As the government shutdown goes on, there are a lot of mixed messages on Capitol Hill about the health care issue at the center of the fight.
The tax credits that make ACA health care premiums affordable for many Americans don’t expire until December, as Republican lawmakers note.
These are real health insurance marketplaces where real people — 24 million of them — buy coverage.
In a memo, they wrote: “Voters don’t want to see people losing their health insurance.”
The Congressional Budget Office estimates that 4 million people will become uninsured in the next few years if the enhanced tax credits expire.
Democrats argue that it is critical to extend the Affordable Care Act tax credits. Republicans say there’s plenty of time to figure it out.
As the government shutdown goes on, there are a lot of mixed messages on Capitol Hill about the health care issue at the center of the fight.
Republican lawmakers point out that the tax credits that help many Americans afford their ACA health care premiums don’t expire until December. However, before enrollment starts in November, Democratic lawmakers would like to see them extended. 1, and they have mandated that in order to vote to reopen the government.
There is more to the conflict than just political messaging. There are 24 million actual people who purchase health insurance on these actual marketplaces. It has a significant impact on how much of their monthly premiums are covered by the federal government.
These are the policy’s five main facts.
First. The public supports the subsidies.
More than 75% of respondents, regardless of political affiliation, support Congress extending the expanded ACA tax credits, according to a survey conducted last week. The nonpartisan health research organization KFF carried out the survey.
According to Ashley Kirzinger, director of survey methodology at KFF, “What we found is that 78 percent of the public — including majorities of Democrats, independents, Republicans, and [Make America Great Again] supporters – all think Congress should extend the premium tax credits beyond 2025.”.
Similar results have been found in other surveys: according to a July survey conducted by Republican pollsters Tony Fabrizio and Bob Ward, 72% of voters from all political parties favored extending the policy. Even people who had no direct connection to these health plans showed strong support for the policy, according to their survey of two dozen competitive congressional districts.
“Voters don’t want to see people losing their health insurance,” they stated in a memo. “.
2. The problem is critical because open enrollment will soon begin.
The improved subsidies must be extended before open enrollment begins in November, according to Jon Godfread, the insurance commissioner for North Dakota. 1, urging legislators to “do this now.”. A “.
In addition to serving as president of the National Association of Insurance Commissioners, a membership organization for state insurance regulators nationwide, he is an elected Republican in his state. “Red state, blue state, appointed, elected — we have unanimous approval supporting these tax credits,” he declares.
#3. Next year, premiums will likely soar.
When health insurers were setting their rates for 2026, they factored in the rising cost of health care, plus the possibility that the subsidies would expire and drive the healthiest people out of the ACA marketplaces.
When researchers at KFF analyzed 2026 insurance filings, they found that premiums will double for many consumers next year. “On average, we’re expecting premium payments by enrollees to increase by 114 percent if these enhanced tax credits expire,” says Cynthia Cox, director of the Program on the ACA at KFF.
According to her, excessively high premiums may encourage people to take a chance and forego insurance. The Congressional Budget Office estimates that 4 million people will become uninsured in the next few years if the enhanced tax credits expire.
Four.
The people who rely on HealthCare . gov and the other Obamacare marketplaces are people who “work at a place that doesn’t offer them coverage,” explains Cox, of KFF. “A lot of times, that’s a small business. Or it could be farmers and ranchers. It could be gig workers like Uber drivers. “.
Geographically, more than 3 in 4 enrollees live in states that President Trump won in 2024, according to KFF. Part of that is due to the fact that some Southern states have seen dramatic growth in enrollment recently. “In six states (Texas, Louisiana, Mississippi, Tennessee, Georgia and West Virginia), enrollment has more than tripled in five years,” notes Cox’s colleague Emma Wager.
5. The subsidies are expensive for the government.
The subsidies that kept costs down for consumers cost the federal government a lot of money. The Congressional Budget Office estimates it would cost the government $350 billion over the next decade if the enhanced subsidies were extended permanently.
Conservative groups that have always opposed the Affordable Care Act are against the enhanced subsidies. A coalition of groups recently argued in a letter to the president that the enhanced tax credits were meant to be temporary during the COVID-19 pandemic and that extending them will exacerbate rising health care costs.
“While some Americans may be concerned about premiums going up in the short term, removing the incentive for insurers to continue raising their prices will save patients money in the long run,” they write.
Other Republicans — like Rep. Marjorie Taylor Greene of Georgia and Sen. Josh Hawley of Missouri — have said they support extending the tax credits or coming up with a different plan to prevent dramatic rate hikes for consumers.
Godfread, the Republican insurance commissioner of North Dakota, says that the debate over rising health costs is real and worthwhile, but there’s urgency in this moment.
“That discussion is separate,” he argues. “We can talk about the costs of health care and pharmaceuticals, all the pieces — but we’ve still got to get access to consumers and that’s what these subsidies have helped provide. “. Most enrollees live in states that Trump won.
