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Government Shutdown: ACA Subsidies Hang in the Balance, Leaving Americans Anxious
WASHINGTON D.C. – As the federal government shutdown stretches into its third week, a critical point of contention has emerged: the future of Affordable Care Act (ACA) subsidies. These vital premium tax credits, which significantly reduce or eliminate monthly insurance costs for many Americans, are set to expire at the end of 2025, and their fate is now entangled in the ongoing political stalemate.
Democrats are pushing for an extension of these subsidies as a prerequisite to reopening the government, while Republicans insist on a “clean” funding bill first, refusing to negotiate on other matters until the shutdown ends. This standoff has left millions of Americans, who rely on these credits to afford health insurance, in a state of growing uncertainty.
A recent analysis by KFF highlighted the potential impact, indicating that premium payments could more than double in 2026 if the enhanced ACA premium tax credits are allowed to expire. For families already struggling with healthcare costs, this prospect is deeply concerning. Many fear they may be forced to downgrade to less comprehensive plans or, in some cases, lose coverage entirely.
“We Can’t Afford to Not Have Insurance”
Among those most affected are individuals like Doug Butchart, 67, from Eglin, Illinois. His wife, Shadene, 58, lives with amyotrophic lateral sclerosis (ALS) and depends on insurance purchased through the health insurance marketplace. As her condition progressed, the Butcharts upgraded from a basic “bronze” plan to a more comprehensive “gold” plan, which currently costs $1,273.82 per month.
Thanks to enhanced premium tax credits, the Butcharts receive $670 towards their monthly premium, leaving them to pay $603.82 out-of-pocket. However, without these credits, Doug Butchart states that paying the full premium would be unsustainable.
“I’ve heard [premiums could rise] anywhere from 25 to 50%,” he explained. “And that’s not sustainable because we can’t afford that but can’t afford to not have insurance.”
The Butcharts find themselves in a challenging position, as Shadene does not qualify for Medicare, and their income exceeds the threshold for Medicaid. “We’re stuck in the middle,” Doug said.
“Normally with an ALS diagnosis, you’re automatically eligible for [Social Security Disability Insurance] and Medicare, but she doesn’t have any work credits, so she doesn’t qualify for Social Security Disability. So right now, we’re doing everything off of my Social Security, and it’s very hard to try and pay all the bills and keep insurance.”
Anticipating the potential loss of tax credits, the couple is now scrambling to utilize their current insurance to secure as much essential equipment as possible for Shadene before the year’s end. This includes a new eye-driven wheelchair, an item that could cost between $65,000 and $95,000. Doug Butchart worries that a downgrade to a lower-tier plan next year might not cover his wife’s vital medications.
As a retired mechanic, Doug feels fortunate to have paid off his house and car, but he never anticipated the struggle to meet monthly insurance costs. “You work your entire life to make yourself comfortable,” he reflected. “You don’t realize how important insurance is until you need it.”
“It’s Very Much a Worry”
Nancy Murphy, a retired registered nurse and insurance industry veteran from Fort Lauderdale, Florida, is another American deeply concerned by the potential expiration of the subsidies. This year marked the first time Murphy, 60, was able to secure insurance through the ACA with Florida Blue. Her monthly premium of $1,019 is entirely covered by the enhanced premium tax credits.
“It’s very much a worry. I definitely could not afford that if the tax credits expire,” Murphy stated. As a Type 1 diabetic who relies on an insulin pump, which her current plan covers without a co-pay, the thought of losing these credits is “a scary thought.”
Beyond her medical needs, Murphy is also managing property taxes and her daughter’s college tuition in Boston. The uncertainty surrounding future premium costs is causing significant anxiety.
“I’m like in limbo and it’s a really uncomfortable feeling,” she said. “I like to budget and plan out my budget.
With tuition, property taxes and repairs that need to be done around the house, I need to map these out.”
Murphy expressed her frustration, emphasizing, “These things to me are so upsetting. We are American citizens. We should be able to access our tax dollars for our health care needs.”
With the November 1st open enrollment deadline approaching and the potential for these crucial tax credits to vanish by year-end, the government shutdown’s impact on healthcare affordability is becoming a deeply personal and pressing concern for countless American families.