Senate Votes ‘No’ on ACA Health Care Plans

Premium support set to expire December 31 without legislative solution

December 11, 2025

After much anticipation, the Senate voted against dueling partisan proposals today to address the expiration of Affordable Care Act (ACA) tax credits.

The vote on ACA premium assistance was the key piece to ensure the end of the government shutdown last month. Any resolution was unlikely to pass, requiring 60 votes to advance to the House.

What was on the table

The parties offered contrasting solutions to address the expiration of the enhanced premium tax credits that are set to expire at the end of the year.

Senate Democrats last week released their proposal for a “clean” three-year extension for the tax credits; the Republican plan would have allowed the premium assistance to expire, replacing it with direct payments into health savings accounts for consumers on high-deductible plans.

The Republican proposal failed by a 51–48 margin. The Democratic plan failed 51–48.

In the House, a small group of Republicans led by Representative Brian Fitzpatrick (R-Pa.) have advanced a proposal that would extend the premium assistance two years while adding new requirements for eligibility. It remains unclear if that plan—or any other alternative—will have the support needed to advance ahead of the December 31 “subsidy cliff.”

What’s next?

The votes arrived just ahead of the December 15 deadline for consumers to select plans for the New Year. The end of open enrollment is January 15.

About 5.8 million people have enrolled for 2026 coverage, including 4.6 million through the federal exchange and nearly 1.2 million through state-based marketplaces, according to a CMS report.

In Pennsylvania, the state marketplace Pennie has grown 50 percent from 2020 to 2025, approaching 500,000 enrolled. This fall, HAP has warned of the potential fallout of failing to extend the ACA premium assistance.

“We urge you to protect affordable coverage for Pennsylvanians by preserving enhanced premium tax credits,” HAP noted in a letter earlier this year. “These actions are vital to prevent further uncompensated care burdens that put care at risk for entire communities, protect our most vulnerable residents, and maintain the health and competitiveness of our commonwealth.”

HAP will monitor the latest on ACA tax credits and provide updates to members. For questions or comments, contact John Myers, vice president, federal advocacy.