As Shutdown Drags On, Health Care Costs Push Millions to the Brink

As the federal government shutdown stretches into its third week, millions of Americans brace for steep hikes in health insurance premiums that could strip away their coverage altogether. Speakers at a national briefing hosted by American Community Media warned that without congressional action to renew the Affordable Care Act’s enhanced premium tax credits, the nation faces what one called a “double whammy” of higher costs and growing inequity in access to care.

The discussion, titled “As Shutdown Drags On, Is a Compromise Over Health Care Costs Possible?”, brought together three leading policy voices: Anthony Wright, Executive Director of Families USA; Jennifer Sullivan, Director of Health Coverage Access at the Center on Budget and Policy Priorities; and Dr. Ashley Kirzinger, Director of Survey Methodology at KFF. Each described how the political stalemate in Washington threatens to erase years of progress in reducing the number of uninsured Americans.

A Policy Choice, Not an Economic Certainty

Anthony Wright opened with an unflinching assessment of what is at stake. “The increases people are seeing are not inevitable,” he said. “This is a policy choice by Congress and this administration.” He explained that as enhanced premium tax credits expire at the end of 2025, millions who rely on the ACA marketplace will confront skyrocketing monthly costs. “After several years of single-digit increases, the base premium is going up by double digits, about 18 percent on average. For many families, that feels like their premiums doubling or even tripling,” Wright said.

He added that these changes will hit hardest among small business owners, gig workers, and middle-income families who do not qualify for Medicaid. “Across the country, people are opening letters from their insurers and seeing eye-popping increases,” he said. “These are teachers, barbers, restaurant owners, people who run gas stations or nail salons. They are the backbone of local economies.”

Wright called the lapse of premium credits “a man-made crisis.” He warned that up to four million people could lose coverage as soon as the credits expire. “If Congress waits until December, the sticker shock alone will cause one and a half million people to drop out,” he said. “The clock is ticking, and the time to act is now.”

Rural America and Latino Families at Risk

Wright also highlighted the outsized burden facing rural residents and Latino workers. “People in rural areas are going to feel the full brunt of these high health costs,” he said, noting that hospitals in those regions already operate on thin margins. “Fewer paying patients and more uncompensated care could push community hospitals to close. This is not just about people who buy individual coverage. It affects the health system we all rely on.”

In California, Wright estimated that more than half of Covered California’s 1.7 million enrollees are Latino. “These are working people, farmers, construction workers, gig drivers, and small business owners. The progress we made narrowing the coverage gap could unravel overnight,” he said.

The Data Behind Public Anxiety

Dr. Ashley Kirzinger of KFF presented new polling data showing that seven out of ten Americans say they cannot afford higher health care costs without harming their household budgets. “We are seeing deep anxiety across all income groups,” she said. “The shutdown is amplifying that concern because people sense that policymakers are playing politics with their basic security.”

Kirzinger explained that the public’s frustration reflects a broader truth. The United States spends more on health care per capita than any other industrialized nation but lacks the universal systems that help control costs abroad. “Without a unified system, it becomes harder to invest in preventive care and keep costs contained,” she said. “The question now is not whether people support affordable health care, they overwhelmingly do, but whether there is political will to sustain it.”

Who Will Lose the Most

Jennifer Sullivan of the Center on Budget and Policy Priorities broke down who stands to lose coverage if Congress fails to act. “Ninety-three percent of marketplace enrollees receive a premium tax credit,” she said. “These are people who work, small business owners, self-employed workers, young adults just entering the job market, and older adults nearing Medicare eligibility.”

Sullivan said that the expiration of the enhanced credits would hit low-income communities hardest. “Nearly half of enrollees earn less than twice the federal poverty level, about thirty-two thousand dollars a year,” she explained. “For them, even a small increase in monthly costs can make the difference between being insured or uninsured.”

She noted that the tax credit enhancements adopted during the pandemic led to historic gains in coverage among Black and Latino Americans. “We saw a one hundred eighty-six percent increase in coverage among Black people and a one hundred fifty-eight percent increase among Latinos,” she said. “Those gains are now at risk.”

Sullivan emphasized the importance of maintaining zero-dollar premium plans for very low-income enrollees. “People will be out of the game if they have to pay even a dollar,” she said. “When the cost barrier disappears, people enroll. When it comes back, they fall off.”

The Human Cost of Delay

Speakers agreed that the ongoing shutdown and congressional gridlock are deepening public cynicism. “Telling people to wait until December is not realistic,” Sullivan said. “When they see premiums doubling, they panic. For families living paycheck to paycheck, health insurance becomes a luxury.”

The panelists underscored that this moment could reverse more than a decade of progress achieved since the passage of the Affordable Care Act. “This is not about statistics,” Wright concluded. “It is about people’s lives, their mental health, their ability to take their kids to the doctor. Extending these tax credits is the difference between stability and catastrophe for millions of American families.”

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Mientras el Cierre Gubernamental se Prolonga, los Costos Médicos Ponen a Millones al Límite

Mientras el cierre del gobierno federal entra en su tercera semana, millones de estadounidenses enfrentan aumentos drásticos en las primas de seguro médico que podrían dejarles sin cobertura. En una conferencia nacional organizada por American Community Media, expertos advirtieron que si el Congreso no renueva los créditos fiscales ampliados del Acta de Cuidado de Salud Asequible, el país se enfrenta a una crisis sanitaria evitable.

El foro, titulado “A medida que el cierre se prolonga, ¿es posible un compromiso sobre los costos de la atención médica?”, reunió a Anthony Wright, director ejecutivo de Families USA; Jennifer Sullivan, directora de acceso a cobertura de salud del Center on Budget and Policy Priorities; y la Dra. Ashley Kirzinger, directora de metodología de encuestas en KFF.

Una Decisión Política, No Económica

Wright abrió con una advertencia clara. “Estos aumentos no son inevitables,” dijo. “Son una decisión política del Congreso y de esta administración.” Explicó que la expiración de los créditos fiscales a fin de año provocará que millones de familias vean duplicarse o triplicarse sus primas mensuales. “Después de años de incrementos menores, ahora veremos aumentos del dieciocho por ciento en promedio,” afirmó.

Wright subrayó que la crisis golpeará con más fuerza a trabajadores independientes y familias de ingresos medios. “Son los maestros, barberos, restauranteros, dueños de gasolineras y salones de belleza. La gente que mantiene viva la economía local,” dijo.

Impacto en Comunidades Rurales y Latinas

Según Wright, las áreas rurales y las familias latinas serán las más afectadas. “Los hospitales rurales podrían verse obligados a cerrar por la falta de pacientes asegurados,” explicó. En California, donde más de la mitad de los inscritos en Covered California son latinos, el impacto será devastador. “Los avances logrados para reducir la brecha de cobertura podrían desaparecer de la noche a la mañana,” advirtió.

Datos que Reflejan la Angustia Pública

La Dra. Kirzinger presentó encuestas que muestran que siete de cada diez estadounidenses no pueden afrontar mayores costos médicos sin afectar su presupuesto familiar. “El público siente ansiedad y frustración,” señaló. “Gastamos más que cualquier otro país industrializado, pero no tenemos un sistema unificado que controle los costos.”

Quiénes Son los Más Vulnerables

Jennifer Sullivan detalló que el noventa y tres por ciento de las personas que usan el mercado de seguros reciben créditos fiscales. “Son trabajadores, pequeños empresarios y adultos mayores que aún no califican para Medicare,” explicó. “Casi la mitad gana menos del doble del nivel federal de pobreza.”

Sullivan añadió que las mejoras implementadas en 2021 impulsaron una expansión histórica en la cobertura de afroamericanos y latinos. “Si se eliminan estos créditos, esos logros desaparecerán,” dijo. También defendió la necesidad de mantener los planes con prima de cero dólares. “Para muchas familias, incluso un dólar adicional significa perder su seguro.”

El Costo Humano de la Inacción

Los tres expertos coincidieron en que la falta de acción del Congreso agrava la desesperanza. “Decirle a la gente que espere hasta diciembre no es realista,” afirmó Sullivan. “Cuando ven aumentos tan altos, simplemente se rinden.”

Wright cerró el panel con un llamado urgente. “No se trata de números. Se trata de vidas. Extender estos créditos es la diferencia entre estabilidad y catástrofe para millones de familias estadounidenses.”

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