With only weeks left before enhanced Affordable Care Act (ACA) subsidies expire, Congress is edging toward a year-end showdown that could raise health insurance costs for millions. Attempts to forge a deal collapsed in the Senate on Thursday, underscoring the widening divide within both parties as lawmakers race to avoid a steep jump in premiums in January.
Senate Gridlock Intensifies
Two rival proposals-one backed by Democrats for a multi-year subsidy extension, and another by Republicans pivoting toward government-supported health savings accounts-both fell short of the necessary votes.
In a rare move, Alaska’s two Republican senators broke from most of their caucus and supported advancing the Democratic plan. Senator Lisa Murkowski also voted in favor of the GOP alternative, while Senator Dan Sullivan withheld support from his party’s version.
Murkowski emphasized her willingness to back a short-term fix, noting that neither proposal fully met the urgency of the moment. Sullivan, acknowledging the looming consequences for Alaskans, said his vote was an effort to push the discussion forward.
Alaska Faces Some of the Harshest Impacts
Alaska’s unusual position in the debate stems from its higher-than-average cost of living, which makes marketplace coverage disproportionately expensive. A recent analysis from the Kaiser Family Foundation showed significant price jumps if subsidies lapse. A typical 40-year-old Alaskan earning $32,000 per year could see monthly premiums rise from $15 to $129. For older residents earning above the federal subsidy threshold, the increases would be even more dramatic-surpassing $1,000 per month in some cases.
While other states would also experience higher premiums, the financial shock in Alaska stands out, explaining the senators’ break from party lines.
House Moderates Mount a Last-Ditch Campaign
On the House side, moderate Republicans are pushing leadership to allow a vote on extending the subsidies as part of a broader health package expected to be considered next week. Representatives Jen Kiggans of Virginia and Brian Fitzpatrick of Pennsylvania are circulating discharge petitions in hopes of forcing the issue, though the procedural hurdles make success unlikely this month.
A core dispute among House Republicans centers on whether any extension could indirectly support abortion coverage-an issue with the potential to stall negotiations in the Rules Committee, where conservatives hold significant influence.
Despite internal friction, several Republicans privately acknowledged the need for a temporary bridge to prevent abrupt financial strain on families. “I think we need something in place,” one conservative lawmaker said.
Leadership Pushes Forward With Separate Health Agenda
GOP leaders are preparing their own health care overhaul proposal, expected to reach the House floor next week. Majority Leader Steve Scalise indicated the framework will not include an ACA subsidy extension and may exclude new federal contributions to health savings accounts due to budgetary constraints. Lawmakers are exploring whether giving Americans more flexibility within existing HSA rules could garner broad enough support.
In parallel legislative action, the House voted 231–195 to restore collective bargaining rights for federal employees, reversing earlier restrictions. Twenty Republicans joined Democrats in passing the bill.
Outlook Remains Uncertain
With the deadline quickly approaching, bipartisan talks continue but have yet to yield a clear path forward. Murkowski expressed cautious optimism about discussions in the House, though no agreement appears imminent.
If Congress fails to act, more than 20 million Americans could see higher premiums beginning January 2026, with residents of high-cost regions-particularly Alaska-facing the steepest increases.
