Dem
47
GOP
53
Politics is an odd profession. Sometimes you win when you lose. That's generally not true in sports, business, and other professions. The Democrats fought to have ACA health-care subsidies extended and even allowed the government to shut down over them. One of the conditions for ending the shutdown was that there would be a vote on them. That vote is scheduled for next week and there is currently no momentum for any bipartisan plan to actually solve the problem. If there is no agreement and the vote is along party lines, subsidies will lapse and premiums will spike for about 20 million Americans.
Much of the problem is due to a split within the Senate GOP conference. Some hard-line Republican senators hate the ACA, have always hated it, always will hate it, and want it to go away. They see killing the subsidies as a good first step. On the other hand, senators from swing states understand the consequences for them of killing the subsidies and don't want to go down with the ship.
On top of this, there is a brewing battle over abortion. Current law bans the use of federal funds for performing abortions. Subsidies are federal funds. Some Republicans want to spell out that any health care insurance that benefited from a federal subsidy may not cover abortions. Democrats will not accept this.
Of course, these things often go down to the wire, sometimes beyond it. There have been times when the (analog) clocks in Congress were unplugged at 11:59, so members could claim the deal they made in the wee hours of the next morning was made before the clock struck midnight. But so far, the parties are far apart. Each party is concocting a plan in secrecy, but 60 votes are needed to advance a plan, so unless seven Democrats jump ship and support the Republican plan or 13 Republicans go for the Democrats' plan, no bill will advance.
The ironic thing here is that failure would be a win for the Democrats, although no Democrat would dare say that out loud. It is all about stove touching. With Republicans in control of Congress and the White House, if no deal is made and insurance premiums spike, Republicans are going to get the lion's share of the blame and the Democrats will have a potent issue for the midterms. Of course, millions of people will get hurt if there is no deal, and Democrats actually do care about their constituents, so in the end, they might cave. Republicans have repeatedly shown that they don't care if their constituents are hurt by their policies—for example, farmers being hurt by tariffs.
Donald Trump could come running to the rescue at the last minute, but so far he hasn't put his cards on the table. Most likely he doesn't understand health care beyond "Obamacare bad." In the past, he has touted Health Savings Accounts, but that basically amounts to people putting their own money in a special kind of bank account to pay for future health care expenses. That approach would not be popular with voters or politicians.
Of course, at the very last minute, there is always that beloved "kick the can down the road" trick. That would extend the subsidies for a few months while Congress bickers over what to do. It wouldn't be the first time. (V)