The stakes of the federal government shutdown are high, even if Americans won’t feel the full impact until the end of December. That’s when the Affordable Care Act’s premium tax credit expansion, broadened under the Biden administration, expires. If the shutdown fails to produce a compromise, millions of Americans could lose their health coverage, while others would be forced to pay twice as much.
This would also hurt hundreds of thousands of Hungarian Americans, many of whom rely on these subsidies for their health insurance. The Trump camp has tried to frame the benefit as a handout for undocumented immigrants, but Hungarian Americans themselves are the best evidence that this is false. In many Hungarian communities across the U.S., large numbers of low-income residents are not undocumented but poor and could not afford higher premiums without this assistance.
These issues were the focus of a press briefing organized by American Community Media, featuring Dr. Ashley Kirzinger, Director of Survey Methodology and Associate Director of the KFF Public Opinion and Survey Research Program; Jennifer Sullivan, Director of Health Coverage Access and head of the Beyond the Basics project at the Center on Budget and Policy Priorities; and Anthony Wright, Executive Director of Families USA.
“This would be the most significant coverage loss since the Affordable Care Act was enacted,” said Anthony Wright, Executive Director of Families USA. “With every passing day we get closer to open enrollment, which means more people will be shocked to lose their coverage and we won’t be able to get them back. If millions fall off coverage, that means fewer paying patients, more uncompensated care, and greater financial strain on hospitals,” Wright warned.
Jennifer Sullivan, Director of Health Coverage Access, said the loss of the ACA’s enhanced premium tax credits would hit modest-income families the hardest. “Currently, 93 percent of marketplace enrollees receive a premium tax credit,” she said. “Nearly half have incomes below twice the poverty level, around $32,000 a year. That’s not much money.” According to Sullivan, the subsidies produced historic gains in access to health care, particularly among communities of color, who in 2024 accounted for more than half of all ACA enrollees nationwide.
“After the improvements took effect, we saw a 186 percent increase in coverage among Black Americans and a 158 percent increase among Latinos,” she said. The dispute is not merely about budget numbers: Republicans and Democrats remain sharply divided over health-policy priorities, from how ACA marketplaces should operate to Medicaid rules and the day-to-day functioning of public-health agencies. The fight is multi-layered. Republicans have demanded tighter conditions on certain health programs and inserted multiple policy riders, substantive provisions, not just funding levels, into the spending bills.
These include proposals to scale back ACA-related subsidies and, at times, to impose new conditions on federal Medicaid funding such as work requirements. Democrats, meanwhile, prioritize maintaining ACA subsidies, keeping Medicaid and CHIP financing stable, and ensuring that the public-health infrastructure – CDC, NIH, community health centers, and WIC – continues without interruption.
During the COVID-19 pandemic, the Inflation Reduction Act extended the enhanced ACA premium tax credits through the end of 2025. Those credits lowered household premiums dramatically: millions gained unprecedentedly low-cost or even zero-premium plans. If Congress fails to act, a “subsidy cliff” will arrive in 2026, when the rollback would drive widespread premium hikes and push many people out of coverage.
Sullivan also voiced concern for immigrant families who are eligible for benefits but afraid to claim them amid anti-immigrant rhetoric. “We’re likely to see a steep drop-off a decline in the number of people eligible for these benefits who feel comfortable applying,” she said. She recalled that during the Trump era, ICE located some immigrants using tax data because they had trusted the government enough to file returns, data that was later shared with enforcement agencies.
KFF’s projections show that the expiration of the enhanced subsidies would sharply raise premiums across income groups, hitting low- and middle-income Americans the hardest. One major question in the current negotiations is whether lawmakers will extend the higher subsidy levels beyond 2025. In political messaging, each side frames it differently: Democrats describe the extension as preventing a “premium-tax” hike on families, while Republicans portray it as an expensive, deficit-inflating entitlement that distorts the market. The timeline is clear: if no extension is passed, the program ends in late 2025, and the premium shock arrives in 2026.
The most likely short-term outcome is a continuing resolution (CR), a temporary funding measure to reopen or keep open the government while broader talks continue. The ACA subsidy extension, set to expire at the end of 2025, could easily become part of that “grand bargain.” Democrats view the measure as direct relief for working families; many Republican negotiators call it a costly “social expansion.” A possible compromise might involve a limited, targeted extension or offsetting budget provisions to neutralize costs.
“Slightly less than half of U.S. adults say it’s difficult for them and their families to afford health care,” said Ashley Kirzinger, KFF’s Director of Survey Methodology and Associate Director of the Public Opinion and Survey Research Program. “One in four say they’ve had problems paying medical bills in the past year, and that’s even with the enhanced premium tax credits in place,” she said, citing KFF’s latest public-opinion data.
