As the United States marks yet another government shutdown, the country finds itself at the epicenter of a bitter political struggle over health care, social protections, and the very future of public services. Federal agencies have been shuttered since October 1, 2025, after Congress failed to pass a bill to fund the government, leaving roughly 750,000 nonessential federal workers on enforced leave and essential employees working without pay. At the heart of the deadlock lies a heated dispute over the future of Affordable Care Act (ACA) subsidies, a lifeline that millions of Americans rely on to keep their health insurance affordable.
According to reporting by CNN, Democrats are demanding the extension of enhanced tax credits for people purchasing insurance through the ACA marketplace—credits that were beefed up during the Covid-19 pandemic but are set to expire at the end of this year. The stakes are enormous: if Congress fails to act, premiums for 24 million Americans could spike by an average of 114% in 2026, jumping from $888 in 2025 to a staggering $1,904 the following year. The Congressional Budget Office warns that four million people could lose coverage altogether.
Democrats argue that letting these subsidies lapse would be catastrophic for working families, particularly in rural areas and Republican-leaning states like Texas and Florida, where ACA enrollment is highest. Their rallying cry has been simple: "Protect working families. Extend the subsidies. Reopen the government." As the shutdown drags on, their message resonates with much of the public. A recent KFF survey found that 78% of Americans support extending the subsidies, including 59% of Republicans.
But Republican leaders, who currently control Congress and the White House, insist that health care policy should be debated separately from government funding. They have proposed what they call a "clean" bill to keep the government running through November 21, without any strings attached. However, the party itself is divided. Some moderates support the extension of subsidies, seeing the potential political fallout of premium hikes, while hardline conservatives reject what they label as "Covid-era handouts." The intra-party rift became especially visible when Georgia Congresswoman Marjorie Taylor Greene broke ranks, expressing her outrage that premiums could double for her own grown-up children.
"Everyone’s just getting destroyed," Greene lamented in comments to CNN. "Look, Democrats, you created this mess. Republicans, you have no solutions. You haven’t come up with a new plan in place, and we’re not even talking about it, and it is hurting so many people." Her criticism extended to GOP leadership, including Speaker Mike Johnson, whom she urged to bring the House back to Washington to build consensus. "Any serious speaker of the House is going to build consensus within his conference behind a plan. It’s not something secret that gets worked on in a committee," she said.
Greene also sounded the alarm about the coming "cliff for millions and millions of Americans where their health insurance premiums are about to skyrocket." She didn’t spare President Donald Trump’s advisers, suggesting the former president isn’t always "getting the best advice." While she reaffirmed her support for Trump, Greene emphasized her responsibility to her district, stating, "I also work for my district, and I made that clear over and over again, that’s who has voted for me." She further criticized her GOP colleagues for blaming Senate Minority Leader Chuck Schumer for the shutdown, warning that Republicans are losing the messaging war. "I think the politics are terrible," she told CNN. "I don’t think anyone is sitting at home going, ‘Oh, this is great. The Republicans and Democrats have the government shut down, and they’re not discussing anything to fix it.’"
The finger-pointing is relentless. Republicans accuse Democrats of holding the government hostage over unrelated demands, while Democrats counter that Republicans are risking the health of millions by refusing to extend ACA subsidies. The rhetoric has been further inflamed by Trump and his allies, who have pushed misleading claims that Democrats want to give free health care to undocumented immigrants—a charge that, according to CNN, is not supported by current law or Democratic proposals.
Public opinion reflects the complexity of the situation. According to a CBS News/YouGov poll, 39% of Americans blame Trump and GOP lawmakers for the shutdown, 30% blame Democrats, and another 31% blame both parties equally. In this climate of mutual recrimination, the prospect of a quick resolution seems remote.
Meanwhile, the crisis in health care is not confined to the corridors of Congress. On October 14, nearly 46,000 Kaiser Permanente nurses and healthcare professionals across California, Oregon, and Hawaii are set to strike, according to an open letter published by the WSWS Healthcare Worker Newsletter. Their grievances—unsafe staffing, sub-inflation pay raises, and relentless overwork—mirror the broader struggles facing the U.S. health care system. The letter frames the strike as part of a nationwide fight not just for better working conditions, but for the survival of public health and democratic rights.
The letter is unflinching in its criticism of both major parties. It accuses the Trump administration of using the shutdown to escalate authoritarian rule, with plans to permanently fire federal workers and slash Medicaid—a move that would devastate hospitals and push millions further into poverty. But it also charges Democrats with mounting "no serious opposition," alleging that both parties serve the interests of a corporate and financial oligarchy profiting from austerity and the destruction of public health.
The Kaiser workers’ demands are sweeping: enforce the democratic decision to strike, fight for an open-ended strike until all demands are met, organize mass support, set staffing ratios by workers themselves, defend immigrant workers and patients, demand inflation-busting raises, limit overtime, guarantee free vaccination and COVID-19 protections, reinstate infection-control protocols, and redirect Kaiser’s billions in profit toward care and wages. The letter notes that Kaiser Permanente’s net income tripled to $12.9 billion last year, with total assets of $74.1 billion, even as workers face austerity and burnout.
The broader context is one of deepening social and political crisis. The letter links the struggle of health care workers to attacks on science, public health, and democratic norms, citing the spread of vaccine misinformation and the rollback of pandemic protections as part of a deliberate policy to reduce spending on social programs and increase profits for the wealthy. It warns that the destruction of public health is central to what it calls a "fascistic agenda," and urges workers to unite across industries to resist authoritarianism and defend the right to high-quality, affordable health care for all.
As the shutdown continues with no clear end in sight, millions of Americans are left in limbo—facing the specter of soaring health care costs, lost coverage, and a political system seemingly incapable of compromise. The coming weeks will test not only the resolve of lawmakers in Washington, but the capacity of workers and communities across the nation to demand a future where health care is a right, not a privilege.
