Health Care Stalemate Underscores A New Reality in Congress: Bipartisan Deals Are Getting Harder

A grand show of bipartisan negotiations doesn’t seem to be coming to save health care talks.

Earnest negotiating efforts on big issues have become increasingly rare as partisanship hardens. Long gone are the days of senate “gangs” — bipartisan working groups that brought together different factions of the respective parties. The deal-making middle has only further collapsed with lawmakers like Sens. Kyrsten Sinema, Joe Manchin and Mitt Romney retiring in recent years.

The latest stalemate on health care underscores what has long been true: It’s hard to make a deal, and it’s only getting harder.

When Sen. Jeanne Shaheen, one of the lead Democrats who negotiated the deal to end the shutdown last month, was asked Tuesday whether members are close to a deal on health care, she replied: “I think we’re not.”

Shaheen was one of the small group of Senate Democrats who in November struck a deal to reopen the government in exchange for a vote on health care, now scheduled for next week. Talks quickly lost steam among lawmakers looking for compromise ahead of Affordable Care Act subsidies expiring on Dec. 31. A growing number of lawmakers are now casting the upcoming vote as a lost cause.

Senate Majority Leader John Thune, who intends to honor the scheduled vote next week, said he doesn’t know what it even will be on and doesn’t think it will pass.

“A lot of this will depend a little bit on what the Democrats decide they want to do,” Thune said Tuesday. “We’ve got some members, as you know, who want to work with them in a constructive way on something that could be a bipartisan solution … I don’t think at this point we have a clear path forward.”

That is not to say there aren’t any ideas percolating around about health care in both chambers and both parties: Democrats are floating clean extensions. Republicans are floating extensions with some caveats. Republicans are also floating broader health care reforms.

The lack of obvious negotiations, especially in the Senate, is a difficult sign for the issue at hand and for the future of dealmaking in the chamber as a whole.

Negotiating groups don’t always fail. Recent sessions of Congress saw some deals actually work out, including the bipartisan infrastructure deal in 2021 and the CHIPS Act in 2022. But there are some major blunders in recent memory that loom over negotiating efforts this term.

Just last Congress, a bipartisan group helmed by Democratic Sen. Chris Murphy and Republican Sen. James Lankford, alongside former Sen. Sinema, an independent, negotiated a deal on border reform in exchange for Ukraine funding. That group spent months, including over the holidays, huddled up in their offices as reporters staked out their every step. Both wings of Senate leadership publicly encouraged the trio’s engagement.

When President Donald Trump turned on the plan, so did everybody else. It failed on the floor with only a handful of GOP votes.

“I spent six months negotiating,” Murphy told NOTUS shortly before the holiday break. “I spent six months, 24/7, negotiating an immigration package with Senate Republicans, and they abandoned it the minute that Donald Trump opined. So that’s the trouble today, is that you can, you can have good faith negotiations with Republicans, but it just doesn’t matter until Donald Trump weighs in.”

Murphy added: “Which is why it would be much more effective for our leadership, Sen. Schumer and Minority Leader Jeffries, to be speaking directly with the White House. That’s really the only effective forum right now.”

When NOTUS asked Lankford about that past round of border negotiations, he joked: “You remember, huh?” In the end, Lankford stood behind the deal he, Murphy and Sinema negotiated, despite his colleagues jumping ship.

He still insisted health care talks could bear fruit if they “keep it narrow.” When asked how much Trump’s influence matters, he replied: “You’ve got the House, the Senate and the White House. Everybody’s got to agree. So everybody’s influence matters.”

Sen. Thom Tillis, another lawmaker who has engaged in bipartisan working groups on things like immigration, appeared to let out a chuckle when NOTUS noted that these bipartisan negotiating groups don’t tend to work. Still, he went on to say bipartisan dealmaking is “always hard” and that this Congress is no different.

“Every one of these deals are like a fingerprint,” Tillis said. “It’s not like you can dust off any of the ones that I’ve been involved in. And it works. It’s a different dynamic, different politics, different timing relative to election cycle, everything else. So you just got to get the chemistry to work.”

He added, “You got to keep it simple. Complex never works around this place, on bipartisan bills, when you’ve got to get votes moved pretty quickly.”

Other lawmakers said they are not totally giving up hopes that health care talks can speed up just yet. There are still a handful of days before the vote, and sometimes a handful of days is all you need.

Though ACA subsidies are set to expire on Dec. 31, lawmakers in both chambers are slated to leave town for the holiday break well before then.

“We’re working things through regular order, which means you’ve got two different committees that have an interest in it,” Republican Sen. Mike Rounds insisted. “They have been working and coordinating kind of discussions on different ideas. I’m optimistic that we can find a path forward.”

When NOTUS asked GOP Sen. Josh Hawley shortly before the Thanksgiving break whether he thought the talks would bear fruit, he replied: “I don’t know. I mean, I hope so. I hope we can get to something that will allow us to hold down the cost of premiums. Premiums are already too high.”

Hawley is among those who are debuting new ideas on health care, including a bill to allow individuals to deduct up to $25,000 in health care expenses on their taxes. But, like others, the chance of that bill gaining a critical mass of support in the Senate with days to spare is slim.

Senate Democratic leadership, meanwhile, is not showing signs that they’re anticipating a breakthrough.

“Republicans have no answers, no solutions, are making no effort to fend off the crisis,” Senate Minority Leader Chuck Schumer said Tuesday. “They’re in disarray. They’re fighting with each other. They say different things all the time. They don’t have any idea how the American people are suffering, and they have no inclination to fix it.”