhanced “Price Transparency.” House GOP moderates are also currently pushing a discharge petition to force a vote on a bill to extend the enhanced ACA subsidies for two years, while some more conservative Republicans are focused on including new abortion-coverage restrictions—leaving the conference with no clear consensus on a path forward.
The looming expiration of the subsidies comes as a new poll from Gallup shows that 57% of Americans approve of the ACA, while 35% disapprove. Support varies depending on respondents’ political affiliation, with approval of the ACA ranging from 91% of Democrats to 63% of independents and only 15% of Republicans. Separately, a New York Federal Reserve survey this week found that U.S. households grew more pessimistic about their current and near-term financial situations last month, with many concerned about increased medical expenses, which jumped to a 10.1% expected increase—the highest in more than a decade.