WASHINGTON — The Senate on Thursday deadlocked on competing proposals to avert rising health care premiums, blocking Democratic and Republican alternatives in an outcome that made it all but certain that expanded tax subsidies for health coverage under the Affordable Care Act will expire at the end of the month.

Republicans squelched a bid by Democrats, who had demanded action on the issue during the 43-day government shutdown, to extend the insurance subsidies for three years.

Democrats turned back a Republican alternative that would replace the subsidies with an expansion of tax-advantaged health savings accounts and direct payments of up to $1,500 to people who buy the most basic health insurance plans.

Neither proposal could muster the 60 votes necessary to overcome a filibuster and

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