Hours after the federal government shutdown, Julio Fuentes stood just steps from the U.S. Capitol to deliver an urgent message about the Latino voting bloc that helped bring the Republican Party to power last year.
Those votes, he warned, would be in jeopardy unless Congress passes legislation that would lower the monthly costs of marketplace plans established by the Affordable Care Act (ACA) for the roughly 4.7 million people with such coverage in Florida, his home state.
“Hispanic voters helped put Donald Trump back in the White House,” said Fuentes, president of the Florida Hispanic Chamber of Commerce. “Republican leaders would do well to keep health insurance affordable, and their voters will keep that in mind as the midterm elections approach.”
Less than a month before many people will choose their health insurance plan for next year, Democrats in Congress have blocked approval of government funds to pressure Republicans. The goal is to provide billions of dollars in federal subsidies that have sharply reduced monthly costs in recent years and helped record numbers of people gain health insurance.
Democrats see this political moment as an opportunity to talk about the need to make health care affordable as millions of people, including those with insurance through work or Medicare, prepare to face higher costs next year.
Hoping to win back the support of some working-class voters who have drifted away from them, party leaders took the opportunity to recall cuts to health care programs that Republicans recently approved.
For their part, Republicans are publicly confident that the strategy will have no impact and remind people that it was Democrats who caused the government shutdown. However, new analysis of CFF shows that 80% of all premium subsidies benefited people studying in states where Trump won.
The closure coincides with the start of open enrollment season, as insurers prepare to send rate notices for next year to the roughly 24 million people enrolled in ACA plans.
If the subsidies expire, monthly costs for the average beneficiary are expected to duplicate yourself. Insurers also warned they would be forced to sharply raise premium prices because many healthy people could stop paying for insurance if it becomes too expensive, leaving a weaker group of policyholders with fewer resources to cover them.
“More than 20 million Americans will see their premiums, copays and deductibles skyrocket in the coming days as Republicans refuse to extend Affordable Care Act subsidies,” Hakeem Jeffries, Democratic House Minority Leader, said Thursday on the steps of the Capitol.
In most states, open enrollment begins November 1st. Some insurers and state exchanges have delayed sending rate notices until next year as they wait to see what happens in Washington. For example, Covered California, the state's insurance marketplace, plans to send notices to more than one million members later than usual this year, by Oct. 15.
From her home in Richmond, Virginia, Natalie Thayer, 31, anxiously awaits the arrival of her notice. Check your state's marketplace website daily to see if they have posted new rates for your plan.
Thayer has relied on market coverage for more than a year while working part-time for a small local video production company and earning a master's degree to become a school counselor. The subsidies cover $255 of your monthly premium, reducing your payment to $53. Since you are in generally good health, if your loans expire and your premium increases significantly, you will likely have to drop your coverage.
“I probably had to go without health insurance and rely on hope,” Thayer said.
But Democrats' efforts to focus the government shutdown debate on the issue of health care costs clash with many of the shutdown's other unpleasant realities: millions of federal workers without pay, the suspension of some functions of public health agencies and the risk of withholding food assistance payments to low-income mothers, among other consequences.
The ACA has been a political hotspot since 2010, when Republicans opposed the landmark health law. Shortly after, the party won multiple legislative elections, leading to another government shutdown in 2013 when they attempted to eliminate the program. Republican leaders tried again in 2017 to repeal the law as part of Trump's campaign promise.
The current conflict—over billions of dollars in subsidies that Democrats pushed during the Covid pandemic to boost student enrollment in the ACA—has been simmering for months.
The same Democrats who wrote the legislation that introduced and then expanded those benefits have scheduled the increased subsidies to expire at the end of this year. Even some Republicans warned this summer that expiring them could be harmful. Republican pollsters Tony Fabrizio and Bob Ward issued a memo warning that extending the loans could make a difference in next year's congressional elections.
Expanding ACA subsidies, which lowered monthly premiums to $0 or $10 for low-income people and limited costs for middle-income people to 8.5% of their wages, is also a popular move among many Americans.
More than three-quarters of Americans want these subsidies to continue, according to a new KFF poll conducted before the shutdown. About three in four people said they would blame Trump or the GOP if they were overturned.
While they have so far declined to address the issue this year, GOP leaders have said they are willing to extend them, but with new restrictions on who is eligible. They also said they wanted to discuss policy details within a few weeks rather than under the pressure of a lockdown.
On October 6, House Speaker Mike Johnson accused Democrats of inventing a political problem to shut down the government and urged them to pass a continuity resolution only to “save health care.”
“They decided they were going to start a fight over health care,” Johnson said, adding that he believed subsidies were a “December 31st issue,” referring to the expected expiration date.
With open enrollment starting next month, insurers will need to start publishing premium prices so customers can compare prices in the coming days. Democrats say waiting months to reach an agreement that could change those prices could lead to widespread confusion.
While more and more Americans seem to blame Trump and Republicans for the government shutdown, only a quarter of the public is convinced that Democrats' proposal to extend ACA subsidies justifies the government shutdown, according to CBS News poll will take place on the weekend of October 4th.
Health care is often a winning message for Democrats, who have struggled in recent years to unite around issues that appeal to the working class, said William Pierce, a health policy consultant who served under President George W. Bush.
“Everything revolves around healthcare. They want it all to revolve around health care,” Pierce said, calling it a weak point for Republicans. “They need to talk about it all the time.”
Republicans in the White House and Congress They responded with statementsbased on the dubious evidence that Democrats are seeking to expand free health care to immigrants without legal status in the country.
In fact, these immigrants cannot enroll in the health insurance marketplace, and Democrats did not propose opening ACA coverage to them in their proposal.
Back in Richmond, Thayer is worried about her reporting next year, but she's also concerned that the debate will focus on immigrants. Some of his classmates and colleagues are also worried.
“The reality is that what's happening with these subsidies is that ordinary people – those who want to work in the public sector, those who want to educate their children – we're also going to lose health care,” Thayer said.
KFF Health News Senior Correspondent Bernard J. Wolfson contributed to this report.
KFF health news is a national newsroom that produces in-depth journalism on health issues and is one of the core operating programs of KFF, an independent source of health policy research, polling and journalism. Find out more about Kff.
USE OUR CONTENT
This story may be republished free of charge (details).
