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As the federal government shutdown drags on with no end in sight, the debate over whether to extend federal health insurance subsidies continues to play a central role in the impasse.

U.S. Senate Democrats are conditioning their votes to reopen the government on an extension of tax credits for the Affordable Care Act, or Obamacare. Republicans remain unwilling to negotiate until the shutdown ends, with some calling for a more-comprehensive overhaul of health care in place of extending the subsidies. 

Democratic state legislators pressed the issue at a news conference at the Minnesota Capitol last week, joined by union representatives and others affected by health care costs.

One of those speakers was Lisa Lynch, a single mother from Minneapolis who was diagnosed with Stage 4 breast cancer last January. Lynch said she relies on Medicaid, MinnesotaCare and other public insurance programs to access life-saving treatment. 

“Health care for me isn’t a partisan issue, it’s a human one,” Lynch said. “I’m asking our elected officials to end the shutdown and restore funding for Medicaid and the ACA, because no one fighting for their life should have to fight for their coverage, too.” 

Becky Cook, who uses MNsure for health coverage, said she’s dependent on daily medications costing up to $46,000 per month to treat a condition that can cause sudden swelling, including of her tongue and throat. She said next year, for the same plan, her premiums will rise by almost $5,000 more per year.  

“There have been times that I have gone without my rescue meds because a trip to the ER costs less for me than having to buy the rescue medication,” Cook said, calling Republicans’ position “unconscionable.” 

DFL state legislators including Sen. Alice Mann, a physician from Edina, warned that nearly 200,000 Minnesotans are at risk of losing their health coverage if the subsidies — which are set to expire at the end of the year — are not extended. 

“We are here begging for health care from the same government that just gave Argentina a $20 billion bailout, from the same government that is remodeling the White House and adding a ballroom,” she said.

If the subsidies expire, some out-of-pocket premiums are expected to increase by more than double for those receiving assistance through the Affordable Care Act, according to state Rep. Kaohly Her.

Republicans in Congress say they want a broader overhaul of the health care system. Party leaders have not outlined how they’ll handle the expiring tax credits, insisting they won’t negotiate on the issue until Democrats agree to end the shutdown.

House Speaker Mike Johnson told a press conference Monday that the tax credits are “subsidizing bad policy." Republicans "have a long list of ideas" to address health care costs, he said, and are “grabbing the best ideas that we’ve had for years to put it on paper and make it work.”

“We believe in the private sector and the free market and individual providers,” Johnson added.

The Associated Press reported that a September analysis from the nonpartisan Congressional Budget Office estimated that permanently extending the tax credits would increase the deficit by $350 billion from 2026 to 2035. The number of people with health insurance would rise by 3.8 million in 2035 if the credits are kept, CBO projected.

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As the federal government shutdown drags on with no end in sight, the debate over whether to extend federal health insurance subsidies continues to play a central role in the impasse — including in Minnesota.

A flag waves on the state capitol building 

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people speaking at minnesota state capitol 

In Minnesota and Washington, debate over health care subsidies continues as shutdown drags on

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