Four Republican senators broke ranks by voting in favor of a three-year extension of the Affordable Care Act’s (ACA) enhanced health insurance premium subsidies, including two vulnerable incumbents who are up for reelection next year.

Senate Democratic Leader Chuck Schumer introduced the Democratic proposal, which was supported by Senators Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), Dan Sullivan (R-Alaska), and Josh Hawley (R-Mo.).

Although the measure did not receive the 60 votes required to proceed, they joined all 47 Democrats in voting to advance it. 51 to 47, the motion to move forward with the measure was rejected. The overwhelming majority of Republican senators opposed the measure.

In an attempt to regain control of the Senate, Democrats are vying for the seats of Collins and Sullivan, who are up for reelection in 2026.

Before the vote, Collins had kept her cards close to the vest, telling reporters that she wanted her staff to carefully review the Democratic proposal before making a decision.

Collins and Sen. Bernie Moreno (R-Ohio) introduced a bill Monday that would extend the ACA’s enhanced health insurance premium subsidies for a further two years, but only for households with annual incomes under $200,000.

Additionally, they suggested mandating that Americans with lower incomes who use the ObamaCare marketplace pay premiums of at least $25 per month.

Hawley and Murkowski have also advocated for market reforms.

Additionally, earlier Thursday, all four Republican senators supported a plan led by Senate Finance Committee Chair Mike Crapo (R-Idaho) and Senate Health, Education, Labor, and Pensions Committee Chair Bill Cassidy (R-La.) to shift funds for the enhanced insurance premium subsidies into contributions to health savings accounts to cover the out-of-pocket expenses of those who purchase insurance through the ACA marketplace. And that measure didn’t move forward.

“I’m really an all-of-the-above-approach kind of guy. At this point, I think we need to do everything possible to bring down the cost of premiums,” Hawley told reporters.

Hawley said he would support multiple plans to address rising health insurance premiums, including proposals that didn’t come to the floor for a vote this week.

“Let’s take some votes and show people that we want to do all that we can,” he said. “If you talk to people, what they’re going to say is their health care costs are out of control.”

House Minority Leader Hakeem Jeffries grew visibly upset at a CNBC host last week as she pressed him over extending taxpayer-provided subsidies for the Affordable Care Act, more commonly known as “Obamacare,” which was passed without any Republican support during then-President Barack Obama’s first term.

On Friday, Jeffries got into a heated debate with CNBC host Becky Quick on Friday while discussing the state of the subsidies, which House Speaker Mike Johnson (R-La.) said the GOP majority would begin working on after the recent Democrat-induced government shutdown ended.

“Let’s not go back to what’s done in the past, and what’s not been extended. If you want something to get done, you NEED to do something bipartisan,” Quick said to a visibly frustrated Jeffries, who immediately pivoted to blaming Republicans though Democrats, when they controlled Congress under then-President Joe Biden, implemented the provision sunsetting subsidies on December 1.

“I don’t think you want to get a deal done. I think this is something where you’d like to see the rates go higher and allow Republicans to hang themselves with it,” Quick finally said to Jeffries.

“That is a ridiculous assertion! Shame on you!” Jeffries shot back.