Overview

• The health care dispute has kept the government shuttered since Oct. 1 after Senate Democrats rejected a seven-week House stopgap, with the House-passed funding bill failing in the Senate 10 times.
• Democrats say they will not vote to reopen the government without a guarantee to permanently extend the enhanced Affordable Care Act premium tax credits and reverse Medicaid cutbacks.
• Republicans argue the subsidies question should be handled separately from funding, emphasizing that the enhanced aid was meant to be temporary and citing a Congressional Budget Office estimate of roughly $335 billion over 10 years to make it permanent.
• Conservative analysts warn of higher long‑run costs and program integrity issues, with Cato pegging a 10‑year price at $488 billion, EPIC noting eligibility expanded to very high earners under the temporary rules, and Paragon alleging tens of billions in subsidies for exchange enrollees with no claims in 2024.
• Researchers at the Urban Institute project that letting the credits lapse would lead 7.3 million current marketplace enrollees to forgo coverage in 2026, including 4.8 million who could become uninsured, with average premiums rising sharply, while local reporting highlights nearly 100,000 Long Islanders facing sizable cost increases.