As the clock ticks down toward a September 30 deadline, the U.S. Congress is caught in a fierce standoff over government funding, with health care policy and research at the heart of the battle. With the threat of a government shutdown looming, the debate has become deeply personal for millions of Americans, from cancer patients in Maine to expectant mothers in rural Georgia, all watching anxiously as lawmakers spar over the future of Medicaid, health insurance subsidies, and medical research funding.
On September 17, 2025, Republican leaders in both the House and Senate made it clear: they will not accept Democratic demands for an immediate extension of health care subsidies in the must-pass stopgap spending bill. According to the Associated Press, Senate Majority Leader John Thune, R-S.D., put the choice squarely on the Democrats’ shoulders, declaring, “They can work with Republicans, or they can shut down the government with all that will mean for the American people.”
The House is poised to vote as soon as September 18 on a Republican-backed measure that would keep federal agencies funded through November 21, buying time for further negotiation. Republicans insist their bill is a "clean" funding measure, free of partisan add-ons, and argue it mirrors what Democrats have demanded in previous budget fights. Yet Democrats say it falls far short, especially for Americans who rely on Affordable Care Act subsidies and Medicaid.
Late on September 17, Democrats released a counterproposal that would extend subsidies for low- and middle-income individuals buying insurance through the Affordable Care Act and reverse Medicaid cuts included in the so-called “big beautiful bill” passed earlier this year. The Democratic plan also calls for more than $180 million for congressional security and $140 million for the Supreme Court and federal courts, compared to the GOP’s $88 million increase for security spending—a reflection of heightened safety concerns after the recent assassination of conservative activist Charlie Kirk.
But Republican leaders, including House Speaker Mike Johnson, have refused to consider the Democratic alternative. “They’re trying to insert unrelated matters into the middle of a clean government extension. And I don’t think that’s going to work,” Johnson told CNBC on Wednesday morning.
The stakes are high. Without support from at least seven Senate Democrats, the Republican bill cannot pass, and a government shutdown on October 1 becomes likely. A shutdown would close most federal agencies and halt paychecks for millions of federal employees, including many in the military. Democrats, led by Senate Majority Leader Chuck Schumer, warn that Republicans will bear the blame if the government shuts down. “They’re going to end up shutting down the government,” Schumer said, arguing that the public is more wary of Trump and the GOP after the passage of Medicaid cuts earlier this year.
The political brinksmanship has real-world consequences, especially in rural communities. In Lavonia, Georgia, St. Mary’s Sacred Heart Hospital announced on September 10 that it will discontinue its labor and delivery unit next month, a casualty of the $1 trillion Medicaid funding cuts in the federal budget reconciliation package enacted earlier in 2025. The hospital’s parent company, Trinity Health Georgia, cited an 18-month discernment process, recruitment challenges, changing demographics, and “recent Congressional cuts to Medicaid” as key factors in the decision.
Pregnant patients in at least four Northeast Georgia counties will now have to travel to Athens—over an hour away by car—or to Stephens County Hospital in Toccoa for labor and delivery services. St. Mary’s Emergency Department will still handle emergency births, but it’s not equipped for higher-level care. According to the Center for Healthcare Quality and Payment Reform, only 36% of Georgia’s rural hospitals still provide labor and delivery services as of August 2025. In Georgia, 45% of all births—and nearly 60% in rural areas—are covered by Medicaid, highlighting how deeply these cuts affect local communities.
The closure of rural maternity wards is not just a health crisis; it’s an economic one. As HomeTown Health CEO Jimmy Lewis told local reporters, “Over a period of the last five to 10 years, we’ve closed somewhere in the vicinity of 14 baby delivery systems. And when they close, it puts the community in an extremely adverse situation, both from a health care standpoint and from an economic development standpoint.”
Hospitals like Evans Memorial in Georgia are also considering scaling back services due to budget shortfalls tied to Medicaid cuts. While the federal budget reconciliation bill did allocate $50 billion to offset the impact of these cuts, it’s up to state governments to apply for and distribute the funds. On September 14, White House spokesperson Victoria LaCivita called on all governors to apply for the program, describing it as “a win for every rural community across the country.”
The fight over health care funding is also being felt in Maine, where cancer patients and advocates from the American Cancer Society Cancer Action Network met with the state’s congressional delegation in Washington, D.C. this week. Their message: protect federal funding for cancer research and extend health insurance subsidies before the September 30 deadline. “Health should not be about wealth,” said Shawna Ackley, a cancer survivor from Scarborough, Maine.
Advocates are deeply concerned about the unpredictability caused by short-term funding measures. “We want there to be predictability, so that the market can make plans, that patients and families can make plans, that hospital systems can make plans,” said Mikala Bousquet, the organization’s lead ambassador for Maine.
Since President Donald Trump’s second term began, millions are expected to lose health insurance due to tax cut legislation signed on July 4, 2025. The administration has also suspended and cut many National Institutes of Health (NIH) and other federal grants, particularly those related to diversity, equity, and inclusion (DEI) programs, following a U.S. Supreme Court decision in August. Jackson Laboratory in Maine, for example, saw the termination of DEI-related grants and delays in NIH funding. Senator Susan Collins of Maine, chair of the Senate Appropriations Committee, has faced criticism for her approach to addressing these funding cuts, though she has long championed federal support for medical research.
Congressional committees have largely rejected Trump administration proposals to further slash funding for medical research and health initiatives for the 2026 fiscal year, but the future of the enhanced premium tax credit—vital for thousands of Mainers and millions nationwide—remains uncertain. In Maine alone, about 61,000 people are enrolled through the state’s health insurance marketplace. Without action, they could see steep premium hikes and reduced access to care.
U.S. Senator Jon Ossoff, a Democrat from Georgia, criticized the Medicaid cuts and the resulting service closures during a September 14 appearance in Atlanta. “It’s not a mystery that in a flourishing society, the means of achieving health and long life are a right accessible to all, and not just to those who live in the right place or have the means,” Ossoff said. “Especially when the disappearance of those services for the people is a result of the pursuit of other priorities, namely to further enrich those who already have the most.”
Former President Donald Trump, for his part, has been dismissive of Democratic warnings about a shutdown, saying, “If you gave them every dream, they would not vote for it.” Democrats have seized on those words, insisting that Trump and the GOP would take the blame if the government shuts down.
As the September 30 deadline approaches, Americans across the country are left waiting—some with hope, many with frustration—as their access to health care, research, and even the economic stability of their communities hangs in the balance.
