By Brendan Scanland
WASHINGTON, D.C. — Tonight, the federal government remains shut down. At the heart of the fight is healthcare.
Democrats want to expand access and reverse past cuts, while Republicans argue the Democratic funding proposal would open the door to healthcare coverage for unlawful immigrants. Each side is accusing the other of lying about how and where federal healthcare dollars are spent.
Democrats want to extend enhanced subsidies for Affordable Care Act (ACA) coverage and also roll back cuts to Medicaid from President Trump’s domestic policy bill, which they warn is set to deliver big price hikes across the board.
“Every single Michigander with private employer-provided insurance, including you and me, is going to get a notice of prices going up between 10 and 20% starting January 1,” said Sen. Elissa Slotkin (D-Mich.).
The enhanced subsidies — part of the Biden administration’s COVID relief — are set to expire at the end of this year. If they lapse, ACA marketplace enrollees could see their out-of-pocket premium payments more than double next year, according to the nonpartisan health policy research group KFF.
“If the subsidies expire, like you mentioned, the premiums could rise. So what can happen is for a lot of Americans, they could lose coverage. Their insurance premiums can go up. And that’s I think an estimated about 4 million Americans that could be impacted and lose coverage,” said Dr. William Soliman, founder and CEO of the Accreditation Council for Medical Affairs.
This week, much of the debate focused on exactly who benefits from federal healthcare dollars and programs like Medicaid.
“The Chuck Schumer–AOC wing of the Democratic Party shut down the government because they said to us, ‘we will open the government, but only if you give billions of dollars of funding for health care for illegal aliens.’ That’s a ridiculous proposition,” said Vice President JD Vance.
A fact sheet from the White House said the Democrats’ funding proposal would result in nearly $200 billion spent on healthcare for illegal immigrants and other non-citizens over the next decade.
But under current law, eligibility for Medicaid and CHIP is limited to lawfully present immigrants with a qualified immigration status.
“Undocumented immigrants do not get federal health insurance premiums. Period. They’re lying,” said Senate Minority Leader Chuck Schumer (D-N.Y.).
Republicans in Washington have recently pointed to emergency room visits by unlawful immigrants to support their argument. At Medicare-participating hospitals, all individuals are required to be treated- regardless if they can pay- under the 1986 Emergency Medical Treatment and Labor Act.
But according to KFF, less than 1% of total Medicaid spending went toward emergency Medicaid for undocumented immigrants in fiscal year 2023.
While both sides agree the shutdown can’t last forever, neither party is backing down on healthcare. That means the stalemate — and the uncertainty for millions of Americans — could drag on.
