- Both parties alarmed that enhanced ACA subsidies expire, threatening massive premium spikes and coverage losses starting November 1.
- Bipartisan momentum growing: GOP senators and moderates consider extending credits with conservative tweaks to avert political fallout.
- Public concern is high across parties, pressuring lawmakers to find a compromise amid the prolonged government shutdown.
WASHINGTON — With the federal government shutdown stretching into its 24th day — the second-longest in U.S. history — a growing chorus of lawmakers from both sides of the aisle is sounding the alarm over a looming crisis in health care affordability.
At the heart of the standoff is the impending expiration of enhanced subsidies under the Affordable Care Act, set to vanish at year’s end without congressional action.
These credits, which have helped more than 20 million Americans afford insurance, face a potential double-whammy: their lapse could more than double premiums for many, just as open enrollment kicks off on November 1.
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The shutdown, triggered by partisan clashes over spending and policy riders, has frozen federal operations and left federal workers unpaid, but it’s the health care ripple effects that are now dominating headlines.
A fresh poll from Data for Progress and the Groundwork Collaborative, released Friday after surveying 1,215 likely voters, underscores the urgency: 75% of respondents expressed worry about skyrocketing insurance premiums, up from 72% the previous week.
That anxiety cuts across party lines — 83% of Democrats, 72% of independents, and 69% of Republicans voiced concerns.
“While the president’s main priority may be his brand new ballroom, American voters have made their priority loud and clear: Averting the healthcare premium cliff that will more than double their insurance premiums,” said Elizabeth Pancotti, managing director of policy and advocacy at Groundwork Collaborative.
Why These Poll Numbers Matter
The numbers paint a stark picture. The Washington Post reported Friday that premiums for the most popular plans on Healthcare.gov are poised to jump an average of 30% next year, based on rates approved by the Centers for Medicare and Medicaid Services.
Without the enhanced subsidies — first introduced in 2021 as part of COVID-19 relief and extended through 2025 in the 2022 climate law — middle-income families could see costs balloon by over 100%, according to analysis from the health research group KFF.
An estimated 10 million people might lose Medicaid coverage if related cuts aren’t reversed, and millions more could forgo insurance altogether.
President Donald Trump, who jetted off to Asia late Friday amid the chaos, has drawn fire for what critics call misplaced priorities.
The White House’s East Wing is being demolished to make way for a lavish ballroom funded by corporate donors — including weapons makers, tech giants, and private equity firms — even as the shutdown grinds on.
House Republicans, who control the chamber, have no plans to reconvene next week, further delaying any resolution.
Their earlier funding bill stalled in the Senate without Democratic backing, which Democrats have withheld unless it scraps GOP-proposed Medicaid reductions and extends the ACA credits.
Yet amid the finger-pointing, glimmers of bipartisan unity are breaking through, offering a potential off-ramp from the impasse.
Bipartisan Efforts Provide Clarity
Republicans, long the ACA’s fiercest critics, are increasingly acknowledging the political and human toll of inaction.
Trump’s own pollster, John McLaughlin, has warned GOP lawmakers privately and publicly that failing to extend the subsidies could spell a “potential political catastrophe for the G.O.P.” — a nod to the 2018 midterm backlash after failed repeal efforts cost Republicans their House majority.
In the Senate, a group of GOP senators is quietly drafting legislation to extend the credits with conservative tweaks, such as income caps to target aid more precisely, according to sources familiar with the discussions.
The effort has drawn “technical assistance” from the Senate Finance Committee.
“There’s some very interesting potential health care discussions and even solutions out there, and obviously reforms that need to be made to the Obamacare enhanced subsidies,” Senate Majority Leader John Thune said recently, floating the idea of bundling it into a broader package post-shutdown.
Over in the House, the bipartisan Problem Solvers Caucus is pushing hard to revive talks.
The group, which includes moderates from both parties, met Monday to explore folding a subsidy compromise into a bipartisan funding deal.
Rep. Brian Fitzpatrick (R-Pa.), a caucus leader, has co-sponsored a bill with Democrats to extend the credits for a year without new restrictions — already backed by 12 Republicans and seven Democrats.
His colleague, Rep. Jen Kiggans (R-Va.), introduced a similar measure in early September, emphasizing reforms to curb fraud and waste while preserving access.
“If we have health care reforms on the table that protect and provide greater freedom and independence for patients and doctors, then I’m on board,” Kiggans told reporters.
Even House Speaker Mike Johnson, who has admitted to lingering “PTSD” from the 2017 repeal fiasco, is signaling openness to a path forward.
Options under discussion include attaching a scaled-back, two-year extension to a package of full-year funding bills once the shutdown lifts — potentially advanced via “suspension of the rules,” which would require a two-thirds majority and Trump’s public nod.
Thirteen House Republicans echoed this in a letter last week, urging their party to prioritize the issue after reopening government: “Our Conference and President Trump have been clear that we will not take healthcare away from families who depend on it. This is our opportunity to demonstrate that commitment through action.”
Democrats, for their part, are framing the subsidies not as a partisan win but a shared imperative.
House Minority Leader Hakeem Jeffries told NPR on Tuesday that public pressure will ultimately force a deal. “We’ve made clear that we want to reopen the government. We want to find a bipartisan path forward toward a spending agreement that actually makes life better for the American people,” Jeffries said.
Senate Minority Leader Chuck Schumer has similarly warned on a Zoom call with health advocates that GOP intransigence could lead to “skyrocketing health care costs that would force some people to forgo coverage altogether.”
Is the Division Gap Closing Between Republicans and Dems?
This unlikely alliance traces back to September, when Republicans aligned with Trump joined Democrats and industry groups in calling for an extension to avert a “tax hike” on their base — a rare admission that Obamacare, derided for years, now underpins coverage for millions in red states like Florida, Texas, and Georgia.
Enrollment has more than doubled since 2021, with huge gains in non-Medicaid-expansion states.
A KFF survey found 76% of adults, including 59% of Republicans, support renewal.
Complicating matters are conservative holdouts, like members of the House Freedom Caucus, who view the credits — estimated at $350 billion through 2035 if made permanent — as a boon to insurers rife with “phantom enrollment.”
Anti-abortion groups have also lobbied against any extension, claiming it indirectly funds procedures.
But the momentum appears to be shifting: As notices of premium hikes begin hitting mailboxes next month, the human stakes could tip the scales toward compromise.
For now, the shutdown’s toll mounts — from furloughed workers to delayed Medicaid processing — but the subsidy fight highlights a broader truth: Health care, once a wedge issue, is evolving into a reluctant unifier.
If lawmakers can channel this cross-aisle energy, they might not just end the stalemate but deliver a win for voters tired of Washington gridlock.
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