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Republicans make up a majority of the Indiana Senate, but more than a dozen voted against President Trump's new political map, which aimed to add Republicans in Congress.
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Republicans blocked Democrats' effort to extend the expiring subsidies while Democrats thwarted a G.O.P. proposal to replace them with direct payments for basic health coverage.
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The speaker has repeatedly lost his grip on the House floor thanks to a once rare parliamentary maneuver that G.O.P. members are increasingly using to force action on legislation.
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The Senate is set to vote later this week on a three-year extension of Affordable Care Act subsidies that Republicans oppose. The G.O.P. has yet to coalesce around an alternative.
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