Government Shutdown Concluded but ACA Subsidies in Limbo

After the House of Representatives voted to pass the Senate-approved government funding package on November 12, the longest recorded government shutdown in American history came to an end. However, the reason for the shutdown and Democrat hesitation to sign the bill to begin with—the federal tax credit that offset the cost of the Affordable Care Act (ACA)—was not a part of the bill, leaving the future cost of ACA plans unknown.

The government shutdown began on October 1, when Senate Democrats rejected the spending bill proposed by the Republicans, as it did not include an extension of the ACA subsidies, which are set to expire this year.¹ The subsidies were first introduced in 2021 and were for coverage in private health insurance marketplaces, which primarily help people who make too much to apply for Medicaid but do not get insurance through their employer.² The subsidies aim to make the marketplace coverage affordable based on income. About 24 million people are set to be affected by the rise in premiums should these subsidies not be extended.

A total of 8 senators who caucus with the Democrats agreed to a deal on November 10 to end the shutdown. However, this decision came without any agreement on the fate of the subsidies.³ Senate Republicans have since agreed to vote on extending the subsidies in December but there has been no indication that House Republicans are also willing to take this to a vote. Despite that, the bill passed the House in a 222 to 209 vote, with 6 Democrats voting with Republicans to end the shutdown.

Should the subsidies not be extended, they will end at the end of 2025. A KFF analysis found that premium payments for the ACA marketplace would more than double for some individuals.⁴ Those at 115% and 141% of the federal poverty level could see their premiums increase from $0 to up to $794 due to both the subsidies ending and changes to tax credit calculations brought on by the Trump administration. Experts worry that this could leave millions without health insurance due to the change in affordability.

House Democrats are reportedly aiming to force a vote on the ACA subsidies using a discharge petition, which would require 218 signatures to get the issue on the floor.⁵ With only 214 Democrats in Congress, this would require at least 4 Republicans to sign to bring it to a House vote.

President Donald Trump has called for sending money saved from not extending the tax subsidies to Americans to use to purchase other types of insurance.³ It is unknown how feasible this plan is and whether this plan would lead to higher health care costs, with some experts suggesting that it would be easier for insurance companies to pocket more money that they collect on premiums.⁶ Experts also indicated that the plan could work for younger, healthier adults but would be a detriment to those with underlying conditions or of older age.

The future of ACA subsidies lies in limbo as the new year approaches, with only a couple of weeks until Americans face the increased price of insurance. With several plans in motion to address this, with varying levels of feasibility, the potential for loss in coverage across the nation could affect areas that have already been affected by cuts to Medicaid from the One Big Beautiful Bill. A solution to these subsidy increases will be needed to prevent widespread loss of insurance coverage among those using the ACA.

References

1. Wong S, Boudreaux L, Thorp F V, Nobles R. Some senators predict the government shutdown, now the longest in history, could end this week. NBC News. November 4, 2025. Accessed November 13, 2025. https://www.nbcnews.com/politics/congress/senators-predict-government-shutdown-end-this-week-rcna241823

2. The health insurance subsidies behind the government shutdown. Harvard Kennedy School. October 20, 2025. Accessed November 13, 2025. https://www.hks.harvard.edu/faculty-research/policy-topics/health/health-insurance-subsidies-behind-government-shutdown

3. Picchi A. Failure to extend ACA tax credits in government funding package leaves millions in limbo. CBS News. Updated November 13, 2025. Accessed November 13, 2025. https://www.cbsnews.com/news/government-shutdown-affordable-care-act-premium-tax-credits-what-next/

4. Lo J, Levitt L, Ortaliza J, Cox C. ACA Marketplace premium payments would more than double on average next year if enhanced premium tax credits expire. KFF. September 30, 2025. Accessed November 13, 2025. https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/

5. Wu N, Hill ML. House Dems to launch effort to force Obamacare subsidies extension. Politico. November 12, 2025. Accessed November 13, 2025. https://www.politico.com/live-updates/2025/11/12/congress/house-dems-to-launch-effort-to-force-obamacare-subsidies-extension-00648096

6. Kekatos M. Is Trump’s idea to pay Americans directly for health care possible? ABC News. November 12, 2025. Accessed November 13, 2025. https://abcnews.go.com/Health/trumps-idea-pay-americans-directly-health-care/story?id=127410223