Behind the Shutdown: The Fight Over ACA Health Care Premiums

Senate Minority Leader Chuck Schumer, D-N.Y., speaks at a press conference.
Senate Minority Leader Chuck Schumer, D-N.Y., at a press conference after failed votes to fund the government. (Nathan Posner/Anadolu/Getty Images)

What’s Happening?

A federal government shutdown was driven by a dispute over health policy—specifically, the cost of premiums for health care plans purchased on the Affordable Care Act (ACA, or “Obamacare”) marketplaces.

The Issue: Enhanced Tax Credits

  • Since 2021, enhanced tax credits have made ACA plans more affordable for 24 million Americans.
  • These credits are set to expire at the end of the year.
  • Senate Democrats refused to vote for a Republican funding bill that did not extend these credits.

Why Do Enhanced Tax Credits Matter?

  • They help people who don’t get insurance through work or public programs.
  • Without an extension, average premium payments could increase by 114% (KFF analysis).
  • The Congressional Budget Office estimates 4 million people could become uninsured if the credits expire (CBO report).
  • Extending the credits would cost the government $350 billion over 10 years.

Background

  • The ACA originally provided a sliding scale for premium support, but many still found coverage unaffordable.
  • In 2021, Congress increased funding, making coverage more accessible and reducing the uninsured rate.

The Political Standoff

  • Some Republicans argue the credits are too expensive; others are open to extension but not as part of the shutdown fight.
  • Democrats argue the issue is urgent, as open enrollment and new rates are imminent.

Conclusion

The fight over ACA premium support is a central reason for the government shutdown, highlighting the ongoing political battles over health care in the U.S.


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