GOP Breaks Ranks: Four Republican Senators Side With Democrats on ObamaCare Vote — What Happened?

On December 11, 2025, four Republican senators voted to advance a three-year extension of enhanced health insurance premium subsidies under the Affordable Care Act (ACA). Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), Dan Sullivan (R-Alaska), and Josh Hawley (R-Mo.) joined all 47 Senate Democrats in supporting the measure, which failed to meet the 60-vote threshold, falling short 51-47.

Sen. Josh Hawley expressed his broader support for tackling rising healthcare costs, saying, “At this point, I think we need to do everything we can to bring down the cost of premiums.” The move comes as Collins and Sullivan face reelection in 2026, with Democrats targeting their seats in an effort to regain control of the Senate.

Despite their vote for the extension, these senators had also previously backed a Republican alternative to fund health savings accounts to help cover out-of-pocket ACA marketplace costs. That proposal also failed to advance.

The decision reflects ongoing tensions within the GOP over healthcare policy, as some members push for reforms to the ACA while others seek to preserve or extend its benefits for constituents.