CINCINNATI — Competing bills to address the expiring Affordable Care Act subsidies failed in the U.S. Senate on Thursday, leaving millions of Americans who purchase their health insurance on the ACA marketplace uncertain about what comes next as they face the prospect of higher payments.

The two proposals, one led by Democrats and the other by Republicans, both failed to receive the 60 votes needed to advance. The Democrat-led plan looked to extend ACA subsidies for three years, while the Republican-led plan looked at healthcare funding alternatives , allowing the tax credits to expire.

The subsidies were a major sticking point in the 43-day government shutdown , the longest in U.S. history, which ended, in part, after Democrats negotiated a future vote on the extension.

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