Millions of Americans could lose access to affordable health care as Congress remains deadlocked over funding the federal government. The impasse stems from a dispute over Republican-led budget cuts that Democrats say would slash Medicaid, Affordable Care Act (ACA) tax credits, and other essential programs.
At the center of the conflict is the “One Big Beautiful Bill,” a Republican-backed spending package that includes large tax cuts for corporations and high-income earners. Critics say the measure removes key provisions that help working families afford health insurance and other basic needs.
“My kids have health care through Medicaid — which is especially important for my daughter with autism,” said Alexis Cortes, a mother of four. “The ‘One Big Beautiful Bill’ calls for massive cuts to Medicaid, food assistance, and early childhood education programs.”
According to KFF Health, about 24 million Americans could see their ACA premiums double if the tax credits set to expire this year are not renewed. The report also found that premiums could rise for other insured Americans due to the ripple effect of the lost subsidies.
The legislation also cuts more than $1 trillion from Medicaid to offset corporate tax breaks, which analysts warn could reduce access to long-term care, nursing homes, and hospital services, especially in rural communities.
Republicans are pushing a short-term spending bill that continues former President Donald Trump’s freeze on nearly $500 billion in community funds and maintains widespread agency staffing cuts. The proposal keeps reductions to programs such as education, health care, food assistance, and medical research.
Democrats have introduced an alternative funding plan that restores health care and education funding, stabilizes ACA subsidies, and prevents the White House from withholding congressionally approved funds. With Republicans holding majorities in both chambers, however, the proposal has not advanced.
Nearly 80 percent of Americans, including many Trump supporters, support extending the ACA tax credits, according to recent polling data cited by Democratic lawmakers.
Trump has claimed that Democrats are blocking the bill to prioritize funding for undocumented immigrants, an assertion that immigration experts say is false. Federal law prohibits undocumented immigrants from receiving government health benefits, although they contribute taxes through payroll deductions and purchases.
“The claim that Democrats want to fund undocumented immigrants instead of Americans is simply inaccurate,” said Dr. Lena Howard, a public policy analyst at Georgetown University. “This debate is about domestic funding priorities, not immigration.”
Trump has also vowed to use the shutdown to expand federal worker layoffs and restrict funding for states that voted against him, which critics argue is punitive and politically motivated. Reports indicate that some government agencies have posted partisan messages online blaming Democrats for the shutdown, actions that may violate federal laws including the Hatch Act, the Impoundment Control Act, the Anti-Deficiency Act, and the Anti-Lobbying Act.
As the stalemate continues, families who depend on Medicaid or ACA coverage face growing uncertainty. “We’re scared,” Cortes said. “If our coverage disappears, I don’t know how we’ll afford the care my kids need.”
