Once optimistic and bipartisan discussions to extend expiring Affordable Care Act subsidies have all but fizzled out, with senators on both sides of the aisle skeptical a deal can come together before higher out-of-pocket premiums kick in next month.

The inability to reach a compromise stems largely from a long-running impasse over GOP demands to expand abortion restrictions under Obamacare using so-called Hyde Amendment language, which bars federal funds for abortion except in cases of rape, incest, and life of the mother.