WASHINGTON—Top Senate negotiators said an effort to renew expired healthcare subsidies had effectively collapsed, likely ending the hopes of 20 million Americans that the tax-credit expansion could be revived and lower their monthly insurance premiums.

Talks had centered on a proposal from Sens. Bernie Moreno (R., Ohio) and Susan Collins (R., Maine) to extend a version of the enlarged Affordable Care Act subsidies for at least two years, while cutting off higher-income people from participating and eventually giving enrollees the option of putting money into health savings accounts. It also would eliminate zero-dollar premium plans. But lawmakers from both parties now say the chances of a deal have all but evaporated.

“It’s effectively over,” Moreno said Wednesday. Sen. Bill Cassidy (R., La.)—the architect of an adjacent plan—agreed. While Collins declined to be as definitive, she did say that it was “certainly difficult.”

The collapse in negotiations comes as new, higher health-insurance bills are kicking in for many households and just months after a standoff over extending the subsidies sparked the longest government shutdown in U.S. history. Now, both parties are set to head into the midterm elections with no breakthrough on healthcare coverage. Instead, the focus in Washington has largely turned to new restrictions of immigration enforcement officers.

The ACA subsidies were first expanded in 2021 by Democrats during the coronavirus pandemic with no Republican support. They allowed people with incomes over 400% of the poverty line—currently $128,600 for a family of four—to receive tax credits reducing the cost of premiums. The subsidies dramatically expanded the number of people who could obtain health insurance without paying a premium. The expanded subsidies expired at the end of last year.