Health care at the heart of Capitol Hill standoff as shutdown looms

With a government shutdown just hours away, one of the key sticking points between Republicans and Democrats involves health care, specifically whether to extend premium subsidies under the Affordable Care Act.

The debate centers on enhanced tax credits that help millions of Americans afford insurance through ACA marketplaces. These subsidies are currently scheduled to expire at the end of 2025, but Democrats are pushing for action now to avoid disruptions during the upcoming open enrollment period.

“Twenty-two million people across the country get their coverage through the Affordable Care Act marketplaces,” said Anne Reid, policy director of the Funders Forum on Accountable Health at the Milken Institute School of Public Health at George Washington University.

“The vast majority of th