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Health care subsidies are a major point of contention for Democrats
What happens when the government shuts down: ©Tanaonte - stock.adobe.com
The federal government’s current funding expires tomorrow, September 30. If Congress does not pass either full appropriations bills or a stopgap (known as a “continuing resolution,” or CR for short), many parts of the government will effectively shut down.
Because Republicans control the House, Senate, and the presidency, a shutdown is not purely a Democratic risk — but Republicans still need some Democratic support in the Senate to overcome the procedural hurdle of needing a. 60-vote threshold to advance certain measures. The House passed a “clean” CR—one without major policy changes attached to it—that would extend funding through Nov. 21, 2025, but Democrats have rejected that CR unless it includes certain health care-related changes.
A meeting is scheduled today between President Trump and the top congressional leaders from both parties in hopes of brokering a deal before the deadline, but neither side appears willing to compromise.
Republicans
The Republican leadership’s position can be summarized as wanting a clean extension now and to delay policy fights over health care and other issues later. They want a CR that keeps funding at current levels through mid-November and push specific policy arguments to the end of the year. They say that tying policy changes to the short-term funding measure is inappropriate and makes a deal harder to reach, and thus are pushing back on Democrat demands to immediately extend or increase health subsidy programs. Republican leadership is warning that these demands could undermine the chances of passing any CR, forcing the government to shut down.
They are saying that Democrats are holding the government hostage by demanding policy concessions before fundings is approved, and hope that if a shutdown occurs, they can pin the blame on Democratic intransigence.
President Trump has also threatened to fire thousands of government workers if the shutdown occurs, and has already had the administration take the steps needed to do so.
Democrats
The Democratic position is mainly focused on health care issues. They want to either extend or make permanent the premium tax credits for the Affordable Care Act that were expanded during the pandemic, which are set to expire at the end of the year. They say that letting those subsidies lapse would make health insurance significantly more expensive for many Americans, especially for those who have to buy insurance through the ACA marketplace instead of through an employer. They say the time to discuss these subsidies is now, before price increases might be implemented at the end of the year.
In addition to the subsidies, Democrats also want to eliminate the changes to Medicaid made in the One Big Beautiful Bill Act, including tightening eligibility for funding and adding work requirements.
Democrats have emphasized they won’t just accept whatever the GOP offers in exchange for covering government funding; they want substantive concessions on health care. They also want more oversight limits on executive control over appropriated funds (so the administration can’t redirect money easily).
Some Democrats are implicitly or explicitly signaling that they're prepared to risk a shutdown to force concessions. But the challenge for them is: if they push too hard and get a shutdown that lasts long, the public backlash could hurt them politically.
So in short: Republicans want a clean extension now and defer the tough fights; Democrats want to use the impending funding deadline as leverage to lock in health subsidy provisions now.
If the impasse remains unresolved and funding lapses, here’s what typically happens — and what’s special about this moment:
How a shutdown works legally
What continues (or is less affected)
This particular shutdown fight is more volatile for a few reasons. First, the expiration of enhanced ACA premium tax credits and cuts to Medicaid are happening at year-end regardless. Democrats see the funding standoff as their only real leverage to protect those subsidies now.
If the subsidies aren’t extended, many lower- and middle-income Americans could see large premium increases. Democrats argue that’s politically untenable and a breach of recent commitments. Republicans counter that the subsidy issue should be debated separately and not held hostage to government funding.
Democrats have signaled they are willing to risk a short shutdown to force concessions on health care, seeing it as a wedge issue that resonates with voters. But they also risk blame if a shutdown drags on, especially if the public views them as obstructing funding.
The administration is reportedly preparing for severe personnel cuts and layoffs beyond typical furloughs, signaling this shutdown could be more painful than past ones.
This ramped-up posture may increase pressure to strike a deal but also raise the stakes.
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