No Democrats voted for the GOP bill.
Repeal-and-replace has been a guiding star for Republicans ever since President Barack Obama enacted the law in 2010. That goal, which Trump turned into a top campaign promise, remains out of reach even with Republicans controlling both the White House and Congress. The issue has dominated the opening months of Trump’s presidency.
But Senate Majority Leader Mitch McConnell, R-Ky., said after the bill failed early Friday that he would move to other legislative business in the upcoming week.
Trump also tweeted: “Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!”
The subsidies, totaling about $7 billion a year, help reduce deductibles and copayments for consumers with modest incomes.
The Obama administration used its rule-making authority to set direct payments to insurers to help offset these costs. Trump inherited the payment structure, but he also has the power to end them.
The payments are the subject of a lawsuit brought by House Republicans over whether the Affordable Care Act specifically included a congressional appropriation for the money, as required under the Constitution. Trump has only guaranteed the payments through July, which ends Monday.
Trump previously said the law that he and others call “Obamacare” would collapse immediately whenever those payments stop. He has indicated a desire to halt the subsidies but so far has allowed them to continue on a month-to-month basis.
Without the payments, analysts have said, more insurers might drop out of the system, limiting options for consumers and clearing the way for the insurers who stay to charge more for coverage.
The Senate’s Democratic leader, Chuck Schumer of New York, cautioned such a step, saying it would make health care more expensive.
“If the president refuses to make the cost sharing reduction payments, every expert agrees that premiums will go up and health care will be more expensive for millions of Americans,” Schumer said Saturday in a written statement. “The president ought to stop playing politics with people’s lives and health care, start leading and finally begin acting presidential.”