Medications on pharmacy shelves in Los Angeles, May 12, 2025 (Eric Thayer/Getty Images).
Health care has been a central issue in the longest federal government shutdown in U.S. history. The shutdown appears to be nearing an end, but the broader dispute over health coverage has not been resolved.
Since 2021, people who buy coverage on the Affordable Care Act marketplaces have received expanded help through enhanced tax credits. If Congress does not reach a compromise, those subsidies that helped a record number of Americans enroll could expire for 2026 coverage.
Negotiations to reopen the federal government include an informal promise of a Senate vote on the subsidies by the second week of December, but that commitment is not written into the formal legislation to reopen the government.
Open enrollment has begun, allowing consumers to shop for next year’s plans. Because Congress has not yet renewed the subsidies, many of the roughly 24 million people with marketplace plans may face large monthly premium increases for 2026 compared with their 2025 plans.
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