Competing healthcare plans were blocked in the Senate|Jesse Collins|CC BY 3.0

The Senate on Thursday rejected competing Republican and Democratic healthcare proposals, leaving about 24 million Americans facing steep insurance premium increases on January 1 when a federal subsidy expires.

A 60-vote threshold was required in the 53–47 Republican-led Senate. Four Republicans supported the Democrats’ Obamacare plan, which would have extended Affordable Care Act subsidies for three years. The Republicans’ proposal to replace those subsidies with federal funding for health savings accounts didn’t receive a single Democratic vote and failed by the same margin.