Congress Moves to End Historic Government Shutdown Without Key Health Care Demand

It seems that Congress is on the verge of concluding the longest federal government shutdown ever recorded, yet they’re leaving out a critical request from Democrats: the extension of tax credits aimed at making health insurance more affordable for about 225,000 residents in Colorado.

Laura, who preferred not to share her full name due to her job’s restrictions on public comments, expressed how deeply the situation affected her. “It brought tears to my eyes,” she shared. Living with her husband in the San Luis Valley, they obtained health insurance via the state exchange, which raised deductibles to manage costs. Laura is employed by a nonprofit and does not have employer-provided insurance; her husband is self-employed.

“We have a solid plan at the moment, and our monthly payment is roughly $935,” she explained. They are currently enrolled in the Gold plan, the highest level of coverage. “I looked up other plans recently, and the cheapest one for the next year seems to be over $1,700 a month, which is fairly basic,” she noted.

The couple has an annual income of around $120,000. If they maintain their current plan, their costs would spike to nearly $3,000 a month. “I can’t see spending more than $30,000 just on insurance…it’s just not feasible right now. I really hope nothing happens to either of us; we can’t afford that, either,” she said.

For Mercedes von Pichil and her family in Commerce City, living without insurance is simply not feasible. She and her husband own a small music business, generating about $120,000 last year. They have a bronze plan, and given her asthma, she previously paid around $205 a month for coverage sufficient for their family of three. Recently, they welcomed a new baby, leading to a seven-week stay in the neonatal intensive care unit (NICU).

“My monthly payment is now likely $539.12,” she revealed, even after some subsidies. She intends to enroll her youngest in Medicaid because he needs long-term care not covered by their main insurance. The new premiums will be “barely” manageable, but she feels that, “I can’t take the risk of being uninsured. I just have to make it work.”

“As small business owners, we must cover our own health insurance costs,” von Pichil said. “Before the Affordable Care Act, we couldn’t manage insurance, and we didn’t have kids then. Insurance was life-saving for us.”

While she disapproved of federal employees working unpaid during the six-week shutdown, she appreciated the Democrats’ fight for health care. “I think it’s appalling. Quite frankly, it shouldn’t be happening. But on the other hand, what does it all mean?” she pondered, acknowledging the struggle to help many keep their health insurance. “So, it’s a fight worth having.”

Recent arrangements among eight Senate Democrats to end the filibuster set Congress on a path to reopen the government, with a commitment to discuss the tax credit extension by mid-December.

Von Pichil is skeptical about the likelihood of Republican support for the credit extension. “I’m really frustrated that the Democrats gave in. What’s the point of a government shutdown if nothing changes?”

This situation presents a significant challenge for those purchasing insurance through exchanges. Over the past five years, households dedicating more than 8.5% of their income to insurance have benefited from enhanced federal subsidies, but those are due to expire at year’s end. Meanwhile, insurers are pushing for significant price hikes, the first since 2018.

As reported by the Colorado Department of Insurance, the average premium increase approved for next year stands at 22.6%. For recipients of the subsidy, the net average premium could see a staggering “101 percent increase” due to loss of credit.

Among the largest hikes will be in rural areas; for instance, Crowley faces a 223 percent increase, Delta comes in at 206 percent, Montrose at 246 percent, and Ouray at 237 percent.

Democratic Senator John Hickenlooper voted against the agreement that his party reached to end the shutdown. “There’s a significant difference between an 8% increase and a 250% increase,” he noted, emphasizing that constituents are urging him to persist in the fight. “It’s just not right for anyone, particularly Republicans, to sit back while people risk losing their health insurance.”

Karen, who chose to withhold her last name for candid discussions about her financial situation, had her own struggles. She and her husband, living in Pueblo, have opted for early retirement. After years of employment, they thought this would be manageable. Since married couples can earn up to $100,000 to remain eligible for enhanced tax credits, they were optimistic.

However, upon reviewing their insurance options, they discovered that their current $495 monthly premium would skyrocket to $2,200 the following year.

“The website claims it’s an 18 percent increase, and I’d be thrilled if that were the case, but ours has risen by 345 percent,” Karen revealed. Fully aware of the role subsidies play and their impending phase-out, she expressed disbelief. “Honestly, we had assumed the subsidies would be extended; otherwise, what can we do?”

She added that they are not the type to gamble with their health and feel cornered. “We really can’t take the risk of going without insurance,” she said, emphasizing that the only alternative would mean paying $2,200 monthly.

Even before news of the agreement surfaced, Karen was doubtful that Congress would address the issue. Although she understands the ACA isn’t perfect, “at least we have something,” she reflected.

While she is relieved the government might reopen soon, she fears that Republicans will let the subsidies fade away. “They’ve been trying to repeal the ACA for 15 years. They need to accept reality before voting against it. We lack alternatives; they should have worked to provide options rather than outright repeal,” she argued.

Recently, President Trump suggested that the federal government should give money directly to Americans to help them cover insurance premiums, but no official proposals have emerged yet.

Laura, from the San Luis Valley, also finds it hard to stay optimistic. “I really doubt this will be revisited in December. It’s unsettling to think about what that could mean for us.” Yet, she plans to hold off on making her decision next year about whether to go on the exchange or risk being uninsured.