Alaska's U.S. Sens. Lisa Murkowski and Dan Sullivan were among four Republicans who joined the chamber's Democrats to vote in favor of a measure that would have extended health insurance subsidies used by millions of Americans, including thousands in Alaska.

Still, the bill failed to reach the 60-vote threshold to pass amid opposition from most Senate Republicans.

In a floor speech after the vote, Murkowski called for lawmakers to undertake a bipartisan effort to extend the subsidies, known as the enhanced premium tax credits, which were passed by Democrats in 2022 with a sunset date at the end of this year.

Although Republicans have long said that the subsidies have contributed to the rising cost of health care across the country, they have not advanced a comprehensive solution to lower the underlying cost of health care.

Now, millions across the country, and roughly 25,000 Alaskans, could see insurance costs spike if the subsidies are allowed to expire at the end of the month.

"We have failed," Murkowski said, acknowledging the "imminent pain" coming to some Alaskans who purchase their insurance through the federal exchange and whose annual premiums are expected to increase two- or threefold.

"This is something we have known was coming for a long time," Murkowski said in her Senate floor speech.

She said extending the subsidies in the budget reconciliation bill that passed in July, or during the government shutdown that ended last month, would have been "a win on health care." But most of the Republican majority in the Senate opposed those efforts.

Sullivan and Murkowski also voted Thursday in favor of a GOP health care measure that similarly failed to meet the 60-vote threshold to advance. That legislation would not have extended the subsidies. Instead, it would have provided tax-advantaged funds to some Americans, which could be used to cover the cost of some health-related expenses.

"Maybe a failed vote on both sides is an opportunity for compromise," Sullivan said in a brief interview following the Thursday votes.

Sullivan said he's going to "redouble" his efforts to work on a bipartisan solution to temporarily extend the subsidies. He previously said he supports a two-year extension along with some limits on how the tax credits can be used. His existing proposals could be "potential landing zones for a compromise," he said.

"I'm hopeful, but I'm just going to keep working it," he said.

Although Murkowski voted in favor of both proposals on Thursday, she criticized both for failing to make bipartisan concessions.

"Neither of the proposals, in fairness, met the challenge, as far as I'm concerned," she said.

Still, she argued that there are eight concession proposals circulating among lawmakers, which could serve as the basis for legislation that might pass before the end of the year.

Such concessions include a shorter than three-year extension of the tax credits, and inclusion of measures meant to limit the cost of the subsidies to the federal government, such as income limits for those using them.

Murkowski urged her colleagues to pass such a bipartisan measure before the end of the year.

"I refuse to accept that where we are right now, which is two failed bills, is the best that we can do," she said.

"We can't just say, 'Happy holidays, brace for next year,'" she said. "We need to focus on the people who are going to be hurt if we do nothing."

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