The shutdown continues with no clear end in sight as Congress remains at an impasse over the future of enhanced Affordable Care Act (ACA) tax credits and a rollback of Medicaid cuts passed under the One Big Beautiful Bill Act.
The federal government closure will enter its eighth day as Democrats and Republicans seem no closer to reaching an agreement to fund the government through November 21. Senate votes on competing spending measures from both parties have failed to reach the 60-vote threshold.
RELATED: Federal government shutdown: What it means for Medicare, telehealth, ACA premiums, and rural health
Democrats refuse to vote for the spending measure unless Republicans permanently extend the subsidies, which are due to expire at the end of the year. The matter is urgent, they say, because open enrollment for most Americans who purchase health care coverage through the ACA marketplace starts November 1.
Republicans want to negotiate the subsidies only after the government reopens. Party leaders say they are willing to extend the ACA tax credits with new restrictions on who qualifies for them but want to negotiate the details over several weeks, according to KFF Health News.
Regardless of political affiliation, most Americans support the extension of the ACA tax credits, according to a KFF Health Tracking poll. Without the subsidies, premiums are expected to increase 114 percent.
RELATED: Government shutdown: KFF poll finds majority of public wants Congress to extend ACA tax credits
During the shutdown, which began October 1, millions of federal workers were sent home without pay or deemed essential and required to work without pay. On Tuesday, the Trump administration warned in a memo that that there is no guarantee that back pay will be given to furloughed workers, according to the Associated Press.
Meanwhile, with the lapse in government funding, Medicare’s telehealth flexibilities have also expired. Those flexibilities, initiated during the COVID-19 pandemic, allowed Medicare to cover telehealth services for seniors or those who have disabilities.
CMS Administrator Dr. Mehmet Oz called the shutdown a "public health emergency," warning that CMS staff—many now furloughed—are needed to help manage ACA premium adjustments, Fierce Healthcare reported. He stressed that while technical solutions exist to ease premium burdens, they cannot be implemented during a shutdown.
“You don’t want to make a decision of this importance in the middle of a shutdown when folks aren’t at work and there’s a lot of vitriol going back and forth,” Oz said.