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At the center of shutdown fight, health care is one of the most intractable issues in Congress

Congress remains stalled over extending Affordable Care Act subsidies as millions face higher insurance premiums and federal workers go unpaid amid the ongoing government shutdown.

  • On Wednesday, the U.S. government entered a partial shutdown after the U.S. Senate failed to reach 60 votes for a stopgap funding bill to keep agencies open through Nov. 21.
  • Party divisions over subsidies have driven the impasse as Democrats press to extend Affordable Care Act subsidies permanently through the end of 2025, while Republicans remain split on reforms and temporary extensions.
  • Republican senators have floated compromise fixes such as phased rollbacks, with Senate Majority Leader John Thune, R-S.D., and Sen. Mike Rounds proposing extensions tied to reforms.
  • Hundreds of thousands of federal workers are affected by furloughs and unpaid paychecks, while the White House Office of Management and Budget ordered agencies to prepare reduction-in-force plans.
  • Lawmakers warned Congress to act before open enrollment begins Nov. 1, with 24 million people enrolled in ACA marketplaces and tax credits expiring this year.
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The Smart Citizen Report broke the news in on Monday, October 6, 2025.
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