The Senate is set to vote next week on extending Affordable Care Act health insurance subsidies for three years in a last-ditch effort to preserve them before they expire at the end of the year — but the plan is all but certain to fail.

Democrats have warned that millions of Americans will face higher premiums unless the subsidies are extended. Senate Minority Leader Charles E. Schumer (D-New York) said Thursday on the Senate floor that every Democratic senator would support the bill.

“Republicans have one week to decide where they stand: Vote for this bill and bring health care costs down, or block this bill and send premiums skyrocketing,” Schumer said.

The vote is the culmination of Democrats’ month-long campaign to extend the subsidies, which helped trigger the longest federal government shutdown in history. But it has almost no chance of winning enough Republican support to pass the Senate — and even if it passed, it’s unclear whether House Speaker Mike Johnson (R-Louisiana) would bring it up for a vote or if President Donald Trump would sign it.

Many Republicans immediately rejected the bill, which does not incorporate any changes that some have said would be necessary to win their support.

“They’re not serious,” Senate Majority Leader John Thune (R-South Dakota) told reporters. “It’s obviously designed to fail.”

Thune promised last month to hold a vote on a bill of Democrats’ choice to extend the subsidies by next week as part of a deal to end the shutdown. Sens. Jeanne Shaheen (D-New Hampshire) and Angus King (I-Maine), who played crucial roles in negotiating the bill, expressed optimism that they could negotiate a compromise to extend the subsidies that could win enough GOP backing to pass.

But those talks never went anywhere.

“They couldn’t put pen to paper,” Sen. Peter Welch (D-Vermont) told reporters, referring to Republicans. “They couldn’t propose something that was concrete, where they could say, ‘We’ve got four votes or five votes or six votes.’”

Democrats will need the support of at least 13 Republican senators to overcome a filibuster — and no more than a handful of Republicans are open to supporting the bill.

Sen. Thom Tillis (R-North Carolina), who has said he is open to extending the subsidies if Democrats make changes that Republicans have sought, said he was a “hard no” on the bill.

“I honestly don’t think Schumer wants an outcome,” Tillis said Wednesday. “I think he wants a political outcome that comes from a failed vote. And I’d rather construct something that I think is reasonable and respectful to both sides.”

Democrats are betting that Republicans will shoulder the blame if the subsidies expire. Forty-one percent of Americans who are enrolled in ACA plans and support extending the subsidies would blame Trump in that case, according a poll conducted last month by KFF, a health policy think tank. Thirty-five percent would blame Republicans in Congress, and 23 percent would blame Democrats.

Some Republicans have proposed changes to the subsidies — which Democrats enacted in 2021 without Republican support — in exchange for voting to extend them, including income restrictions and minimum out-of-pocket premiums. But others are vehemently opposed to extending the subsidies at all, splitting the party.

Sen. John Barrasso (Wyoming), the No. 2 Senate Republican, criticized Schumer’s proposal Thursday for not including “a single reform to deal with the waste, the fraud, the abuse and the corruption of these payments and of Obamacare.”

A report from the nonpartisan Government Accountability Office released Wednesday found evidence that the ACA subsidies are vulnerable to fraud.

Sen. Lisa Murkowski (R-Alaska), who introduced a bill in September to extend the subsidies for two years, did not rule out supporting the Democratic bill, but she said she would prefer to see changes to the subsidies.

One of the biggest hurdles to striking a bipartisan deal was abortion. Many Republicans wanted new restrictions to prevent plans bought using the subsidies from covering abortion, which Democrats refused to consider.

Abortion “has always been probably one of the biggest obstacles to getting a deal,” Thune told reporters Wednesday. “The other pieces of this I think you can sort of figure out, but that one is a really challenging one.”

Senate Republicans have discussed holding a vote next week on a health care bill of their own but have not reached a decision. Sen. Roger Marshall (R-Kansas) said such a bill could include funding for health savings accounts, more money for rural hospitals and legislation he introduced with Sen. John Hickenlooper (D-Colorado) to force health care providers to make prices public.

“If you give patients price tags, we put some money in their health care savings accounts, then we’re going to drive down the cost of health care for everybody,” Marshall said.

Multiple bipartisan factions in the House have floated their own ideas for a compromise, but they have not received assurance from Johnson that he would put it up for a floor vote.

Many House Republicans remain steadfastly opposed to extending the subsidies and have suggested more sweeping reforms that they argue could bring down the cost of health care.

Johnson told reporters Thursday that he intends to propose a health care plan next week and vote on it before the end of the year — but it’s unclear what that proposal would be or whether it could notch enough Republican votes to pass the House. Democrats are not expected to support the measure.

A group of more than 30 bipartisan House members led by Reps. Jen Kiggans (R-Virginia) and Josh Gottheimer (D-New Jersey) proposed a framework Thursday that would extend the credits for two years with income caps and new guardrails to prevent fraudulent payouts and would extend the open enrollment period until mid-March.

Although they don’t have a promise to vote on it, the bipartisan group said House Republican leaders recognize they have to do something. The group added that they’re willing to force a vote through a discharge petition if necessary.

“I think they understand there needs to be a plan,” said Rep. Michael Lawler (R-New York), who has signed on to the proposal. “To not put one forward is idiotic. It is not only wrong legislatively, it is stupid politically.”

Marianna Sotomayor contributed to this report.