Hours into the federal government shutdown, Julio Fuentes stood steps from the U.S. Capitol to deliver an urgent message about the Hispanic voting bloc that helped the GOP sweep into power last year.<\/p>\n
Those votes, he cautioned, are at risk if Congress doesn\u2019t pass a law to preserve lower premiums on Affordable Care Act marketplace plans for the roughly 4.7 million people living in his home state of Florida who are enrolled in the coverage.<\/p>\n
\u201cHispanic voters helped return Donald Trump to the White House,\u201d said Fuentes, CEO of the Florida State Hispanic Chamber of Commerce, who called on Congress to reopen the government to work out a deal on the tax credits. \u201cRepublican leaders would do right by their constituents to keep coverage affordable, and they will remember that heading into the midterms.\u201d<\/p>\n
With less than a month to go before many Americans pick their health insurance plans for the next year, Democrats in Congress are holding up government funding to pressure Republicans into extending billions of dollars in federal tax credits that have in recent years dramatically lowered premiums and contributed to record-low rates of uninsured Americans.<\/p>\n
Democrats see the high-stakes standoff as a chance to talk about affordable health care as millions of Americans \u2014 including those enrolled in coverage through a workplace or Medicare \u2014 brace for higher costs next year. Party leaders, hoping to win back support from some of the working-class supporters who have drifted away from them, have used the moment to remind voters of the recent cuts Republicans have approved to some health care programs.<\/p>\n
Republicans are outwardly exuding confidence that the approach will not find traction, reminding the public that Democrats forced the shutdown. But a new KFF analysis<\/a> shows that 80% of all premium tax credits benefited enrollees in states Trump won.<\/p>\n The shutdown coincides with open enrollment season, with insurers preparing to send notices revealing next year\u2019s premium rates for roughly 24 million people enrolled in ACA coverage. The average enrollee is expected to pay more than double<\/a> if the tax credits are left to expire. Insurers have also said they\u2019ll have to dramatically raise the price of premiums because healthier people will opt out of coverage as it becomes more expensive, leaving a sicker pool of Americans \u2014 and less money to cover them.<\/p>\n \u201cOver the next few days, what you\u2019re going to see is more than 20 million Americans experience dramatically increased health care premiums, copays, and deductibles because of the Republican unwillingness to extend the Affordable Care Act tax credits,\u201d House Minority Leader Hakeem Jeffries said Oct. 2 on the steps of the Capitol.<\/p>\n Open enrollment in most states begins on Nov. 1. Some insurers and exchanges have delayed sending notices detailing premium rates for next year, because they are waiting to see what unfolds in Washington. For example, Covered California, the state\u2019s insurance marketplace, is planning to mail out notices to more than a million enrollees later than usual this year, on Oct. 15.<\/p>\n From her home in Richmond, Virginia, 31-year-old Natalie Tyer is anxiously awaiting the arrival of her notice. She checks the state\u2019s marketplace website daily to see whether new rates for her insurance plan have been posted.<\/p>\n Tyer has been relying on marketplace coverage for over a year now while she works part-time for a small video production company and pursues a master\u2019s degree to become a school counselor. The tax credits help cover $255 of her monthly premium, bringing it down to $53. Since she\u2019s generally healthy, if the credits expire and her premiums go up significantly, she might drop coverage altogether.<\/p>\n \u201cI very well might have to go without health insurance and may have to rely on hope,\u201d Tyer said.<\/p>\n Democrats\u2019 push to center the shutdown on health care affordability, though, runs up against many uncomfortable realities of the federal government\u2019s closure, which will leave millions of federal workers without paychecks, hamper some functions of public health agencies, and threaten food assistance payments for low-income mothers, among other effects.<\/p>\n The ACA, meanwhile, has been a political flash point since 2010, when Republicans fought against the passage of the landmark health care legislation. A wave of Republican congressional victories soon followed that fight, spurring a government shutdown in 2013, when the GOP tried to gut the program. Party leaders again tried to repeal it in 2017 to follow through on a Trump campaign promise.<\/p>\n The latest clash \u2014 over the billions of dollars in tax credits that Democrats issued during the covid-19 pandemic to boost enrollment in the ACA \u2014 has been simmering for months. Democrats, who wrote the original legislation introducing and then extending them, set the enhanced tax credits to expire at the end of this year. Even some Republicans began warning this summer that letting those tax credits lapse could be detrimental, with Republican pollsters Tony Fabrizio and Bob Ward issuing a memo cautioning that an extension of the credits could make a difference in next year\u2019s midterm election.<\/p>\n Extending the ACA tax credits, which have reduced monthly premiums to as little as $0 for poorer enrollees and capped the amount middle-income Americans pay to just 8.5% of their income, also would be a popular move.<\/p>\n More than three-quarters of Americans want those tax credits to continue, according to a new KFF poll<\/a> conducted before the shutdown. About 3 in 4 people said they will blame Trump or the GOP if they end. KFF is a health information nonprofit that includes KFF Health News.<\/p>\n Although they\u2019ve declined to address the tax credits so far this year, Republican Party leaders have signaled they are willing to extend the ACA tax credits, but with new restrictions on who qualifies for them. GOP leadership has also said they want to hash out the policy details over several weeks, not under the gun of a shutdown.<\/p>\n On Oct. 6, House Speaker Mike Johnson accused Democrats of manufacturing a political issue to shut down the government and urged them to pass the continuing resolution just to \u201ckeep the lights on.\u201d<\/p>\n \u201cThey decided that they would pick a fight on health care,\u201d Johnson said, adding that he believes the tax credits are \u201ca Dec. 31 issue,\u201d referring to when the credits are set to expire.<\/p>\n Since open enrollment begins next month, insurers will need to start posting premium prices for customers to window-shop in the coming days. Democrats have argued that waiting months to work out a deal, which could change those prices, might spur widespread confusion.<\/p>\n While more Americans appear to be faulting Trump and Republicans for the shutdown, only a quarter of people are convinced that the Democrats\u2019 proposal to extend the ACA tax credits is worth closing the government over, according to a CBS News poll<\/a> over the weekend.<\/p>\n Health care is typically a winning message for Democrats, who have struggled to coalesce around issues that appeal to the working class in recent years, said William Pierce, a health policy consultant who served under President George W. Bush.<\/p>\n \u201cIt\u2019s all about health care. They need to make this all about health care,\u201d Pierce said, describing it as a weak spot for Republicans. \u201cThey need to just keep talking about it, constantly.\u201d<\/p>\n Republicans in the White House and Congress have countered with factually dubious claims<\/a> that Democrats are seeking to expand free health care for immigrants who do not have legal status in the U.S.<\/p>\n In fact, such immigrants are not eligible for enrollment in the marketplace, and Democrats have not proposed opening ACA coverage to them in their proposal.<\/p>\n Back in Richmond, as Tyer worries about her coverage for next year, she\u2019s bothered to see the debate focus on immigrants. Some of her classmates and colleagues are worried, too.<\/p>\n \u201cThe reality is, what\u2019s happening with these tax credits is that normal people \u2014 people who want to work in the public sector, who want to educate kids \u2014 we are also going to lose health care,\u201d Tyer said.<\/p>\n KFF Health News senior correspondent Bernard J. Wolfson contributed to this report.<\/em><\/p>\n\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n