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Tag: Affordable Care Act

  • What to know about ACA ‘phantom enrollees’ GOP talking point

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    The idea that Affordable Care Act marketplaces are riddled with fraud has become a major talking point among Republicans, as lawmakers in Congress argue about whether to extend the enhanced tax credits that are helping offset the cost of health care marketplace coverage for low- and middle-income people. Those ACA subsidies expire at the end of the year and have become a flash point in the government funding showdown.

    “The tax credits go to some people deservedly. And we think the tax credits actually go to a lot of waste and fraud within the insurance industry,” said Vice President JD Vance during a recent interview on CBS News. “We want to make sure that the tax credits go to the people who need them.”

    Key to the Republican argument of widespread fraud is a report published in August by the Paragon Health Institute, a Republican-aligned think tank. The report focuses on “phantom enrollees” in the ACA marketplaces.

    Paragon president Brian Blase said these “phantom enrollees,” who don’t use any medical care in a year, exceed the percentages of “what you would expect in a normal, functioning health insurance market.”

    Blase and his team say they have quantified the percentage of zero-claim enrollees in the ACA marketplace by analyzing Centers for Medicare & Medicaid Services data released in August.

    This highlights one of the central issues with the CMS data: It tracks the number of plan enrollments rather than individual enrollees.

    The federal data that Paragon analyzed could count enrollees twice if they’ve switched plans during the year, said Cynthia Cox, a vice president and the director of the Program on the ACA at KFF, a health information nonprofit that includes KFF Health News.

    Per that data, in 2021, the percentage of enrollments without any medical claims was 19%. That percentage jumped to 35% in 2024.

    To Blase and Paragon, this increase in zero-claim enrollments is evidence of fraud. It indicates, they say, that rogue insurance brokers are signing up people who don’t exist, don’t qualify, or have other insurance and don’t need ACA coverage.

    “Basically, what happened is you had insurers benefit, brokers benefit financially, and just massive numbers of people got put on the program,” Blase said. That’s where these phantoms come in. “They have no idea that they’re enrolled, and, as such, they use no medical care.”

    In 2021, former President Joe Biden signed into law the American Rescue Plan Act, which included enhanced ACA subsidies that made plans available at low or no cost to certain low-income individuals and expanded eligibility for subsidies to some middle-income people. Those credits were extended through 2025 as part of the Inflation Reduction Act, signed in 2022.

    News stories show how simple it could be for insurance brokers in certain states to sign people up for zero-cost ACA insurance plans, unbeknownst to the consumers. The Department of Health and Human Services has tried to crack down on those fraudulent practices.

    But health policy experts and analysts have cautioned against reading too deeply into the numbers of zero-claim enrollees.

    “It’s not that he’s wrong, but I think he’s overinterpreting,” said Michael Cannon, director of health policy studies at the libertarian Cato Institute, of Blase’s analysis.

    Cox said there’s evidence that plan-switching has increased, due in part to extended open enrollment periods. Increased plan-switching could make the number of people being double-counted higher in the federal data and increase the percentage of zero-claim enrollees over the years. Some enrollees also may have been on an ACA plan for only part of the year, which would make them less likely to make a claim.

    “We’re not trying to argue there is no fraud. It’s a real thing. But the question is, how big of a scale is this problem?” Cox said. “Just suggesting that anyone who’s not using health care is a fraudulent enrollee — that’s not true. Plenty of people don’t use health care.”

    It’s not uncommon for healthy people in an insurance marketplace not to use their insurance in a given year, according to health policy experts. And with the enhanced ACA subsidies, more people signed up for marketplace coverage. Enrollment data shows that it made the marketplace population younger, and younger enrollees may be less likely to use their insurance. A recent report found that each year from 2018 to 2022, an average of 23% of enrollees in employer-sponsored plans didn’t use their health insurance.

    “Somehow the idea that people not using health insurance is some sort of a problem — it might be. But in principle it isn’t,” said Joseph Antos, a health policy expert and senior fellow emeritus at the right-leaning American Enterprise Institute. “The point is that for insurance to work, you need some people who are not making claims on the insurance.”

    The main trade associations for insurers and hospitals, AHIP and the American Hospital Association, have also disputed Paragon’s characterization of the federal data and even published blog posts breaking down their arguments. AHIP pushed back on the idea that the insurance industry is profiting from the enhanced subsidies by stating that existing law caps health plan profits.

    Paragon was started by Blase in 2021 and has become widely influential in Republican health policy circles. Alumni of the organization are staffers in the Trump administration and in House Speaker Mike Johnson’s office, so it follows that the group’s takeaways would become Republican talking points.

    It’s also not new for the GOP to say that government programs are full of fraud. During the negotiations over the One Big Beautiful Bill, Republican lawmakers insisted Medicaid wouldn’t be cut to pay for the tax cuts, but that “waste, fraud, and abuse” in the health program would be eliminated.

    Now, the ACA is center stage in the ongoing federal government shutdown, with Democrats pushing for Congress to extend the current ACA subsidies, which are set to expire at the end of the year. And fraud, again, is a centerpiece of the argument for Republicans. Democrats take a different view on the amount of fraud in the program, instead emphasizing how the subsidies’ expiration will increase insurance premiums.

    “It’s become a boondoggle. It’s a subsidy for insurance companies,” Speaker Johnson said of the ACA subsidies at a shutdown press conference last week. “When you subsidize the health care system, and you pay insurance companies more, the prices increase. That’s been the problem.”

    KFF Health News senior correspondent Julie Appleby contributed to this report.

    This article first appeared on KFF Health News.

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  • Get the Facts: Health insurance expected to rise if tax credits expire amid government shutdown

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    At the core of the government shutdown is a debate about the extension of health insurance subsidies under the Affordable Care Act, first implemented in 2021.The shutdown began at the start of the new fiscal year, Oct. 1. In budget negotiations, Democrats were aiming to extend the expanded subsidies, set to expire at the end of 2025, while Republicans have emphasized reopening the government before beginning health care talks.If these tax credits expire, it’s estimated that the more than 24 million people enrolled in marketplace plans will pay twice as much out of pocket, according to Jeanne Lambrew, director of health care reform at the Century Foundation. KFF estimated the average premium payment would increase 114% from $888 to $1,904 without expanded subsidies.Plus, the impacts could be felt even sooner as open enrollment is set to begin Nov. 1 for people to select health insurance coverage for 2026. The ACA, sometimes referred to as “Obamacare,” was designed to make health care affordable and accessible via marketplaces, Lambrew said, who also worked on drafting and implementing the ACA during the Obama administration.The goal of the marketplaces were to fill in the gaps, according to Lambrew. It is for people who make too much to qualify for Medicaid, but also for people who don’t have access to affordable insurance through their work.Enrollment in the ACA has increased since its passage in 2014, but really climbed in the last five years. From 2020 to 2025, enrollment more than doubled as a result of expanded tax credits passed in the American Rescue Plan Act in 2021, which increased the subsidies and lifted a cap that disqualified people making four times the poverty level or more from being eligible for the subsidies. Under 2025 guidelines for the 48 contiguous states and Washington, D.C., the federal poverty level is $15,650 for a one-person household. At 400%, it’s $62,600.Nearly all states saw an increase in enrollment under the ACA from 2020 to 2025, with 20 states more than doubling in enrollment.Six states more than tripled in the number of people enrolled under the ACA — Texas, Mississippi, West Virginia, Louisiana, Georgia and Tennessee.States that President Donald Trump won in the 2024 election have the majority of enrollees, according to an analysis from KFF.“We know that three out of four enrollees in the health insurance marketplace live in states that voted for President Trump in 2024,” Lambrew said. “So this is not a partisan issue, it’s a nationwide issue, and it affects people in different ways, but the overall effect is significant.”Who is impacted?The subsidies, also called tax credits, at the center of the shutdown are utilized by about 92% of people enrolled in marketplace plans under the ACA, according to data from the Centers for Medicare & Medicaid Services.These expanded credits allow households of different sizes and income levels to be capped with maximum out-of-pocket costs.Once the expanded tax credits expire at the end of this year, the out-of-pocket maximums will increase across the board, and people making above four times the poverty level will become ineligible for any tax credits.More than 6.7% of those who were enrolled in ACA plans earned more than 400% of the federal poverty level, accounting for 1.6 million people. Once the subsidies expire, these enrollees would no longer qualify for the subsidies under the ACA.Also heavily impacted are people approaching retirement age. The age group with the highest enrollment in marketplace plans is ages 55 to 64, data shows. KFF estimated in March that about half the enrollees who would lose the tax credit upon expiration are between 50 and 64.As people grow closer to retirement age, they may not rely as much on employer-provided insurance before turning 65 and qualifying for Medicaid, according to Lambrew.How much would premiums change?KFF has estimated the average premium will more than double next year if the expanded subsidies were to expire.In addition to the potential ending of the subsidies, insurance rates are projected to rise across marketplace plans and employer-provided insurance.”I looked at Medicare history, employer-sponsored insurance history, marketplace history. Without a doubt, this is the highest one-year increase in premiums for people in history,” Lambrew said.The Get the Facts Data Team analyzed maximum out-of-pocket rate changes for benchmark plans to find how rates may change.A one-person household with an annual income of $25,000 — a little more than 1.5 times the federal poverty level — is estimated to go from paying a maximum $100 out of pocket annually to $1,168. They would pay a maximum of less than $98 a month — 10 times more than the previous payment of less than $9 a month.Households with an income between 100% and 150% of the federal poverty level made up the largest share of enrollees at almost 45%. Under the expanded subsidies, they aren’t required to pay anything out of pocket for benchmark plans.If the tax credits expire, they will pay a maximum between 2.1% and 4.19% of their income annually. At 1.5 times the federal poverty level, a one-person household would be earning $23,475 annually and may have to pay nearly $984 a year.The interactive below shows how the maximum out-of-pocket rates for benchmark plans may change if expanded subsidies expire for one, two and four-person households at various incomes. Estimates were calculated using maximum out-of-pocket rates from KFF published by the IRS, along with 2025 federal poverty level data from the U.S. Department of Health and Human Services for the 48 contiguous states plus D.C. The tool is not intended to calculate an individual’s actual payments. Healthcare.gov and other state marketplaces are the best source for specific premium costs.PHNjcmlwdCB0eXBlPSJ0ZXh0L2phdmFzY3JpcHQiPiFmdW5jdGlvbigpeyJ1c2Ugc3RyaWN0Ijt3aW5kb3cuYWRkRXZlbnRMaXN0ZW5lcigibWVzc2FnZSIsKGZ1bmN0aW9uKGUpe2lmKHZvaWQgMCE9PWUuZGF0YVsiZGF0YXdyYXBwZXItaGVpZ2h0Il0pe3ZhciB0PWRvY3VtZW50LnF1ZXJ5U2VsZWN0b3JBbGwoImlmcmFtZSIpO2Zvcih2YXIgYSBpbiBlLmRhdGFbImRhdGF3cmFwcGVyLWhlaWdodCJdKWZvcih2YXIgcj0wO3I8dC5sZW5ndGg7cisrKXtpZih0W3JdLmNvbnRlbnRXaW5kb3c9PT1lLnNvdXJjZSl0W3JdLnN0eWxlLmhlaWdodD1lLmRhdGFbImRhdGF3cmFwcGVyLWhlaWdodCJdW2FdKyJweCJ9fX0pKX0oKTs8L3NjcmlwdD4=

    WASHINGTON —

    At the core of the government shutdown is a debate about the extension of health insurance subsidies under the Affordable Care Act, first implemented in 2021.

    The shutdown began at the start of the new fiscal year, Oct. 1. In budget negotiations, Democrats were aiming to extend the expanded subsidies, set to expire at the end of 2025, while Republicans have emphasized reopening the government before beginning health care talks.

    If these tax credits expire, it’s estimated that the more than 24 million people enrolled in marketplace plans will pay twice as much out of pocket, according to Jeanne Lambrew, director of health care reform at the Century Foundation. KFF estimated the average premium payment would increase 114% from $888 to $1,904 without expanded subsidies.

    Plus, the impacts could be felt even sooner as open enrollment is set to begin Nov. 1 for people to select health insurance coverage for 2026.

    The ACA, sometimes referred to as “Obamacare,” was designed to make health care affordable and accessible via marketplaces, Lambrew said, who also worked on drafting and implementing the ACA during the Obama administration.

    The goal of the marketplaces were to fill in the gaps, according to Lambrew. It is for people who make too much to qualify for Medicaid, but also for people who don’t have access to affordable insurance through their work.

    Enrollment in the ACA has increased since its passage in 2014, but really climbed in the last five years.

    From 2020 to 2025, enrollment more than doubled as a result of expanded tax credits passed in the American Rescue Plan Act in 2021, which increased the subsidies and lifted a cap that disqualified people making four times the poverty level or more from being eligible for the subsidies.

    Under 2025 guidelines for the 48 contiguous states and Washington, D.C., the federal poverty level is $15,650 for a one-person household. At 400%, it’s $62,600.

    Nearly all states saw an increase in enrollment under the ACA from 2020 to 2025, with 20 states more than doubling in enrollment.

    Six states more than tripled in the number of people enrolled under the ACA — Texas, Mississippi, West Virginia, Louisiana, Georgia and Tennessee.

    States that President Donald Trump won in the 2024 election have the majority of enrollees, according to an analysis from KFF.

    “We know that three out of four enrollees in the health insurance marketplace live in states that voted for President Trump in 2024,” Lambrew said. “So this is not a partisan issue, it’s a nationwide issue, and it affects people in different ways, but the overall effect is significant.”

    Who is impacted?

    The subsidies, also called tax credits, at the center of the shutdown are utilized by about 92% of people enrolled in marketplace plans under the ACA, according to data from the Centers for Medicare & Medicaid Services.

    These expanded credits allow households of different sizes and income levels to be capped with maximum out-of-pocket costs.

    Once the expanded tax credits expire at the end of this year, the out-of-pocket maximums will increase across the board, and people making above four times the poverty level will become ineligible for any tax credits.

    More than 6.7% of those who were enrolled in ACA plans earned more than 400% of the federal poverty level, accounting for 1.6 million people. Once the subsidies expire, these enrollees would no longer qualify for the subsidies under the ACA.

    Also heavily impacted are people approaching retirement age. The age group with the highest enrollment in marketplace plans is ages 55 to 64, data shows.

    KFF estimated in March that about half the enrollees who would lose the tax credit upon expiration are between 50 and 64.

    As people grow closer to retirement age, they may not rely as much on employer-provided insurance before turning 65 and qualifying for Medicaid, according to Lambrew.

    How much would premiums change?

    KFF has estimated the average premium will more than double next year if the expanded subsidies were to expire.

    In addition to the potential ending of the subsidies, insurance rates are projected to rise across marketplace plans and employer-provided insurance.

    “I looked at Medicare history, employer-sponsored insurance history, marketplace history. Without a doubt, this is the highest one-year increase in premiums for people in history,” Lambrew said.

    The Get the Facts Data Team analyzed maximum out-of-pocket rate changes for benchmark plans to find how rates may change.

    A one-person household with an annual income of $25,000 — a little more than 1.5 times the federal poverty level — is estimated to go from paying a maximum $100 out of pocket annually to $1,168.

    They would pay a maximum of less than $98 a month — 10 times more than the previous payment of less than $9 a month.

    Households with an income between 100% and 150% of the federal poverty level made up the largest share of enrollees at almost 45%. Under the expanded subsidies, they aren’t required to pay anything out of pocket for benchmark plans.

    If the tax credits expire, they will pay a maximum between 2.1% and 4.19% of their income annually. At 1.5 times the federal poverty level, a one-person household would be earning $23,475 annually and may have to pay nearly $984 a year.

    The interactive below shows how the maximum out-of-pocket rates for benchmark plans may change if expanded subsidies expire for one, two and four-person households at various incomes. Estimates were calculated using maximum out-of-pocket rates from KFF published by the IRS, along with 2025 federal poverty level data from the U.S. Department of Health and Human Services for the 48 contiguous states plus D.C.

    The tool is not intended to calculate an individual’s actual payments. Healthcare.gov and other state marketplaces are the best source for specific premium costs.

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  • Most Americans fear rising health care costs, poll finds | Long Island Business News

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    Most U.S. adults are worried about care becoming more expensive, according to a new , as they make decisions about next year’s health coverage and a keeps future health costs in limbo for millions.

    About 6 in 10 Americans are “extremely” or “very” concerned about their health costs going up in the next year, the survey from The Associated Press-NORC Center for Public Affairs Research finds — a worry that extends across age groups and includes people with and without .

    Many Americans have other health care anxieties, too. The poll found that about 4 in 10 Americans are “extremely” or “very” concerned about not being able to pay for health care or medications they need, not being able to access health care when they need it, or losing or not having health insurance.

    beneficiaries are already shopping for next year’s coverage, and open enrollment periods for many other health plans are approaching quickly in November. Federal policies have left millions of people at risk of skyrocketing health insurance premiums or of losing their health insurance altogether. The findings show that many Americans are feeling vulnerable to spiking , with some expressing concerns about whether they’ll have coverage at all.

    Latoya Wilson, an independent nurse consultant in Lafayette, Louisiana, currently uses a health insurance plan from the marketplace. But in the past two weeks, the 46-year-old has applied for more jobs than she had previously in her life, largely because she’s concerned about her premiums going up and wants the stability of employer-sponsored insurance.

    “Even before these health care cuts came into play, I was already having a significant issue getting the care that I needed this year,” she said. “Anything worse than what I already have is pretty scary.”
    Health care remains important to Americans when it’s center stage in Washington

    About 8 in 10 U.S. adults say the issue of health care is “extremely” or “very” important to them personally. That includes about 9 in 10 Democrats and three-quarters of Republicans, and it puts health care next to the economy among Americans’ top issue priorities.

    That significant attention on the issue raises the political stakes in what’s already been a crucial moment for federal health policy in the nation’s capital.

    President Donald Trump’s mega-bill passed this summer cuts more than $1 trillion from federal health care and food assistance over a decade, largely by imposing work requirements on those receiving aid and by shifting certain federal costs onto the states. Republicans say the cuts will prevent people who don’t need aid from gaming the system, but the cuts will ultimately result in millions of people losing health insurance coverage, according to projections from the nonpartisan Congressional Budget Office.

    More urgently, a congressional deadlock over Affordable Care Act subsidies that expire this year has thrown the federal government into a shutdown that’s dragged into a fourth straight week with no end in sight. Democratic lawmakers want any funding bill they sign to extend the subsidies, which have made ACA premiums less expensive for millions of people. Republicans in Congress have expressed willingness to negotiate on the issue, but only after the government is reopened.

    In interviews, some Americans said they doubted government leaders would take the necessary action to address their concerns on health care.

    “It is the federal government’s job to provide a better way of life for its people,” said Caleb Richter, a 30-year-old certified nursing assistant in Belleville, Wisconsin, who identifies as an independent. ”Right now, it just feels like they’re not trying.”

    But the poll reveals a deep ideological divide over what the government’s role should be, with Democrats far more likely than Republicans to say it’s the federal government’s job to make sure all Americans have health coverage. About 8 in 10 Democrats say this, compared with about one-third of Republicans.
    Most US adults disapprove of Trump’s handling of health care, the poll finds

    Health care continues to be a weakness for Trump. Only about 3 in 10 U.S. adults approve of the Republican president’s handling of health care, which hasn’t changed meaningfully since September. Almost all Democrats disapprove of his approach, but so do about 8 in 10 independents and about one-third of Republicans.

    Wilson, a Democrat, said she thinks Trump should be “doing things that affect the good of the group” when it comes to health care, including catering more to working-class Americans.

    But Michelle Truszkowski, a disabled veteran in Sterling Heights, Michigan, who is politically conservative, said she appreciates how Trump is focused on cutting and abuse in the health care system.

    “I like that people who shouldn’t be getting benefits from the government are getting kicked off of them,” the 48-year-old said. “Health care is not a right. It’s a privilege.”
    Democrats trusted more than Republicans on health care, but many trust neither

    About 4 in 10 U.S. adults say they trust the Democrats to do a better job handling health care, compared with about one-quarter who trust the Republicans more. About one-quarter trust neither party, and about 1 in 10 trust both equally.

    Americans are more likely to trust their own party on health care, generally speaking, but 76% of Democrats trust their party more on health care, while only 57% of Republicans have more trust in theirs.

    Independents are especially likely to trust neither party on health care — about half of independents say this. But the remaining independents are more likely to trust the Democrats.

    Richter, in Wisconsin, said he wishes Congress would put more faith and funding into hospital staffers who know how to help patients. He said he’d be fine with paying higher taxes if it meant ensuring health care for people who need it.

    But instead of working toward solutions, he said, federal lawmakers are acting “like a bunch of high school arguing.”

    “My faith that something will get done is very, very low at this point,” Richter said. “It just feels like they don’t really care.”


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  • Senate Republicans head to White House as government shutdown enters fourth week

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    As the government shutdown enters its fourth week, Senate Republicans are headed to the White House on Tuesday — not for urgent talks on how to end it, but for a display of unity with President Donald Trump as they refuse to negotiate on any Democratic demands.Senate Democrats, too, are confident in their strategy to keep voting against a House-passed bill that would reopen the government until Republicans, including Trump, engage them on extending health care subsidies that expire at the end of the year.With both sides showing no signs of movement, it’s unclear how long the stalemate will last — even as hundreds of thousands of federal workers will miss another paycheck in the coming days and states are sounding warnings that key federal programs will soon lapse completely. And the meeting at the White House appears unlikely, for now, to lead to a bipartisan resolution as Senate Republicans are dug in and Trump has followed their lead.“I think the president’s ready to get involved on having the discussion” about extending the subsidies, said Senate Republican leader John Thune, R-S.D., on Monday. “But I don’t think they are prepared to do that until (Democrats) open up the government.”Missed paychecks and programs running out of moneyWhile Capitol Hill remains at a standstill, the effects of the shutdown are worsening. Federal workers are set to miss additional paychecks amid total uncertainty about when they might eventually get paid. Government services like the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, and Head Start preschool programs that serve needy families are facing potential cutoffs in funding. On Monday, Energy Secretary Chris Wright said the National Nuclear Security Administration is furloughing 1,400 federal workers. The Federal Aviation Administration has reported air controller shortages and flight delays in cities across the United States.Still, there has been little urgency in Washington as each side believes the other will eventually cave.“Our position remains the same, we want to end the shutdown as soon as we can and fix the ACA premium crisis that looms over 20 million hardworking Americans,” said Senate Democratic leader Chuck Schumer, D-N.Y., on Monday, referring to the expanded Affordable Care Act subsidies that expire in December.Schumer called the White House meeting a “pep rally” and said it was “shameful” that House Speaker Mike Johnson, R-La., has kept the House out of town during the shutdown.November deadlinesMembers of both parties acknowledge that as the shutdown drags on, it is becoming less likely every day that Congress will be able to either extend the subsidies or fund the government through the regular appropriations process. The House GOP bill that Senate Democrats have now rejected 11 times would only keep the government open through Nov. 21.Thune on Monday hinted that Republicans may propose a longer extension of current funding instead of passing individual spending bills if the shutdown doesn’t end soon. Congress would need to pass an extension beyond Nov. 21, he said, “if not something on a much longer-term basis.”Democrats are focused on Nov. 1, when next year’s enrollment period for the ACA coverage begins and millions of people will sign up for their coverage without the expanded subsidy help that began during the COVID-19 pandemic. Once those sign-ups begin, they say, it would be much harder to restore the subsidies even if they did have a bipartisan compromise.“Very soon Americans are going to have to make some really difficult choices about which health care plan they choose for next year,” Schumer said.What about Trump?Tuesday’s White House meeting will be a chance for Republican senators to engage with the president on the shutdown after he has been more involved in foreign policy and other issues.The president last week dismissed Democratic demands as “crazy,” adding, “We’re just not going to do it.”North Dakota Sen. John Hoeven said that Republican senators will talk strategy with the president at Tuesday’s lunch. “Obviously, we’ll talk to him about it, and he’ll give us his ideas, and we’ll talk about ours,” Hoeven said. “Anything we can do to try to get Democrats to join us” and pass the Republican bill to reopen the government, Hoeven said.Still, GOP lawmakers expect Trump to stay in line with their current posture to reject negotiations until the government is open.“Until they put something reasonable on the table to talk about, I don’t think there’s anything to talk about,” said Louisiana Sen. John Kennedy.Democrats say they believe Trump has to be more involved for the government to reopen.“He needs to get off the sidelines, get off the golf course,” said House Democratic leader Hakeem Jeffries, D-N.Y. “We know that House and Senate Republicans don’t do anything without getting permission from their boss, Donald J. Trump.”___Associated Press writers Kevin Freking, Stephen Groves and Matt Brown contributed to this report.

    WASHINGTON —

    As the government shutdown enters its fourth week, Senate Republicans are headed to the White House on Tuesday — not for urgent talks on how to end it, but for a display of unity with President Donald Trump as they refuse to negotiate on any Democratic demands.

    Senate Democrats, too, are confident in their strategy to keep voting against a House-passed bill that would reopen the government until Republicans, including Trump, engage them on extending health care subsidies that expire at the end of the year.

    With both sides showing no signs of movement, it’s unclear how long the stalemate will last — even as hundreds of thousands of federal workers will miss another paycheck in the coming days and states are sounding warnings that key federal programs will soon lapse completely. And the meeting at the White House appears unlikely, for now, to lead to a bipartisan resolution as Senate Republicans are dug in and Trump has followed their lead.

    “I think the president’s ready to get involved on having the discussion” about extending the subsidies, said Senate Republican leader John Thune, R-S.D., on Monday. “But I don’t think they are prepared to do that until (Democrats) open up the government.”

    Missed paychecks and programs running out of money

    While Capitol Hill remains at a standstill, the effects of the shutdown are worsening. Federal workers are set to miss additional paychecks amid total uncertainty about when they might eventually get paid. Government services like the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, and Head Start preschool programs that serve needy families are facing potential cutoffs in funding. On Monday, Energy Secretary Chris Wright said the National Nuclear Security Administration is furloughing 1,400 federal workers. The Federal Aviation Administration has reported air controller shortages and flight delays in cities across the United States.

    Still, there has been little urgency in Washington as each side believes the other will eventually cave.

    “Our position remains the same, we want to end the shutdown as soon as we can and fix the ACA premium crisis that looms over 20 million hardworking Americans,” said Senate Democratic leader Chuck Schumer, D-N.Y., on Monday, referring to the expanded Affordable Care Act subsidies that expire in December.

    Schumer called the White House meeting a “pep rally” and said it was “shameful” that House Speaker Mike Johnson, R-La., has kept the House out of town during the shutdown.

    November deadlines

    Members of both parties acknowledge that as the shutdown drags on, it is becoming less likely every day that Congress will be able to either extend the subsidies or fund the government through the regular appropriations process. The House GOP bill that Senate Democrats have now rejected 11 times would only keep the government open through Nov. 21.

    Thune on Monday hinted that Republicans may propose a longer extension of current funding instead of passing individual spending bills if the shutdown doesn’t end soon. Congress would need to pass an extension beyond Nov. 21, he said, “if not something on a much longer-term basis.”

    Democrats are focused on Nov. 1, when next year’s enrollment period for the ACA coverage begins and millions of people will sign up for their coverage without the expanded subsidy help that began during the COVID-19 pandemic. Once those sign-ups begin, they say, it would be much harder to restore the subsidies even if they did have a bipartisan compromise.

    “Very soon Americans are going to have to make some really difficult choices about which health care plan they choose for next year,” Schumer said.

    What about Trump?

    Tuesday’s White House meeting will be a chance for Republican senators to engage with the president on the shutdown after he has been more involved in foreign policy and other issues.

    The president last week dismissed Democratic demands as “crazy,” adding, “We’re just not going to do it.”

    North Dakota Sen. John Hoeven said that Republican senators will talk strategy with the president at Tuesday’s lunch. “Obviously, we’ll talk to him about it, and he’ll give us his ideas, and we’ll talk about ours,” Hoeven said. “Anything we can do to try to get Democrats to join us” and pass the Republican bill to reopen the government, Hoeven said.

    Still, GOP lawmakers expect Trump to stay in line with their current posture to reject negotiations until the government is open.

    “Until they put something reasonable on the table to talk about, I don’t think there’s anything to talk about,” said Louisiana Sen. John Kennedy.

    Democrats say they believe Trump has to be more involved for the government to reopen.

    “He needs to get off the sidelines, get off the golf course,” said House Democratic leader Hakeem Jeffries, D-N.Y. “We know that House and Senate Republicans don’t do anything without getting permission from their boss, Donald J. Trump.”

    ___

    Associated Press writers Kevin Freking, Stephen Groves and Matt Brown contributed to this report.

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  • Florida is one of ‘hardest hit’ states if ACA credits expire

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    As the government shutdown entered its third week, Democrats continued to withhold their support for a government funding bill unless Republicans agree to extend expiring Affordable Care Act marketplace subsidies. 

    A Democratic lawmaker said Florida will be affected by the expiring subsidies more than any other state after the Nov. 1 ACA enrollment start.

    “FL will be HARDEST HIT by Obamacare cuts in the nation on Nov 1st,” U.S. Rep. Darren Soto, D-Fla., wrote Oct. 13 on X. “4.6 Million Floridians will see HUGE healthcare hikes of 75% or more unless Congress fixes it. The clock is ticking!” 

    Soto, who represents Florida’s 9th Congressional District, which includes eastern Orlando and the cities of Kissimmee and St. Cloud, expanded on his point in an Oct. 12 Orlando Sentinel opinion editorial. “The top 10 Obamacare congressional districts are all in the state,” Soto wrote. “Our district has the second-most enrollment in the nation, with 271,000 people receiving the Premium Tax Credits.”

    Without congressional action, the pandemic-era enhanced ACA credits will expire Dec. 31, and researchers estimate premiums around the U.S. will rise by more than 114% on average for enrollees who use the credits, leading to an estimated 3.8 million more people becoming uninsured over the next decade.

    Health care experts said Soto’s Florida warning is on point.

    “Florida might be tied with Texas in the percentage of enrollment increase since the credits have been in place, but it has always had a lot of people signing up for the ACA,” said Cynthia Cox, vice president of the ACA program at KFF, a health care research think tank. “This might be due to demographics and the kinds of jobs residents have, but Florida would definitely be the top, or tied as the top state affected by these cuts.”

    Soto’s office pointed PolitiFact to Congressional Budget Office and KFF estimates for coverage loss and premium increases if the credits expire.

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    What will happen in Florida if the enhanced ACA tax credits expire?

    Florida has more people enrolled in Affordable Care Act plans than any state — around 4.7 million in 2025. About 97% of enrollees receive a discount that makes their plans cheaper.

    In 2021, then-President Joe Biden signed legislation that made ACA subsidies more generous, by reducing the maximum amount enrollees would have to pay for coverage and enabling households whose incomes were higher than 400% of the federal poverty level to receive the subsidies. Congress renewed these enhanced subsidies in 2022 through the end of 2025, so they are now poised to expire.

    Determining whether Florida would be the “hardest-hit” state if the enhanced credits expire depends on how that is measured. Data shows Florida as one of the top states, if not the top, for the number of people affected.

    “There are different ways to measure the effects,” Cox said. “For instance, if it’s the steepest premium increases for a smaller number of people, that might be West Virginia or Wyoming.”

    An Oct. 14 Washington Post analysis found that Florida has the highest number of people receiving the enhanced credits, which could result in the state bearing the biggest blow, relative to its population, of residents becoming uninsured or experiencing steep premium increases. The analysis puts Texas second. 

    About 8% of ACA enrollees under 65 nationwide use the enhanced credit; but in Florida, the same share is 24% — the highest in the country, The Washington Post found. 

    That disparity is largely because Florida did not expand Medicaid eligibility, making the ACA the main pathway for people with lower incomes to obtain affordable coverage. Many people with ACA coverage are self-employed or work for a small business.

    About 2.4 million Floridians with ACA Marketplace plans in 2025 earn under 138% of the federal poverty limit. 

    “When states expand Medicaid, anyone who makes below 138% of the federal poverty level is eligible for the program, so they’re not on the ACA marketplaces,” Cox said. “In states that didn’t expand Medicaid, like Florida, Texas and Georgia, residents can get ACA coverage and qualify for the enhanced credits.”

    Another study, by the nonpartisan Urban Institute think tank and the Commonwealth Fund health care research organization, put Texas ahead of Florida for the overall number of people who will not enroll in ACA plans in 2026.

    “In terms of absolute numbers of people becoming uninsured, our tables show Texas being hit harder,” said Jessica Banthin, a senior fellow at the Urban Institute’s health policy division and one of the report’s authors. “But in terms of population share, it’s very likely the case that Florida is being hit harder.”

    A KFF analysis found that, in every Florida congressional district, enrollees over age 60 who make just over 400% of the federal poverty level — about $84,600 for two people — will face premiums in 2026 quadruple what they pay now, on average.

    Overall, lower- and middle-income Floridians will feel the brunt of expired subsidies.

    “Especially an older couple who are early retirees who may still have a moderate income,” Cox said. “They won’t have any other option and may see a premium increase of $20,000 because they aren’t eligible for Medicare yet.”

    Floridians with private employer-based insurance may also see indirect effects.

    “If many more people in Florida become uninsured, then hospitals and other providers will face an increase in patients who can no longer pay their medical bills,” said Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute. “These costs are projected to result in service cutbacks, hospital closures and mergers, particularly in rural areas, which affect everyone.”

    Our ruling

    Soto said Florida will be the “hardest hit” state if ACA enhanced subsidies expire.

    Florida has 4.7 million people enrolled in ACA plans in 2025, more than in any other state. One analysis found that 24% of Florida’s enrollees under age 65 use enhanced subsidies, the highest in the country, compared with 8% of enrollees nationally.

    “Hardest hit” can mean many things. In terms of the share of enrollees relative to a state’s population, Florida is safely one of the most affected states, if not the most affected for people who will see premium increases or become uninsured as a result of higher prices. By raw numbers in another analysis, Texas might be first, because it has a bigger population.

    Experts said other states such as West Virginia may face steeper premium hikes, but for a smaller number of people. 

    Soto’s statement is accurate but needs additional information. We rate it Mostly True.

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  • Central Florida Dems among lawmakers warning about looming health care crisis

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    Florida has more to lose than any other state if Congress doesn’t extend enhanced premium tax credits for so-called Obamacare coverage.

    That was the message a trio of Democratic members of Congress delivered Tuesday on Day 14 of the government shutdown. At the center of the shutdown is a partisan battle over extending the tax credits to lower the costs of health care coverage. 

    The credits expire at the end of the year. Democrats are holding up government funding to pressure Republicans into extending them. While Republicans have said they are open to talks, they insist Democrats vote to continue government operations until late November.

    “If Trump and Republicans continue to refuse to negotiate our way out of this health care coverage crisis, it’s going to be absolutely brutal, disproportionately for Florida,” said U.S. Rep. Debbie Wasserman Schultz, a Democrat from Weston.

    Florida leads the nation in the number of people who purchase insurance through the federal exchange (healthcare.gov), which was established under the Affordable Care Act (ACA), sometimes called Obamacare. 

    U.S. Centers for Medicare & Medicaid Services data from March show that of the 4.7 million Florida residents with an Obamacare plan in 2025, 4.6 million receive the tax credits.

    Obamacare enrollment for 2026, meanwhile, is set to begin next month.

    “If these credits expire, millions of people will — and thousands of people that we represent,  really, hundreds of  thousands — will face double, triple, or quadruple price hikes in their [health insurance] premiums. That’s not exaggeration or hyperbole. We’ve seen the notices,” said Wasserman Schultz, whose district includes 209,000 Obamacare enrollees, 203,000 of whom receive the tax credits. 

    “We’ve talked to insurance companies and we know that that’s what’s coming,” she added. “And you all know what that really means. Families will be forced to drop coverage, chronic diseases will go undiagnosed, ERs will be flooded.”

    Joining Wasserman Schultz in a Zoom meeting were U.S. Reps. Darren Soto and Maxwell Frost, who said the loss of the enhanced premiums plus Florida’s decision to not expand Medicaid to low-income childless adults will prove devastating.

    Soto said his congressional district has the second highest Obamacare enrollment (271,000) in the nation.

    “And there’s a good reason for that. We have a lot of folks working for small businesses. We have a lot of folks who are independent contractors, and they don’t have access to affordable, employer-based health care, so they’ve gone on the exchange, and the fact that Florida didn’t expand Medicaid only made it more desperate for folks to have to use the ACA exchange,” Soto said.

    He added: “Remember when Donald Trump ran on lowering costs? Well, now he’s running away from lowering costs with this key negotiation.”

    Advanced premium tax credits have been available since passage of the Affordable Care Act. During COVID, Congress agreed to make the premium tax credits more generous. Those enhanced credits lower out-of-pocket costs for the coverage and allow people who earn more money to qualify for the subsidies.

    Only Alabama, Mississippi, and Texas (all of which have lower Obamacare enrollment) have lower average monthly premiums.

    While the battle over the tax credits has been partisan, conservatives including Associated Industries of Florida President and CEO Brewster Bevis, Florida Hospital Association President and CEO Mary Mayhew, President and CEO of Florida Association of Community Health Centers Jonathan Chapman, and President and CEO of the Florida Hispanic Chamber of Commerce Julio Fuentes aligned under the Florida Conservatives for Affordable Health Care moniker and came out in support of their continuation over the summer.

    “I have been around this debate over health care coverage for decades and, while the politics of the ACA have been heated over the years, there should be a unified political voice in support of the federal marketplace and the premiums assistance in Florida,”  Mayhew said during a press conference this summer.

    U.S. Sens. Rick Scott and Ashley Moody both oppose extending the tax credits. Moody’s position could hurt her election bid next year, a public opinion survey conducted by the Tyson Group shows.

    Scott, the multimillionaire former health care executive who launched his political career opposing Obamacare, doubled down on his opposition to the longstanding federal health care law last week on Fox News’ The Sunday Briefing.

    ‘Heartbreaking’

    For his part, Frost said the argument is an extension of the battle this summer over the GOP’s “One Big Beautiful Bill” and that he was “proud” that Democrats are “standing strong” on the issue.

    “We are the party of the working class, we’re the party of working people, and we don’t want people’s health care costs to go up anywhere from 50% to 300%. We don’t want millions of people in this country losing their health care, because we believe health care is a human right for every single person in this country, and that’s what we’re fighting for,” he said.

    Frost said his office has asked constituents to share videos of themselves talking about the looming health insurance premium increases they face. His office, he said, has been posting them online.

    One “heartbreaking” story he described involved a woman who said her monthly premiums were about to double.

    “She’s having to cut from her grocery trips. She had to cancel a trip to go see her parents that she hasn’t seen in a long, long time. And a lot of people are considering having to change their housing situation because the rent is too damn high,” Frost said.

    “We have to remember that Donald Trump is throwing us into this healthcare crisis while he’s also thrown us into a grocery store crisis, while he’s also thrown us into a housing crisis, even worse than it ever was before. Everything is so much more expensive.”

    With wages stagnant and costs of living increasing, Frost said, “working people just need a break, and taking away their health care — it’s one of the most inhumane things a person can do.”

    Silence

    Meanwhile, state political leaders to date have been silent on the issue.

    The three Democrats were critical of Insurance Commissioner Michael Yaworski and Gov. Ron DeSantis for not warning state residents about the increases.

    “Absolutely,” Soto said when asked whether the governor and insurance commissioner should be making people aware.

    “They can’t hide these numbers. Obviously, people want to know, and they should know, and there’s a duty to tell them ahead of time.”

    Frost said DeSantis and Yaworski are motivated by political considerations.

    “The governor knows that in about a year, he’s going to become pretty irrelevant on the national stage, and he’s trying to find relevancy. He doesn’t want to rub Trump the wrong way. And so instead of looking out for Floridians and what’s best for the people he’s supposed to lead and represent, he’s going to keep his mouth shut and continue to play partisan games,” Frost said.

    OIR presentation

    Meanwhile, OIR Deputy Commissioner for Life and Health Alexis Bakofsy updated the House Health Health Care Facilities & Systems Subcommittee Tuesday afternoon, including news that a statewide average 34% increase in premiums will take effect Jan. 1.

    An OIR slide presentation shows the state expects Obamacare enrollment to “drop significantly during 2026 Open Enrollment with the expiration of enhanced subsidies & Federal Rule implementation.” OIR has a demographic breakout but Bakofsy said she didn’t have the information available with her.

    She did tell committee members that 95% of Obamacare enrollees live in a county with at least four carriers. Monroe County is the only area in the state with only one health insurer offering a Obamacare plan through the exchange, the result of Aetna exiting the market (in Florida and nationally.)

    Bakofsy repeatedly said Florida consumers should shop, given the changes that are occurring.

    “When I say ‘shop’ I mean understand how you’re going to be impacted both on the exchange but also what are your options off exchange. Every consumer is going to be different to the extent that we can provide you with resources so that they can go. I would hate for someone to come to Dec. 15 and realize that the plan that they had, the plan they want to keep, is no longer available.”

    Bakofsy also told members that the OIR plans to collect data on enrollment and claims starting next year to ensure the office can effectively track participation in the market.

    The OIR had not publicized the steep rate increases, a fact that Bakofsy acknowledged and which irked committee member and state Rep. Robin Bartleman, a Democrat from Weston.

    Bartleman said many residents haven’t even received notice from insurance companies warning them of the rate increases (Florida law requires the notice to go out 45 day in advance. Bakofsy said that gives the carriers until mid-November to send the notices).

    “So, what? What is your plan? Because everyone this committee, we’re going to be left holding that ball, and we had nothing to do with this. But you work for the state. You work for the governor. What are you going to do, because it’s not just low-income people or minority people. I can give you the numbers of every person in this community and how many people in your district aren’t going to be able to afford health care insurance. What can you do to help us, help Floridians get this information out?”

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    Florida has more to lose than any other state if Congress doesn’t extend enhanced premium tax credits for Obamacare coverage, Democrats argue

    Disney argued a strike by any of its employees would violate a contract the company has with the union covering its workers

    Alex Kelly discussed what he said was a ‘huge challenge’ in getting young people interested in working in a skilled labor environment



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  • Stalemate in Congress puts ACA subsidies, and millions of Americans, at risk

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    Lori Hunt, a breast cancer survivor, says she “couldn’t afford” health insurance without the subsidies she receives through the Affordable Care Act.

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  • GOP Sen. Kevin Cramer says Congress can reach health care deal after government reopens

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    GOP Sen. Kevin Cramer says Congress can reach health care deal after government reopens – CBS News










































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    One week after it began, lawmakers appear no closer to ending the government shutdown. Republican Sen. Kevin Cramer of North Dakota joins “The Takeout” to discuss the state of play.

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  • Sen. Peter Welch lays out health care concerns fueling government shutdown

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    Sen. Peter Welch lays out health care concerns fueling government shutdown – CBS News










































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    The federal government shutdown stretched into its second day on Thursday with no sign of a deal. Democratic Sen. Peter Welch of Vermont joins “The Takeout” to discuss the stakes of the fight.

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  • Do Democrats want health care for ‘illegal aliens’?

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    As the U.S. headed for a government shutdown, Republicans repeatedly accused Democrats of forcing the closure because they want to give health care access to immigrants in the U.S. illegally.

    “Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of healthcare benefits to illegal aliens,” Vice President JD Vance said Sept. 28 on “Fox News Sunday.”

    President Donald Trump, House Speaker Mike Johnson and Republican members of Congress have repeated this line.

    It’s wrong.

    Democrats have refused to vote for Republicans’ resolution to extend the federal spending deadline, and their position does, in part, hinge on health care spending. Democrats want to extend pandemic-era Affordable Care Act subsidies that are set to expire at the end of the year and roll back Medicaid cuts in the tax and spending bill that Trump signed into law this summer. 

    Sign up for PolitiFact texts

    The Democrats’ proposal wouldn’t give health care to immigrants illegally in the U.S. — they are already largely ineligible for federally funded health care. Instead, the proposal would restore access to certain health care programs for legal immigrants who will lose access under the Republican law.

    The White House did not respond to PolitiFact’s request for comment for this fact-check. Vance addressed criticism of his talking point in another interview by saying it was included in the Democrats’ spending proposal; it’s not.

    A White House X account followed up with screenshots of the Democratic proposal repealing a section of the Republican law labeled “alien Medicaid eligibility.” It’s important to know that these changes would not give Medicaid access to immigrants illegally in the U.S.

    Vance defended his statement again in an Oct. 1 White House press conference, saying former President Joe Biden “waived away illegal immigration status” that helped migrants access federal assistance. It’s important to note that many people granted lawful status through humanitarian parole or Temporary Protected Status programs don’t automatically qualify for Medicaid; TPS  recipients aren’t eligible, and many people who entered the U.S. on humanitarian parole are required to wait five years before accessing it.

    The Trump administration has ended humanitarian parole and Temporary Protected Status for many people, rendering them ineligible for Medicaid and the Affordable Care Act marketplace.

    We did not find evidence that Democrats want to spend “hundreds of billions” in costs for insuring migrants with unlawful presence. 

    Immigrants in the U.S. illegally are ineligible for federally funded health care

    The vast majority of federal health care dollars cannot be spent on health care for people in the U.S. illegally. They cannot enroll in Medicaid or Medicare, and they are ineligible to purchase health care coverage through the Affordable Care Act marketplace. A small Medicaid program reimburses hospitals for uninsured emergency care, which can include immigrants in the country illegally but is not exclusive to them.

    Some states including California and Illinois expanded Medicaid coverage for people regardless of their immigration status, and the states pay for that. Federal law already banned states from using federal money for these programs. An earlier version of the Republican spending law would have penalized such states by withholding funding, but that provision didn’t last.

    People in the country illegally might receive some federally funded health care in emergency cases; in those situations, hospitals must provide care even if a person is uninsured or in the country illegally. Emergency Medicaid covers hospital care for immigrants who would be eligible for Medicaid if not for their immigration status. The Republican tax and spending law reduced the amount hospitals can receive for emergency immigrant care.

    Most of the Emergency Medicaid spending is used on childbirth. In all, it represented less than 1% of total Medicaid spending in fiscal year 2023, according to KFF, a health think tank.

    Republican law limited health care access for immigrants with legal status

    The Republican tax and spending law made several changes to health care eligibility for immigrants in the country with legal permission. An estimated 1.4 million legal immigrants are expected to lose their health insurance, according to KFF’s analysis of Congressional Budget Office projections. 

    Starting October 2026, the law will restrict eligibility for Medicaid and the Children’s Health Insurance Program to lawfully permanent residents, people from the Marshall Islands, Micronesia or Palau who lawfully reside in the U.S. under an international agreement, and certain Cubans and Haitians.

    Previously, a broad group described as “qualified noncitizens” were eligible for Medicaid and CHIP, including refugees and people granted asylum.

    Some immigrants who are eligible for Medicaid and CHIP, such as lawful permanent residents, are required to wait five years before accessing the benefits. 

    The law also limited Affordable Care Act marketplace eligibility to the same group eligible for Medicaid and CHIP beginning Jan. 1, 2027. Previously, people who were described as “lawfully present” were eligible. That group included the “qualified noncitizens” eligible for Medicaid and people with short-term statuses, such as Temporary Protected Status or international students.

    Beneficiaries of the Deferred Action for Childhood Arrivals program, known as DACA, for immigrants who entered the U.S. illegally as children were previously eligible for Affordable Care Act coverage and its subsidies. They are ineligible after an August Trump administration rule.

    Democrats’ proposal would restore legal immigrants’ access to federally funded health care

    The Democrats’ Sept. 17 budget proposal would, in part, permanently extend the Affordable Care Act subsidies and roll back billions in Republican cuts to Medicaid and other health programs. 

    The change would make Medicaid, CHIP and Affordable Care Act coverage available to all legal immigrants who were previously eligible for it, such as refugees and people granted asylum.

    The Democratic proposal would not broaden eligibility to federally funded health care programs to immigrants who are in the U.S. illegally.

    Vance said the Democratic policies would “give hundreds of billions of dollars of health care benefits to illegal aliens,” and the White House did not offer its source for that figure. When Johnson was pressed to support a similar talking point, he referenced the Congressional Budget Office. An August KFF analysis of CBO estimates found that the Republican law’s provisions related to legal immigrants would reduce federal spending by $131 billion; this projection did not include an estimate for people without legal status.

    Our ruling

    Vance said, “Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens.”

    Immigrants in the U.S. illegally are largely ineligible for federally funded health care programs Medicare and Medicaid, and they cannot seek coverage in the Affordable Care Act marketplace or apply for subsidies.

    The Democrats’ budget proposal would not change that.

    The Democrats want to restore access to certain health care programs to legal immigrants who will lose access under the Republican tax and spending law — among other measures aimed at making Medicaid and Affordable Care Act insurance plans easier to keep. 

    Their proposal would not grant federally supported health care benefits to people in the U.S. illegally, because they did not have access to them in the first place. The small amount of funding designated for Emergency Medicaid reimburses hospitals that provide emergency care to immigrants who would be eligible for Medicaid if not for their immigration status. Finally, we did not find evidence for Vance’s assertion that Democrats want “hundreds of billions” in health benefits for migrants in the country illegally. 

    We rate the statement False.

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  • US government shuts down with funding deal out of reach on Capitol Hill

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    (CNN) — The federal government has officially shut down after a deadlocked Congress failed to pass a funding measure to keep the lights on – and no one inside the Capitol knows what will happen next.

    A weekslong stalemate between Republicans and Democrats over enhanced Obamacare subsidies has turned into the first government shutdown since 2019. Leaders of both parties are privately and publicly adamant that they will not be blamed for the funding lapse. Republicans insist Democrats need to simply agree to extend current funding for another seven weeks. But Democrats refuse to do so without major concessions for lending their votes to pass any funding measure in the Senate.

    Senators left the Capitol on Tuesday night in a state of deep uncertainty about how long the shutdown could last. The Senate is on track to vote again late Wednesday morning on the same GOP funding plan — which Republican leaders have vowed to put on the floor day after day until enough Democrats yield and agree to reopen the government. But many Democrats have declared publicly they will not relent, even as President Donald Trump and his budget office have ramped up threats to use the shutdown to further shrink the size of government — in some cases permanently.

    “It’s going to be very harmful for working people,” a visibly exasperated GOP Sen. Josh Hawley told CNN moments after Democrats blocked the bill. “I don’t know how it ends. They don’t know how it ends,” he said. “You’re asking millions of people to pay a really high price.”

    In the Democratic party, the pressure is now on Senate Minority Leader Chuck Schumer to keep more of his members from yielding to the GOP pressure campaign to support their seven-week funding bill and agree to negotiate later on the Obamacare subsidies. That task will become tougher with every day of a shutdown, particularly as Trump has threatened to cancel programs favored by Democrats. Inside the party, there’s growing concern about the damage that the White House budget office could cause across the country that can’t be easily reversed by Congress.

    Asked if he’s concerned that the White House could do permanent damage to the government, Sen. Sheldon Whitehouse told CNN: “Of course, who wouldn’t be? We have a madman in charge.”

    He said Democrats now need to “make sure that Trump is held responsible for all of that, pays the price for it.”

    Some cracks have begun to show: Two more members flipped their positions to back the GOP bill on Tuesday night in the final vote before a shutdown: Democratic Sen. Catherine Cortez Masto of Nevada and Sen. Angus King of Maine, who caucuses with Democrats. Democratic Sen. John Fetterman of Pennsylvania also backed the GOP bill and has criticized his party’s strategy during the shutdown fight.

    At least two other Democrats appeared to be seriously contemplating their vote on the floor Tuesday — which Republicans took as another sign of weakening in the Democratic party’s stance.

    Senior Democrats had long conversations with Sens. Jeanne Shaheen and Maggie Hassan, both of New Hampshire, on the floor before they ultimately voted with Schumer and the rest of their party. After Shaheen cast her vote, she went straight to Senate Republican Leader John Thune and spoke with him privately for several minutes.

    Asked later about what appeared to be extensive lobbying ahead of her vote: Shaheen told reporters: “No, I was just having conversations with other people who are thinking long and hard about how we move forward.”

    She added that she ultimately decided to vote against the bill to force Republicans into talks on ACA subsidies: “I thought getting this done so that we can now hopefully get back to the negotiating table was the best approach.”

    The beefed up premium subsidies, which were first approved as part of a Biden administration Covid-19 rescue package in 2021 and later extended, make Obamacare coverage more affordable for lower-income Americans and enable more middle class households to qualify for assistance.

    They spurred a record 24 million people to sign up for policies for 2025. If the enhanced subsidies are allowed to lapse at year’s end, premiums are expected to skyrocket by 75%, on average, for 2026, according to KFF, a nonpartisan health policy research group.

    Meanwhile, GOP leaders insisted there are other Democrats who are anxious about a shutdown and want to find an off-ramp to the looming crisis.

    “There are Democrats who are very unhappy,” Thune told reporters Tuesday night, adding that he is “having conversations” with some Democrats that he declined to name. “There are others out there I think who don’t want to shut down the government but are being put in a position by their leadership that ought to make all of them very uncomfortable. Tonight is evidence, there is some movement there.”

    Schumer, however, was adamant that the American people would see Republicans as causing the shutdown — not his own party — because of the looming health care cliff: “At midnight, the American people will blame them for bringing the government to a halt.”

    But asked by CNN whether he can guarantee that nine of his Democrats would not cross over and vote with Republicans, the New York Democrat did not answer.

    “Our guarantee is to the American people. We’re going to fight as hard as we can for their health care, plain and simple,” Schumer said, when pressed about the GOP’s plan to put up the same funding plan again and again until enough Democrats yield.

    Democratic Sen. Mazie Hirono of Hawaii was hopeful but also doubtful pressure to cut a deal will build on Republicans from their own constituents who will face higher health care costs when their enhanced subsidies expire at the end of this year.

    “Let’s hope that they come around to the fact that they’re hurting a lot of their own constituents by not negotiating on the health care issue,” she said. “But you never know, because they apparently don’t care.”

    GOP Sen. Lisa Murkowski of Alaska — who is seen as a potential dealmaker on any ACA subsidies deal — told reporters that she believes there still is room to negotiate on health care.

    “I think we do have to talk about the impending cliff that we’re looking at with the premium tax credits. What that’s going to look like, I think, is absolutely a subject of discussion,” Murkowski said.

    “I hope that people who are interested in seeing this shutdown come to a quick end are willing to talk about ways that we might be able to accomplish that,” Murkowski said.

    Shutdown impact

    The shuttering of the federal government means that hundreds of thousands of federal employees will be furloughed, while others who are considered essential will have to keep reporting for work – though many won’t get paid until the impasse ends. Still others, however, will continue collecting paychecks since their jobs are not funded through annual appropriations from Congress.

    About 750,000 federal staffers – who earn a total of roughly $400 million each day – could be furloughed, according to the Congressional Budget Office. It noted that the figure could change if the shutdown is prolonged.

    Americans will also feel the shutdown in a variety of ways. While some essential activities will continue, other services will shut down. While air traffic controllers and Transportation Security Administration employees will remain on the job, staffing shortages have led to snarled flights and longer security lines during past shutdowns.

    It remains unclear whether visitors will be able to go to the more than 400 national park sites during the shutdown, but the Smithsonian museums and the National Zoo will be open at least until October 6 using budget funds from previous years. In the past, some states have said they will use their own funds to keep their national parks open during the impasses.

    Senior citizens, people with disabilities and others will continue to receive their monthly Social Security payments, while jobless Americans will keep getting unemployment benefits as long as their state agencies have enough administrative funds to process them. Medicare and Medicaid payments will also continue to be distributed.

    Medical care and critical services for veterans will not be interrupted during a government shutdown. This includes suicide prevention programs, homelessness programs, the Veterans Crisis Line, benefit payments and burials in national cemeteries. However, the GI Bill Hotline will be suspended, as would assistance programs to help service members shift to civilian life. Also, the permanent installation of headstone and cemetery grounds maintenance will not occur until the shutdown is over.

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  • Government shutdown begins as nation faces new period of uncertainty

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    Plunged into a government shutdown, the U.S. is confronting a fresh cycle of uncertainty after President Donald Trump and Congress failed to strike an agreement to keep government programs and services running by Wednesday’s deadline.What we know: The Senate voted down two short-term spending bills on Tuesday: one Democratic proposal and one Republican proposal that passed in the House.The Senate has adjourned until Wednesday morning. The House is not in session this week.Senate Democrats are demanding that health care subsidies and Medicaid cuts be addressed before passing a funding bill.Thousands of federal workers are facing furloughs or layoffs.This is the first government shutdown in nearly seven years. Roughly 750,000 federal workers are expected to be furloughed, some potentially fired by the Trump administration. Many offices will be shuttered, perhaps permanently, as Trump vows to “do things that are irreversible, that are bad” as retribution. His deportation agenda is expected to run full speed ahead, while education, environmental and other services sputter. The economic fallout is expected to ripple nationwide.”We don’t want it to shut down,” Trump said at the White House before the midnight deadline.But the president, who met privately with congressional leadership this week, appeared unable to negotiate any deal between Democrats and Republicans to prevent that outcome.This is the third time Trump has presided over a federal funding lapse, the first since his return to the White House this year, in a remarkable record that underscores the polarizing divide over budget priorities and a political climate that rewards hardline positions rather than more traditional compromises.Plenty of blame being thrown aroundThe Democrats picked this fight, which was unusual for the party that prefers to keep government running, but their voters are eager to challenge the president’s second-term agenda. Democrats are demanding funding for health care subsidies that are expiring for millions of people under the Affordable Care Act, spiking the costs of insurance premiums nationwide.Republicans have refused to negotiate for now and have encouraged Trump to steer clear of any talks. After the White House meeting, the president posted a cartoonish fake video mocking the Democratic leadership that was widely viewed as unserious and racist.What neither side has devised is an easy offramp to prevent what could become a protracted closure. The ramifications are certain to spread beyond the political arena, upending the lives of Americans who rely on the government for benefit payments, work contracts and the various services being thrown into turmoil.”What the government spends money on is a demonstration of our country’s priorities,” said Rachel Snyderman, a former White House budget official who is the managing director of economic policy at the Bipartisan Policy Center, a think tank in Washington.Shutdowns, she said, “only inflict economic cost, fear and confusion across the country.” Economic fallout expected to ripple nationwideAn economic jolt could be felt in a matter of days. The government is expected Friday to produce its monthly jobs report, which may or may not be delivered.While the financial markets have generally “shrugged” during past shutdowns, according to a Goldman Sachs analysis, this one could be different partly because there are no signs of broader negotiations.”There are also few good analogies to this week’s potential shutdown,” the analysis said.Across the government, preparations have been underway. Trump’s Office of Management and Budget, headed by Russ Vought, directed agencies to execute plans for not just furloughs, as are typical during a federal funding lapse, but mass firings of federal workers. It’s part of the Trump administration’s mission, including its Department of Government Efficiency, to shrink the federal government.What’s staying open and shutting downThe Medicare and Medicaid health care programs are expected to continue, though staffing shortages could mean delays for some services. The Pentagon would still function. And most employees will stay on the job at the Department of Homeland Security.But Trump has warned that the administration could focus on programs that are important to Democrats, “cutting vast numbers of people out, cutting things that they like, cutting programs that they like.”As agencies sort out which workers are essential, or not, Smithsonian museums are expected to stay open at least until Monday. A group of former national park superintendents urged the Trump administration to close the parks to visitors, arguing that poorly staffed parks in a shutdown are a danger to the public and put park resources at risk.Video below: House Speaker rejects Democrats’ calls for health care negotiations as government shuts downNo easy exit as health care costs soarAhead of Wednesday’s start of the fiscal year, House Republicans had approved a temporary funding bill, over opposition from Democrats, to keep government running into mid-November while broader negotiations continue.But that bill has failed repeatedly in the Senate, including late Tuesday. It takes a 60-vote threshold for approval, which requires cooperation between the two parties. A Democratic bill also failed. With a 53-47 GOP majority, Democrats are leveraging their votes to demand negotiation.Senate Majority Leader John Thune has said Republicans are happy to discuss the health care issue with Democrats — but not as part of talks to keep the government open. More votes are expected Wednesday.The standoff is a political test for Senate Democratic leader Chuck Schumer, who has drawn scorn from a restive base of left-flank voters pushing the party to hold firm in its demands for health care funding.”Americans are hurting with higher costs,” Schumer said after the failed vote Tuesday.House Speaker Mike Johnson sent lawmakers home nearly two weeks ago after having passed the GOP bill, blaming Democrats for the shutdown.”They want to fight Trump,” Johnson said Tuesday on CNBC. “A lot of good people are going to be hurt because of this.”Trump, during his meeting with the congressional leaders, expressed surprise at the scope of the rising costs of health care, but Democrats left with no path toward talks.During Trump’s first term, the nation endured its longest-ever shutdown, 35 days, over his demands for funds Congress refused to provide to build his promised U.S.-Mexico border wall.In 2013, the government shut down for 16 days during the Obama presidency over GOP demands to repeal and replace the Affordable Care Act, also known as Obamacare. Other closures date back decades. ___Associated Press writers Matt Brown, Joey Cappelletti, Will Weissert, Fatima Hussein and other AP reporters nationwide contributed to this report.

    Plunged into a government shutdown, the U.S. is confronting a fresh cycle of uncertainty after President Donald Trump and Congress failed to strike an agreement to keep government programs and services running by Wednesday’s deadline.

    What we know:

    • The Senate voted down two short-term spending bills on Tuesday: one Democratic proposal and one Republican proposal that passed in the House.
    • The Senate has adjourned until Wednesday morning. The House is not in session this week.
    • Senate Democrats are demanding that health care subsidies and Medicaid cuts be addressed before passing a funding bill.
    • Thousands of federal workers are facing furloughs or layoffs.
    • This is the first government shutdown in nearly seven years.

    Roughly 750,000 federal workers are expected to be furloughed, some potentially fired by the Trump administration. Many offices will be shuttered, perhaps permanently, as Trump vows to “do things that are irreversible, that are bad” as retribution. His deportation agenda is expected to run full speed ahead, while education, environmental and other services sputter. The economic fallout is expected to ripple nationwide.

    “We don’t want it to shut down,” Trump said at the White House before the midnight deadline.

    But the president, who met privately with congressional leadership this week, appeared unable to negotiate any deal between Democrats and Republicans to prevent that outcome.

    This is the third time Trump has presided over a federal funding lapse, the first since his return to the White House this year, in a remarkable record that underscores the polarizing divide over budget priorities and a political climate that rewards hardline positions rather than more traditional compromises.

    Plenty of blame being thrown around

    The Democrats picked this fight, which was unusual for the party that prefers to keep government running, but their voters are eager to challenge the president’s second-term agenda. Democrats are demanding funding for health care subsidies that are expiring for millions of people under the Affordable Care Act, spiking the costs of insurance premiums nationwide.

    Republicans have refused to negotiate for now and have encouraged Trump to steer clear of any talks. After the White House meeting, the president posted a cartoonish fake video mocking the Democratic leadership that was widely viewed as unserious and racist.

    What neither side has devised is an easy offramp to prevent what could become a protracted closure. The ramifications are certain to spread beyond the political arena, upending the lives of Americans who rely on the government for benefit payments, work contracts and the various services being thrown into turmoil.

    “What the government spends money on is a demonstration of our country’s priorities,” said Rachel Snyderman, a former White House budget official who is the managing director of economic policy at the Bipartisan Policy Center, a think tank in Washington.

    Shutdowns, she said, “only inflict economic cost, fear and confusion across the country.”

    Economic fallout expected to ripple nationwide

    An economic jolt could be felt in a matter of days. The government is expected Friday to produce its monthly jobs report, which may or may not be delivered.

    While the financial markets have generally “shrugged” during past shutdowns, according to a Goldman Sachs analysis, this one could be different partly because there are no signs of broader negotiations.

    “There are also few good analogies to this week’s potential shutdown,” the analysis said.

    Across the government, preparations have been underway. Trump’s Office of Management and Budget, headed by Russ Vought, directed agencies to execute plans for not just furloughs, as are typical during a federal funding lapse, but mass firings of federal workers. It’s part of the Trump administration’s mission, including its Department of Government Efficiency, to shrink the federal government.

    What’s staying open and shutting down

    The Medicare and Medicaid health care programs are expected to continue, though staffing shortages could mean delays for some services. The Pentagon would still function. And most employees will stay on the job at the Department of Homeland Security.

    But Trump has warned that the administration could focus on programs that are important to Democrats, “cutting vast numbers of people out, cutting things that they like, cutting programs that they like.”

    As agencies sort out which workers are essential, or not, Smithsonian museums are expected to stay open at least until Monday. A group of former national park superintendents urged the Trump administration to close the parks to visitors, arguing that poorly staffed parks in a shutdown are a danger to the public and put park resources at risk.

    Video below: House Speaker rejects Democrats’ calls for health care negotiations as government shuts down

    No easy exit as health care costs soar

    Ahead of Wednesday’s start of the fiscal year, House Republicans had approved a temporary funding bill, over opposition from Democrats, to keep government running into mid-November while broader negotiations continue.

    But that bill has failed repeatedly in the Senate, including late Tuesday. It takes a 60-vote threshold for approval, which requires cooperation between the two parties. A Democratic bill also failed. With a 53-47 GOP majority, Democrats are leveraging their votes to demand negotiation.

    Senate Majority Leader John Thune has said Republicans are happy to discuss the health care issue with Democrats — but not as part of talks to keep the government open. More votes are expected Wednesday.

    The standoff is a political test for Senate Democratic leader Chuck Schumer, who has drawn scorn from a restive base of left-flank voters pushing the party to hold firm in its demands for health care funding.

    “Americans are hurting with higher costs,” Schumer said after the failed vote Tuesday.

    House Speaker Mike Johnson sent lawmakers home nearly two weeks ago after having passed the GOP bill, blaming Democrats for the shutdown.

    “They want to fight Trump,” Johnson said Tuesday on CNBC. “A lot of good people are going to be hurt because of this.”

    Trump, during his meeting with the congressional leaders, expressed surprise at the scope of the rising costs of health care, but Democrats left with no path toward talks.

    During Trump’s first term, the nation endured its longest-ever shutdown, 35 days, over his demands for funds Congress refused to provide to build his promised U.S.-Mexico border wall.

    In 2013, the government shut down for 16 days during the Obama presidency over GOP demands to repeal and replace the Affordable Care Act, also known as Obamacare. Other closures date back decades.

    ___

    Associated Press writers Matt Brown, Joey Cappelletti, Will Weissert, Fatima Hussein and other AP reporters nationwide contributed to this report.

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  • Senate adjourns after failed funding votes as government heads for shutdown at midnight

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    Senate Democrats have voted down a Republican bill to keep funding the government, putting it on a near-certain path to a shutdown after midnight Wednesday for the first time in nearly seven years.What we know: The Senate voted down two short-term spending bills — one Democratic proposal and one Republican proposal.The Senate has adjourned until tomorrow morning, all but guaranteeing the government will shut down.Senate Democrats are demanding that health care subsidies and Medicaid cuts be addressed before passing a funding bill.Thousands of federal workers face furloughs or layoffs if the government shuts down at midnight Wednesday.There are fewer than 2 hours before the government shuts down for the first time in nearly seven years. The Senate rejected the legislation as Democrats are making good on their threat to close the government if President Donald Trump and Republicans won’t accede to their health care demands. The 55-45 vote on a bill to extend federal funding for seven weeks fell short of the 60 needed to end a filibuster and pass the legislation.Senate Democratic Leader Chuck Schumer, D-N.Y., said Republicans are trying to “bully” Democrats by refusing to negotiate on an extension of expanded Affordable Care Act tax credits that expire at the end of the year.”We hope they sit down with us and talk,” Schumer said after the vote. “Otherwise, it’s the Republicans will be driving us straight towards a shutdown tonight at midnight. The American people will blame them for bringing the federal government to a halt.”The failure of Congress to keep the government open means that hundreds of thousands of federal workers could be furloughed or laid off. After the vote, the White House’s Office of Management and Budget issued a memo saying “affected agencies should now execute their plans for an orderly shutdown.”Threatening retribution to Democrats, Trump said Tuesday that a shutdown could include “cutting vast numbers of people out, cutting things that they like, cutting programs that they like.”Trump and his fellow Republicans said they won’t entertain any changes to the legislation, arguing that it’s a stripped-down, “clean” bill that should be noncontroversial. Senate Majority Leader John Thune said “we can reopen it tomorrow” if enough Democrats break party lines.The last shutdown was in Trump’s first term, from December 2018 to January 2019, when he demanded that Congress give him money for his U.S.-Mexico border wall. Trump retreated after 35 days — the longest shutdown ever — amid intensifying airport delays and missed paydays for federal workers. Democrats take a stand against Trump, with exceptionsWhile partisan stalemates over government spending are a frequent occurrence in Washington, the current impasse comes as Democrats see a rare opportunity to use their leverage to achieve policy goals and as their base voters are spoiling for a fight with Trump. Republicans who hold a 53-47 majority in the Senate needed at least eight votes from Democrats after Republican Sen. Rand Paul of Kentucky opposed the bill.Democratic Sens. John Fetterman of Pennsylvania and Catherine Cortez Masto of Nevada and Independent Sen. Angus King of Maine voted with Republicans to keep the government open — giving Republicans hope that there might be five more who will eventually come around and help end a shutdown.After the vote, King warned against “permanent damage” as Trump and his administration have threatened mass layoffs.”Instead of fighting Trump we’re actually empowering him, which is what finally drove my decision,” King said.Thune predicted Democratic support for the GOP bill will increase “when they realize that this is playing a losing hand.”Shutdown preparations beginThe stakes are huge for federal workers across the country as the White House told agencies last week that they should consider “a reduction in force” for many federal programs if the government shuts down. That means that workers who are not deemed essential could be fired instead of just furloughed.Either way, most would not get paid. The nonpartisan Congressional Budget Office estimated in a letter to Iowa Sen. Joni Ernst on Tuesday that around 750,000 federal workers could be furloughed each day once a shutdown begins.Federal agencies were already preparing. On the home page of the Department of Housing and Urban Development, a large pop up ad reads, “The Radical Left are going to shut down the government and inflict massive pain on the American people.”Democrats’ health care asksDemocrats want to negotiate an extension of the health subsidies immediately as people are beginning to receive notices of premium increases for the next year. Millions of people who purchase health insurance through the Affordable Care Act could face higher costs as expanded subsidies first put in place during the COVID-19 pandemic expire.Democrats have also demanded that Republicans reverse the Medicaid cuts that were enacted as a part of Trump’s “big, beautiful bill” this summer and for the White House to promise it will not move to rescind spending passed by Congress.”We are not going to support a partisan Republican spending bill that continues to gut the health care of everyday Americans,” House Democratic Leader Hakeem Jeffries said.Thune pressed Democrats to vote for the funding bill and take up the debate on tax credits later. Some Republicans are open to extending the tax credits, but many are strongly opposed to it.In rare, pointed back-and-forth with Schumer on the Senate floor Tuesday morning, Thune said Republicans “are happy to fix the ACA issue” and have offered to negotiate with Democrats — if they will vote to keep the government open until Nov. 21.A critical, and unusual, vote for DemocratsDemocrats are in an uncomfortable position for a party that has long denounced shutdowns as pointless and destructive, and it’s unclear how or when a shutdown will end. But party activists and lawmakers have argued that Democrats need to do something to stand up to Trump.”The level of appeasement that Trump demands never ends,” said Sen. Peter Welch, D-Vt. “We’ve seen that with universities, with law firms, with prosecutors. So is there a point where you just have to stand up to him? I think there is.”Some groups called for Schumer’s resignation in March after he and nine other Democrats voted to break a filibuster and allow a Republican-led funding bill to advance to a final vote.Schumer said then that he voted to keep the government open because a shutdown would have made things worse as Trump’s administration was slashing government jobs. He says things have now changed, including the passage this summer of the massive GOP tax cut bill that reduced Medicaid.Trump’s role in negotiationsA bipartisan meeting at the White House on Monday was Trump’s first with all four leaders in Congress since retaking the White House for his second term. Schumer said the group “had candid, frank discussions” about health care.But Trump did not appear to be ready for serious talks. Hours later, he posted a fake video of Schumer and House Democratic Leader Hakeem Jeffries taken from footage of their real press conference outside of the White House after the meeting. In the altered video, a voiceover that sounds like Schumer’s voice makes fun of Democrats and Jeffries stands beside him with a cartoon sombrero and mustache. Mexican music plays in the background.At a news conference on the Capitol steps Tuesday morning, Jeffries said it was a “racist and fake AI video.”Schumer said that less than a day before a shutdown, Trump was trolling on the internet “like a 10-year-old.””It’s only the president who can do this,” Schumer said. “We know he runs the show here.”___Associated Press writers Seung Min Kim, Kevin Freking, Matthew Brown, Darlene Superville and Joey Cappelletti in Washington contributed to this report.

    Senate Democrats have voted down a Republican bill to keep funding the government, putting it on a near-certain path to a shutdown after midnight Wednesday for the first time in nearly seven years.

    What we know:

    • The Senate voted down two short-term spending bills — one Democratic proposal and one Republican proposal.
    • The Senate has adjourned until tomorrow morning, all but guaranteeing the government will shut down.
    • Senate Democrats are demanding that health care subsidies and Medicaid cuts be addressed before passing a funding bill.
    • Thousands of federal workers face furloughs or layoffs if the government shuts down at midnight Wednesday.
    • There are fewer than 2 hours before the government shuts down for the first time in nearly seven years.

    The Senate rejected the legislation as Democrats are making good on their threat to close the government if President Donald Trump and Republicans won’t accede to their health care demands. The 55-45 vote on a bill to extend federal funding for seven weeks fell short of the 60 needed to end a filibuster and pass the legislation.

    Senate Democratic Leader Chuck Schumer, D-N.Y., said Republicans are trying to “bully” Democrats by refusing to negotiate on an extension of expanded Affordable Care Act tax credits that expire at the end of the year.

    “We hope they sit down with us and talk,” Schumer said after the vote. “Otherwise, it’s the Republicans will be driving us straight towards a shutdown tonight at midnight. The American people will blame them for bringing the federal government to a halt.”

    The failure of Congress to keep the government open means that hundreds of thousands of federal workers could be furloughed or laid off. After the vote, the White House’s Office of Management and Budget issued a memo saying “affected agencies should now execute their plans for an orderly shutdown.”

    Threatening retribution to Democrats, Trump said Tuesday that a shutdown could include “cutting vast numbers of people out, cutting things that they like, cutting programs that they like.”

    Trump and his fellow Republicans said they won’t entertain any changes to the legislation, arguing that it’s a stripped-down, “clean” bill that should be noncontroversial. Senate Majority Leader John Thune said “we can reopen it tomorrow” if enough Democrats break party lines.

    The last shutdown was in Trump’s first term, from December 2018 to January 2019, when he demanded that Congress give him money for his U.S.-Mexico border wall. Trump retreated after 35 days — the longest shutdown ever — amid intensifying airport delays and missed paydays for federal workers.

    Democrats take a stand against Trump, with exceptions

    While partisan stalemates over government spending are a frequent occurrence in Washington, the current impasse comes as Democrats see a rare opportunity to use their leverage to achieve policy goals and as their base voters are spoiling for a fight with Trump. Republicans who hold a 53-47 majority in the Senate needed at least eight votes from Democrats after Republican Sen. Rand Paul of Kentucky opposed the bill.

    Democratic Sens. John Fetterman of Pennsylvania and Catherine Cortez Masto of Nevada and Independent Sen. Angus King of Maine voted with Republicans to keep the government open — giving Republicans hope that there might be five more who will eventually come around and help end a shutdown.

    After the vote, King warned against “permanent damage” as Trump and his administration have threatened mass layoffs.

    “Instead of fighting Trump we’re actually empowering him, which is what finally drove my decision,” King said.

    Thune predicted Democratic support for the GOP bill will increase “when they realize that this is playing a losing hand.”

    Shutdown preparations begin

    The stakes are huge for federal workers across the country as the White House told agencies last week that they should consider “a reduction in force” for many federal programs if the government shuts down. That means that workers who are not deemed essential could be fired instead of just furloughed.

    Either way, most would not get paid. The nonpartisan Congressional Budget Office estimated in a letter to Iowa Sen. Joni Ernst on Tuesday that around 750,000 federal workers could be furloughed each day once a shutdown begins.

    Federal agencies were already preparing. On the home page of the Department of Housing and Urban Development, a large pop up ad reads, “The Radical Left are going to shut down the government and inflict massive pain on the American people.”

    Democrats’ health care asks

    Democrats want to negotiate an extension of the health subsidies immediately as people are beginning to receive notices of premium increases for the next year. Millions of people who purchase health insurance through the Affordable Care Act could face higher costs as expanded subsidies first put in place during the COVID-19 pandemic expire.

    Democrats have also demanded that Republicans reverse the Medicaid cuts that were enacted as a part of Trump’s “big, beautiful bill” this summer and for the White House to promise it will not move to rescind spending passed by Congress.

    “We are not going to support a partisan Republican spending bill that continues to gut the health care of everyday Americans,” House Democratic Leader Hakeem Jeffries said.

    Thune pressed Democrats to vote for the funding bill and take up the debate on tax credits later. Some Republicans are open to extending the tax credits, but many are strongly opposed to it.

    In rare, pointed back-and-forth with Schumer on the Senate floor Tuesday morning, Thune said Republicans “are happy to fix the ACA issue” and have offered to negotiate with Democrats — if they will vote to keep the government open until Nov. 21.

    A critical, and unusual, vote for Democrats

    Democrats are in an uncomfortable position for a party that has long denounced shutdowns as pointless and destructive, and it’s unclear how or when a shutdown will end. But party activists and lawmakers have argued that Democrats need to do something to stand up to Trump.

    “The level of appeasement that Trump demands never ends,” said Sen. Peter Welch, D-Vt. “We’ve seen that with universities, with law firms, with prosecutors. So is there a point where you just have to stand up to him? I think there is.”

    Some groups called for Schumer’s resignation in March after he and nine other Democrats voted to break a filibuster and allow a Republican-led funding bill to advance to a final vote.

    Schumer said then that he voted to keep the government open because a shutdown would have made things worse as Trump’s administration was slashing government jobs. He says things have now changed, including the passage this summer of the massive GOP tax cut bill that reduced Medicaid.

    Trump’s role in negotiations

    A bipartisan meeting at the White House on Monday was Trump’s first with all four leaders in Congress since retaking the White House for his second term. Schumer said the group “had candid, frank discussions” about health care.

    But Trump did not appear to be ready for serious talks. Hours later, he posted a fake video of Schumer and House Democratic Leader Hakeem Jeffries taken from footage of their real press conference outside of the White House after the meeting. In the altered video, a voiceover that sounds like Schumer’s voice makes fun of Democrats and Jeffries stands beside him with a cartoon sombrero and mustache. Mexican music plays in the background.

    At a news conference on the Capitol steps Tuesday morning, Jeffries said it was a “racist and fake AI video.”

    Schumer said that less than a day before a shutdown, Trump was trolling on the internet “like a 10-year-old.”

    “It’s only the president who can do this,” Schumer said. “We know he runs the show here.”

    ___

    Associated Press writers Seung Min Kim, Kevin Freking, Matthew Brown, Darlene Superville and Joey Cappelletti in Washington contributed to this report.

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  • Health care at the heart of Capitol Hill standoff as shutdown looms – WTOP News

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    With a government shutdown just hours away, one of the sticking points between Republicans and Democrats involves health care, specifically whether to extend premium subsidies under the Affordable Care Act.

    With a government shutdown just hours away, one of the key sticking points between Republicans and Democrats involves health care, specifically whether to extend premium subsidies under the Affordable Care Act.

    The debate centers on enhanced tax credits that help millions of Americans afford insurance through ACA marketplaces. These subsidies are currently scheduled to expire at the end of 2025, but Democrats are pushing for action now to avoid disruptions during the upcoming open enrollment period.

    “Twenty-two million people across the country get their coverage through the Affordable Care Act marketplaces,” said Anne Reid, policy director of the Funders Forum on Accountable Health at the Milken Institute School of Public Health at George Washington University.

    “The vast majority of those folks have some level of subsidization of their coverage, which is tied to their income.”

    Reid warns that without an extension, millions could lose coverage or face unaffordable premiums.

    The credits were expanded in recent years to raise income thresholds, allowing more Americans to qualify for help.

    “The credits were enhanced in the sense that a higher minimum income was set so more people could qualify to receive some relief toward these premiums,” Reid said.

    Reid previously served as a senior congressional staffer, where she contributed to health workforce policy during the development of the Affordable Care Act.

    Democrats want the extension included in the continuing resolution needed to keep the government open. Reid said they view it as a must-pass provision.

    “Democrats are arguing that we need to handle this in must-pass legislation, which at the moment is the appropriations bill.”

    They also want to reverse earlier Medicaid cuts that could result in more than 10 million people losing coverage.

    But Republicans argue the funding bill should be a “clean” continuing resolution, focused solely on keeping the government running.

    “Let’s just keep the government going on current fiscal year levels through the middle of November, to give us some time to work things out and negotiate a longer-term package,” Reid said, summarizing the GOP position.

    University of Maryland finance professor David Kass said Democrats are pushing to extend the expanded benefits into 2026, but Republicans want to debate the issue separately from the stopgap funding measure.

    “Fewer Americans would be able to purchase health insurance” if the premium help isn’t available as open enrollment begins, Kass said.

    Reid said the timing is critical, not just for consumers, but for insurers who need clarity to set rates.

    “Days and weeks matter in terms of being able to rightsize the premium levels.”

    The potential shutdown could also hit the D.C. region particularly hard, given its large federal workforce.

    “Job security and financial security would very acutely be felt in the D.C. region, given our demographics and who all comprises the federal workforce,” Reid said.

    With open enrollment approaching and budget negotiations stalled, Reid said the lack of clarity could leave consumers in limbo and millions of Americans at risk of losing affordable health coverage.

    Get breaking news and daily headlines delivered to your email inbox by signing up here.

    © 2025 WTOP. All Rights Reserved. This website is not intended for users located within the European Economic Area.

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    Mike Murillo

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  • Why ACA tax credits for 22 million Americans are at the center of the government shutdown drama

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    A possible U.S. government shutdown on Wednesday could hinge on a deal to maintain a tax credit that helps 22 million Americans lower their health insurance costs when they buy policies through the Affordable Care Act’s marketplaces. 

    Known as the enhanced premium tax credit, the subsidy has been used by millions of low- and middle-class households since it was authorized under the American Rescue Plan Act in 2021. Since then, spurred by the tax credit, the number of people who have enrolled in ACA marketplace health insurance plans has almost doubled, according to health care publication KFF.

    But it is set to expire at the end of 2025, and leading Democratic lawmakers are making a funding deal to keep the government open contingent on Republicans agreeing to extend the credit. 

    Even as the outcome of the funding negotiations in Washington, D.C., remains uncertain, expiration of the premium health care credits could inflict financial pain on millions of Americans, experts told CBS News. 

    “Insurers are already preparing to send notices to households that they will see increases starting in January 2026,” said Alex Jacquez, chief of policy at Groundwork Collaborative, a liberal economic advocacy group, and former a White House economic official under former President Joe Biden, on a conference call Friday to discuss the tax credit. 

    He added, “People are more and more concerned about the cost of living, and [this is] a hit to their pocketbooks that they will start seeing in weeks.”

    The White House didn’t respond to a request for comment. 

    Here’s what to know about the enhanced ACA premium tax credits set to expire at the end of 2025.

    How much could ACA premiums increase?

    The cost of premiums for people who buy their insurance through the ACA marketplaces could rise by an average of 75% after the tax credits expire, according to KFF. About 4 million people would likely drop their insurance coverage if the credit is allowed to expire because they would’t be able to afford the costs, the Congressional Budget Office has estimated. 

    The premium tax credit is aimed at people who earn too much to qualify for Medicaid, the health insurance program for low-income Americans, and who can’t get affordable health care through an employer. The credit is available for those who earn between 100% to 400% of the poverty level, which means a family of four with annual income of up to $128,600 would qualify for the credit.

    With expiration of the ACA coverage credit only months away, some policy holders have already received noticed that their premiums — the monthly fee paid for insurance coverage — are poised to surge next year. Insurers have sent out notices in nearly every state, with some proposing premium increases of as much as 50%.

    Insurers are already planning on substantial premium hikes in 2026, according to a Peterson KFF Health System Tracker survey published last month. The poll found that 312 insurers participating in ACA marketplaces are proposing median increases of 18% next year, about 11 percentage points higher than in 2025. 

    That increase would represent the largest rate hike since 2018, and is driven by higher costs for medical care as well as the expiration of the premium tax credits. Sharply higher ACA premiums would likely cause healthier people to drop coverage, making it more expensive to insure those who remain, the group said. 

    The proposed hikes range from a high of 39.9%, from Blue Cross Blue Shield of Oklahoma, to a low of 4.6% for Oscar Garden State Insurance Corporation, their survey found.

    In Iowa last month, the state’s insurance commissioner weighed increases ranging from 3% to 37%, arousing public concerns. One woman who runs a garden center in Cedar Falls, Iowa, said she was considering dropping health insurance altogether.

    “I am already living as frugally as I possibly can while working as hard as I possibly can, putting in as many hours as I am allowed to at my job, never missing a day of work,” one woman, LuAnn, wrote in a comment published on the commissioner’s website.

    Signs of financial fragility

    The potential hike in insurance costs comes as many Americans continue struggling with the cost of living, said Rohit Chopra, former director of the Consumer Financial Protection Bureau, on the conference call with Jacquez, organized by Groundwork, which supports extending the credits.

    “Some people will need to drop their insurance all together, but households with someone with a chronic illness will have to pay those big, big increases,” Chopra said. That would require some families to make tough financial choices, such as not paying other bills or accumulating debt to cover their expenses, he addd.

    Although inflation around the U.S. has eased significantly since its post-pandemic peak in 2022, costs continue to inch higher. The Federal Reserve’s 2% inflation target is slipping further from reach this year, with the Consumer Price Index climbing higher in recent months. Some consumers are showing signs of increasing financial stress, with credit card delinquencies on the rise and balances creeping higher.

    Meanwhile, many Americans aren’t aware that the ACA enhanced premium tax credits will expire in a matter of months, KFF found in a survey. 

    “Consumers should not panic, but they do need to prepare,” Louise Norris, a health policy analyst at insurance website Healthinsurance.org, said in an email.

    People should make sure to compare various plans available to them on the marketplaces and explore options such as Health Savings Plans, which allows people to set aside money to pay for medical expenses, she said. 

    “Being proactive will help minimize financial surprises,” Norris said.

    The Associated Press

    contributed to this report.

    Aimee Picchi

    Aimee Picchi is the associate managing editor for CBS MoneyWatch, where she covers business and personal finance. She previously worked at Bloomberg News and has written for national news outlets including USA Today and Consumer Reports.

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  • Breaking down fight over health care tax credits as shutdown looms

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    The federal government seems poised to shut down next week unless congressional leaders can reach a deal. One of the major sticking points is the fight over renewing enhanced tax credits to offset healthcare coverage costs under the Affordable Care Act. Cynthia Cox, a vice president at KFF, joins to discuss the potential ripple effects.

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  • The federal government could shut down soon. Here’s what you need to know

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    (CNN) — A possible federal government shutdown is only days away as congressional lawmakers remain at odds over funding the government beyond September 30.

    Although Republicans control Capitol Hill and the White House, they need at least seven Democrats in the Senate to join them to pass a spending package under the chamber’s rules. Senate Minority Leader Chuck Schumer, however, is demanding any funding bill contain an extension of the enhanced Affordable Care Act premium subsidies, along with several other items, to get his party’s support. GOP leaders want an extension of funding for seven weeks, with additional money for security for the legislative, executive and judicial branches.

    President Donald Trump does not appear interested in working out a compromise. He canceled a meeting this week with Democratic leaders and said Thursday that their demands were “totally unreasonable.”

    If the impasse is not resolved, the coming government shutdown could be unlike any other in recent memory. While no two shutdowns are exactly the same, Trump and the White House Office of Management and Budget have already signaled that they are willing to use a totally different playbook — urging agencies to downsize workers in programs whose funding has lapsed and which don’t align with Trump’s priorities.

    Trump is no stranger to government shutdowns. The most recent one occurred during his first term, starting in late December 2018 and lasting 35 days, the longest on record.

    Here’s what we know about the looming government shutdown:

    What is a government shutdown?

    Congress must provide funding for many federal departments and functions every fiscal year, which begins on October 1. If lawmakers fail to pass a spending package for the full year or extend funding for a shorter period, known as a continuing resolution, then many agencies and activities must shutter until Congress appropriates more money.

    Lawmakers have yet to pass through both chambers any of the 12 appropriations bills that make up the federal discretionary spending budget. So the coming shutdown would be considered a full shutdown.

    During prior impasses, Congress approved annual funding for certain agencies, which allowed them to continue operating while other federal departments went dark. That situation is known as a partial shutdown.

    Since 1980, there have been 14 government shutdowns, according to the Bipartisan Policy Center.

    What is the shutdown deadline?

    The shutdown will begin on October 1, first thing Wednesday morning, if Congress doesn’t act before that.

    What programs and payments will stop?

    Every government shutdown differs somewhat, but typically functions that are critical to the protection of lives and property are deemed essential and remain open. Agencies file what are known as contingency plans that detail what operations will continue and how many employees will remain on the job, many of them without pay.

    However, in an unusual move, OMB this time is not posting agencies’ shutdown contingency plans on its website. Instead, the plans are hosted only on each agency’s site — making it harder to assess how the Trump administration will handle the shutdown and which activities it will deem essential. (OMB noted in a memo earlier this week that it had not yet received updated contingency plans from every agency.)

    Previous shutdowns have stalled food inspections; canceled immigration hearings; and delayed some federal lending to homebuyers and small businesses, among other impacts.

    In the most recent shutdown, students had trouble getting needed tax documents from the Internal Revenue Service to get financial aid for the spring semester, and the US Department of Agriculture warned that it could only guarantee to provide food stamp benefits through February.

    Notably, important benefit programs, such as Social Security and Medicare, will continue. Also, key services — including law enforcement and border patrol — are typically deemed essential and aren’t affected.

    Some government functions can continue – at least for a certain period of time – if they are funded through fees or other types of appropriations. For instance, when a shutdown loomed in the fall of 2023, the Internal Revenue Service said it could use some of the funding it received from the Inflation Reduction Act to keep preparing for the upcoming filing season – updating tax forms and technology systems and hiring and training staff.

    If the government shuts down next month, it’s possible that immigration, border patrol and defense activities funded through the One Big Beautiful Bill Act, which Trump signed into law in July, would continue. The relevant agencies’ contingency plans should specify what functions would remain operational.

    Agencies and administrations have some amount of choice in which services they deem essential, said Molly Reynolds, interim director of the governance studies program at the Brookings Institution.

    In Trump’s first term, Reynolds noted that the administration took some measures to make the shutdown less painful, such as allowing the IRS to process tax refunds — a departure from prior shutdowns.

    But that may not be the case this year.

    “The OMB memo threatening wide-scale federal layoffs if there is a shutdown suggests that this time around, they might be looking to make the shutdown more painful,” she said.

    Will national parks stay open?

    The impact of shutdowns on the 400-plus national park sites has differed greatly in recent shutdowns.

    In 2013, an estimated 8 million recreation visits and $414 million were lost during the 16-day shutdown, according to the National Parks Conservation Association, citing National Park Service data. During the most recent shutdown in 2019, many parks remained open though no visitor services were provided. The Park Service lost $400,000 a day from missed entrance fee revenue, according to the association’s estimates. What’s more, park visitors would have typically spent $20 million on an average January day in nearby communities.

    States have also stepped in to keep some national parks open using their own funds. When a shutdown loomed in the fall of 2023, Utah said it would keep the Mighty 5 parks – Arches, Bryce Canyon, Canyonlands, Capitol Reef and Zion – open, while Arizona planned to keep the Grand Canyon operational. Colorado also said it would also keep its four national parks and other federal lands open.

    A National Park Service Ranger conducts a walking tour in Shark Valley, part of the Everglades National Park, on April 17 in Florida. Credit: Joe Raedle / Getty Images via CNN Newsource

    What’s the impact on airline travel?

    Air traffic controllers and Transportation Security Administration officers are typically deemed essential and must remain on the job, though they are not paid. But some workers have called out sick during past shutdowns, snarling flights.

    The decision by 10 air traffic controllers to stay home in January 2019 helped end that shutdown. Their absence temporarily shut down travel at New York’s LaGuardia airport and caused delays at other major hubs, including in New Jersey, Philadelphia and Atlanta, driving Trump to agree to a temporary government funding measure.

    How about the impact on federal workers?

    Federal workers bear the brunt of government shutdowns. Some are furloughed, while others are considered essential and have to continue working. But many don’t get paid until the impasse ends.

    In March, the last time a federal government shutdown loomed before being averted, more than 1.4 million employees were deemed essential, according to Rachel Snyderman, managing director of economic policy at the Bipartisan Policy Center. About 750,000 of them would have continued to be paid since their salaries were funded through other sources.

    Another nearly 900,000 workers would have been furloughed without pay. (Snyderman noted that the estimates did not include the layoffs and departures that occurred in the early weeks of the Trump administration.)

    In 2023, the Biden administration warned that the nation’s 1.3 million active-duty military troops would not get paid, before a shutdown was averted at the last minute.

    This week, judiciary officials warned that federal courts could be affected by a shutdown within days, much sooner than in previous occurrences, because of tight budgets. While judges and Supreme Court justices would continue to be paid, many other judicial employees would not.

    Federal workers are guaranteed to receive their back pay after the impasse is resolved. However, the same is not true for federal contractors who may be furloughed or temporarily laid off by their employers during a shutdown.

    What does a shutdown do to the economy?

    Shutdowns can have real consequences for the economy since federal spending is delayed, and many federal workers pull back on their purchases while they aren’t receiving paychecks.

    The five-week shutdown in 2018-2019 resulted in a $3 billion loss in economic growth that would not be recovered, according to a Congressional Budget Office estimate. It noted that some private sector businesses would never make up their lost income.

    Also, because the IRS reduced its compliance activities during the shutdown, CBO estimated that tax revenues would be roughly $2 billion lower — much of which would not be recouped.

    The impact stretches beyond the federal government.

    The US Travel Association wrote a letter to congressional leaders in late September urging them to avoid a shutdown, which it said would result in flight delays, longer airport security lines and canceled trips.

    “A shutdown is a wholly preventable blow to America’s travel economy — costing $1 billion every week — and affecting millions of travelers and businesses while placing unnecessary strain on an already overextended federal travel workforce,” wrote Geoff Freeman, the association’s CEO. “The consequences of inaction and immediate and severe.”

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    Tami Luhby and CNN

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  • If ACA enhanced subsidies end, would premiums rise 75%?

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    With federal government funding set to run out Oct. 1 unless Congress passes an extension, Democrats are seeking to leverage government shutdown fears to persuade Republicans to extend Affordable Care Act subsidies that would otherwise expire at the end of the year.

    Most Republicans want to pass a “clean” resolution to extend the federal spending deadline; this type of bill would keep the government running at current spending levels and allow added time for more debate about proposed federal spending changes. Some Republicans also oppose the ACA subsidies as too expensive for taxpayers and say they were intended as a pandemic-era policy that has outlived its purpose. Some Republican lawmakers, though, agree that the subsidies should be extended and have worked on crafting legislation to do that. 

    Democrats, who are relatively powerless as the congressional minority, see the moment as an opportunity to attach a key legislative priority — ACA subsidy extension — to must-pass legislation. Democratic lawmakers say the expiration of enhanced subsidies for people who obtain health insurance through Affordable Care Act marketplaces would stick millions of Americans with additional costs.

    House Democratic Whip Katherine Clark, D-Mass., the second-highest ranking House Democrat, said in a Sept. 12 X post, “Republicans are spiking health insurance premiums by 75% for everyday Americans” if they don’t extend the enhanced subsidies.

    Sen. Chris Murphy, D-Conn., used the same figure Sept. 9. And AHIP, an insurance industry group, also cited the 75% figure in an article in which it urged passage of subsidy extensions. 

    Sign up for PolitiFact texts

    The 75% cost increase figure has been cited by KFF, a health care think tank. But it needs more context.

    Clark’s office did not respond to an inquiry.

    What are enhanced subsidies?

    People who use the Affordable Care Act’s marketplaces can buy health insurance from providers at various levels of coverage and varying premium costs. Most purchasers obtain subsidies, as long as they meet the income guidelines. 

    In 2021, then-President Joe Biden signed legislation that made Affordable Care Act subsidies more generous, by reducing the maximum amount purchasers would have to pay for premiums and enabling households whose incomes were higher than 400% of the federal poverty level to receive subsidies. Previously, the subsidies were capped at 400% of the poverty limit for a household, which in 2024 was $60,240.

    Congress renewed these enhanced subsidies in 2022 through the end of 2025, so they are now poised to expire.

    The subsidies proved popular; the number of people receiving them increased from 12 million in 2020 to 21.4 million in 2024, according to KFF’s analysis of federal data. About three-quarters of those receiving subsidies in 2024 were households with incomes at 250% or less of the federal poverty level, or about $37,650.

    Where did the 75% figure originate?

    Using 2024 federal data, KFF calculated the average annual premiums for enrollees who received enhanced subsidies. The government paid $5,727 of the total premium under the original Affordable Care Act subsidy rules. Another $888 came from the beneficiary’s pocket.

    The enhanced subsidy provision covered the final portion, $705. If the enhanced subsidy disappeared and the enrollee had to pay both the $888 and the $705 amounts, that would total $1,593. That’s about 79% more than the same person was paying with the enhanced subsidies in place — which is close to the 75% figure that Clark and Murphy cited.

    The Congressional Budget Office, Congress’ nonpartisan number-crunching arm, has projected that a failure to extend the subsidies would increase the uninsured population by 2.2 million in the first year and by an average of 3.8 million each year from 2026 to 2034.

    CBO also projected that if the enhanced subsidies were to expire, premiums would increase by 4.3% in the first year, because of a decline in the number of people who get coverage, leaving fewer enrollees to pick up the costs. Premiums would increase by an annual average of 7.9% from 2026 to 2034.

    There are nuances to note.

    • Enrollees wouldn’t see a 75% increase in “premiums,” as Clark phrased it. Their increase would stem from a combination of premium increases and reduced subsidies. However, for consumers, that distinction would matter little; by KFF’s calculations, they would still be paying 79% more out of pocket, regardless of the reason. 

    • The 79% figure is an average increase; the figure varies by state. Enrollees in Hawaii would have the lowest increase, 49%, while those in Wyoming would have the highest, 195%. There is also substantial variation based on the number of people in a family and their ages.

    Our ruling

    Clark said, “Republicans are spiking health insurance premiums by 75% for everyday Americans” if they don’t extend enhanced ACA subsidies. 

    If the Republican-controlled Congress does not extend Affordable Care Act enhanced subsidies before they expire at the end of this year, enrollees would have to pay more.

    KFF analysis of federal data found that the average increase in out-of-pocket coverage cost would be 79%, with state-by-state average increases ranging from 49% to 195%.

    This cost increase would come from a combination of insurance premium increases and the disappearance of subsidies, rather than from “spiking health insurance premiums” alone.

    The statement is accurate but needs clarification. We rate it Mostly True.

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  • Republicans unveil a bill to fund the government through Nov. 21. Democrats call it partisan

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    House Republicans unveiled on Tuesday a stopgap spending bill that would keep federal agencies funded through Nov. 21, daring Democrats to block it knowing that the fallout would likely be a partial government shutdown that would begin Oct. 1, the start of the new budget year.The bill would generally fund agencies at current levels, with a few limited exceptions, including an extra $88 million to boost security for lawmakers and members of the Supreme Court and the executive branch. The proposed boost comes as lawmakers face an increasing number of personal threats, with their concerns heightened by last week’s assassination of conservative activist Charlie Kirk.The House is expected to vote on the measure by Friday. Senate Majority Leader John Thune said he would prefer the Senate take it up this week as well. But any bill will need some Democratic support to advance through the Senate, and it’s unclear whether that will happen.Senate Democratic leader Chuck Schumer and House Democratic leader Hakeem Jeffries have been asking their Republican counterparts for weeks for a meeting to negotiate on the bill, but they say that Republicans have refused. Any bill needs help from at least seven Democrats in the Senate to overcome procedural hurdles and advance to a final vote.The two Democratic leaders issued a joint statement saying that by “refusing to work with Democrats, Republicans are steering our country toward a shutdown.””The House Republican-only spending bill fails to meet the needs of the American people and does nothing to stop the looming healthcare crisis,” Schumer and Jeffries said. “At a time when families are already being squeezed by higher costs, Republicans refuse to stop Americans from facing double-digit hikes in their health insurance premiums.”Republicans say it’s Democrats who are playing politics by insisting on addressing health coverage concerns as part of any government funding bill. In past budget battles, it has been Republicans who’ve been willing to engage in shutdown threats as a way to focus attention on their priority demands. That was the situation during the nation’s longest shutdown, during the winter of 2018-19, when President Donald Trump was insisting on federal funds to build the U.S.-Mexico border wall.This time, however, Democrats are facing intense pressure from their base of supporters to stand up to Trump. They have particularly focused on the potential for skyrocketing health care premiums for millions of Americans if Congress fails to extend enhanced subsidies, which many people use to buy insurance on the Affordable Care Act exchange. Those subsidies were put in place during the COVID crisis, but are set to expire.Some people have already received notices that their premiums — the monthly fee paid for insurance coverage — are poised to spike next year. Insurers have sent out notices in nearly every state, with some proposing premium increases of as much as 50%.Johnson called the debate over health insurance tax credits a December policy issue, not something that needs to be solved in September.”It’ll be a clean, short-term continuing resolution, end of story,” Johnson told reporters. “And it’s interesting to me that some of the same Democrats who decried government shutdowns under President Biden appear to have no heartache whatsoever at walking our nation off that cliff right now. I hope they don’t.”Thune said Republicans are simply providing what Schumer has always requested in the past when Democrats were in the majority — “a clean funding resolution to fund the government.” He said that if the House passes the measure and Trump is prepared to sign it, then “it will be only the Democrat leader that is standing between this country and a government shutdown and all that means.”

    WASHINGTON —

    House Republicans unveiled on Tuesday a stopgap spending bill that would keep federal agencies funded through Nov. 21, daring Democrats to block it knowing that the fallout would likely be a partial government shutdown that would begin Oct. 1, the start of the new budget year.

    The bill would generally fund agencies at current levels, with a few limited exceptions, including an extra $88 million to boost security for lawmakers and members of the Supreme Court and the executive branch. The proposed boost comes as lawmakers face an increasing number of personal threats, with their concerns heightened by last week’s assassination of conservative activist Charlie Kirk.

    The House is expected to vote on the measure by Friday. Senate Majority Leader John Thune said he would prefer the Senate take it up this week as well. But any bill will need some Democratic support to advance through the Senate, and it’s unclear whether that will happen.

    Senate Democratic leader Chuck Schumer and House Democratic leader Hakeem Jeffries have been asking their Republican counterparts for weeks for a meeting to negotiate on the bill, but they say that Republicans have refused. Any bill needs help from at least seven Democrats in the Senate to overcome procedural hurdles and advance to a final vote.

    The two Democratic leaders issued a joint statement saying that by “refusing to work with Democrats, Republicans are steering our country toward a shutdown.”

    “The House Republican-only spending bill fails to meet the needs of the American people and does nothing to stop the looming healthcare crisis,” Schumer and Jeffries said. “At a time when families are already being squeezed by higher costs, Republicans refuse to stop Americans from facing double-digit hikes in their health insurance premiums.”

    Republicans say it’s Democrats who are playing politics by insisting on addressing health coverage concerns as part of any government funding bill. In past budget battles, it has been Republicans who’ve been willing to engage in shutdown threats as a way to focus attention on their priority demands. That was the situation during the nation’s longest shutdown, during the winter of 2018-19, when President Donald Trump was insisting on federal funds to build the U.S.-Mexico border wall.

    This time, however, Democrats are facing intense pressure from their base of supporters to stand up to Trump. They have particularly focused on the potential for skyrocketing health care premiums for millions of Americans if Congress fails to extend enhanced subsidies, which many people use to buy insurance on the Affordable Care Act exchange. Those subsidies were put in place during the COVID crisis, but are set to expire.

    Some people have already received notices that their premiums — the monthly fee paid for insurance coverage — are poised to spike next year. Insurers have sent out notices in nearly every state, with some proposing premium increases of as much as 50%.

    Johnson called the debate over health insurance tax credits a December policy issue, not something that needs to be solved in September.

    “It’ll be a clean, short-term continuing resolution, end of story,” Johnson told reporters. “And it’s interesting to me that some of the same Democrats who decried government shutdowns under President Biden appear to have no heartache whatsoever at walking our nation off that cliff right now. I hope they don’t.”

    Thune said Republicans are simply providing what Schumer has always requested in the past when Democrats were in the majority — “a clean funding resolution to fund the government.” He said that if the House passes the measure and Trump is prepared to sign it, then “it will be only the Democrat leader that is standing between this country and a government shutdown and all that means.”

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  • Health insurers to provide $75.6M in rebates

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    BOSTON — More than 350,000 Massachusetts health care consumers will be receiving rebates from several major private health insurers under a state law requiring them to spend a majority of premiums on medical services.

    That’s according to the Healey administration, which recently announced that a review by the state Division of Insurance determined that five of the state’s health insurance carriers had medical loss ratios lower than the required threshold and must return $75.6 million to ratepayers.


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    By Christian M. Wade | Statehouse Reporter

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