U.S. House Minority Leader Hakeem Jeffries (D-NY) and other Democratic House members hold a press conference on the House Steps a day before a partial government shutdown is set to take effect on Capitol Hill in Washington, D.C., U.S., Sept. 30, 2025.
Annabelle Gordon | Reuters
An impasse over health care funding has put the federal government on track to shut down in a matter of hours.
The Affordable Care Act’s enhanced premium tax credits — which millions of Americans have relied on since 2021 — have become a sticking point in the standoff.
Those enhanced credits, which were implemented amid the Covid-19 pandemic, lower the cost of health-insurance premiums paid by Obamacare enrollees and expand their eligibility requirements.
The subsidies are due to expire at the end of the year. Democrats are pressing Republicans, who hold narrow majorities in the House and Senate, to codify an extension of the credits into legislation to keep the government from shutting down starting Wednesday.
Republicans, however, insist that any discussions over extending the subsidies should take place after the shutdown crisis is averted.
That tension has raised questions over the future and cost of health care for the roughly 22 million Americans who rely on the subsidies.
The premiums are relied on by Americans who are not eligible for Medicare or Medicaid, but also do not have health coverage through an employer.
If they disappear at the end of this year, the cost of the tax credits could soar on average by more than 75%, according to KFF, a nonpartisan health policy research group.
For instance, a family of four making $130,000 could see their monthly insurance premiums nearly double to $1,716 from $921, according to a calculator by KFF.
Those price hikes would cause more than four million Americans to lose their insurance by 2034, according to an analysis by the Congressional Budget Office earlier this year.
Part of the health care dispute centers on claims about who, exactly, would receive benefits under Democrats’ proposal.
In addition to the extension of the ACA subsidies, Democrats want to reverse the Medicaid cuts that were signed into law in July through President Donald Trump’s “Big, Beautiful Bill.”
Republicans, however, have seized on their demands to argue that Democrats are pushing to provide government benefits to undocumented immigrants, a claim that Democrats have rebuked.
House Minority Leader Hakeem Jeffries, D-N.Y., on Tuesday called that an “outright lie.”
“Federal law prohibits the use of taxpayer dollars to provide medical coverage to undocumented individuals,” Jeffries said on CNBC’s “Squawk Box.”
“That’s the law, and there is nothing in anything that we have proposed that is trying to change that law,” he said.
At the center of the standoff is a disagreement over a provision in Trump’s policy package that eliminated ACA premium tax credits for “lawfully present” immigrants.
Democrats want to restore access to the premiums for these individuals, which includes those with temporary protected status and other protections.
Undocumented immigrants are ineligible for federally funded health care, according to KFF.