A cross-party coalition of senators is intensifying efforts to secure a healthcare solution as the deadline looms for extending the enhanced subsidies under the Affordable Care Act (ACA) by the end of the month.

Approximately 20 senators gathered on Monday night, responding to an invitation from Sen. Susan Collins (R-Maine). They discussed a proposal from Collins and Sen. Bernie Moreno (R-Ohio), which suggests a two-year extension of ACA tax credits alongside reforms designed to appeal to conservatives. This proposal served as the foundation for their discussions.

Several principal negotiators expressed optimism following the meeting, anticipating ongoing discussions and hinting that a preliminary agreement could be reached by the week’s end.

“There is a strong desire to achieve a solution,” Collins shared with reporters as she exited the meeting with Moreno. “The discussions were focused and practical, with everyone aiming for a positive outcome.”

Despite the optimism, the senators acknowledged that finalizing a deal before the holiday recess might not be realistic, suggesting that January could be a more achievable timeframe.

The group of lawmakers consisted of those from across the political spectrum in both parties, including members of both leadership teams, moderates, and those in conservative and progressive camps.

The meeting came only days after the chamber voted down a pair of partisan health care bills that essentially turned into a messaging exercise. 

A plan offered by Sens. Mike Crapo (R-Idaho) and Bill Cassidy (R-La.) sought to shift funding for the subsidies to become contributions toward health savings accounts in order to help cover out-of-pocket costs for those who are insured via the ACA marketplace. It failed to advance on a nearly party-line vote.

The Democratic measure, which Senate Majority Leader John Thune (R-S.D.) agreed to put on the floor as part of the deal to reopen the government last month, would have extended the enhanced subsidies for three years.

Democrats notably won the support of four Republicans: Sens. Lisa Murkowski (Alaska), Dan Sullivan (Alaska), Josh Hawley (Mo.) and Collins. And senators credited the failed votes for the renewed push toward getting a deal.

“I think sometimes, Democrat bill, Republican bill — fail, fail —maybe helps with the momentum,” Sullivan, who is up for reelection next year, told reporters. “This is a really serious issue for great Alaskans who are going off this cliff through no fault of their own.”

According to attendees, senators tossed out scores of ideas and concerns during the hour-plus meeting. Among them were the potential guardrails and reforms to the subsidies, and how many years an extension should include. 

Collins added that one issue the group discussed is the possibility of extending open enrollment. Most ACA state exchanges allow individuals to sign up for plans until Jan. 15, but anyone who wanted insurance on Jan. 1 had to be signed up by Monday. 

Republicans also brought up potential ways to address the issue of abortion after conservatives pushed to include a Hyde Amendment-like provision barring federal funds from going toward abortion in any health care package.

Perhaps most of all, the meeting sought to cool temperatures that have been simmering for weeks.

Republicans have accused Democrats of not truly wanting to solve the problem and preferring to keep the issue alive ahead of next year’s midterm elections. 

Democrats have similarly panned Republicans for allowing the subsidies to expire and cause health care costs to soar for millions of Americans.

“I think we’re in a … very positive approach to try to solve the problem,” said Senate Minority Whip Dick Durbin (D-Ill.). “We certainly moved in that direction.”

“It’s perilously close to something called legislating, which used to be common in the Senate and hasn’t been in a long time,” he added. 

Despite the positive steps, pessimism continues to seep in among lawmakers who believe that a deal remains too far out of reach for both sides, especially given the abbreviated runway negotiators have to land the legislative plane. 

Democrats, at least publicly, are still holding out for a clean extension of the ACA subsidies.

Republicans, meanwhile, are split on the issue. Moderates have been warning for years that allowing health care costs to spike will cost them in the midterms while conservatives have blanched at the idea of voting to extend subsidies under ObamaCare, which they’ve battled for more than a decade.

In the House, leadership is aiming to vote on a GOP-crafted health care package this week that doesn’t include an extension of the subsidies. An amendment proposed by moderates to address the subsidies appeared to hit major roadblocks.

At the same time, there are three active discharge petitions — two from GOP moderates and one from Democratic leaders — that could force a bill to extend the enhanced subsidies to the floor if one receives enough signatures.

Senate Majority Leader John Thune (R-S.D.) told reporters that despite bipartisan talks continuing through the weekend into Monday, he was not “terribly optimistic” that a result would come about, especially one that could get the requisite 60 votes. 

“Those conversations continue, but there isn’t anything I would say at the moment … that can probably be something signed into law,” Thune said. 

Other top lawmakers were more blunt about the challenge facing the bipartisan group. 

“Lots of people have been able to pull legislative rabbits out of a hat,” said Sen. Brian Schatz (D-Hawaii), a member of Democratic leadership. “But that’s what this would be.”