The Cost of a Shutdown Over Health Care

By:  Dr. Kirkpatrick Williams

Published September 14, 2025  

The United States once again faces the possibility of a federal government shutdown. At the heart of the current standoff is not just the broader budget, but the question of how to fund health care programs and whether to extend subsidies under the Affordable Care Act (ACA). The debate is familiar. The stakes are serious. And the outcome will affect millions of Americans.

Government shutdowns are costly and disruptive. Federal employees face furloughs, public services stall, and economic uncertainty ripples outward. Markets, contractors, and everyday citizens who rely on timely processing of benefits all feel the consequences. Each shutdown also erodes public trust in the ability of elected officials to govern responsibly.

Health care funding adds another layer of urgency. The ACA subsidies at issue help millions of Americans afford coverage, especially lower- and middle-income families who do not receive insurance through employers. Ending or reducing those subsidies could mean higher premiums or loss of coverage for many households. At the same time, lawmakers raising concerns about long-term spending argue that subsidies represent an ongoing cost that should be revisited in the context of overall federal fiscal responsibility.

Both perspectives deserve consideration. Supporters of extending subsidies emphasize access, affordability, and the social and economic benefits of preventive health care. Opponents highlight budget discipline, federal deficits, and the importance of evaluating whether subsidies remain the most effective policy tool. The disagreement is real, but the vehicle of a government shutdown risks overshadowing the substance of the debate.

Shutting down the government does not resolve policy disputes. It delays them, while simultaneously imposing costs on federal workers, families, and communities who have little say in budget negotiations. Moreover, it deepens public cynicism about Congress’s ability to find common ground.

Lawmakers on both sides of the aisle should prioritize avoiding a shutdown. They should commit to continuing negotiations on health care funding without holding essential government operations hostage. Compromise may not satisfy either party completely, but a functioning government is itself a cornerstone of democracy.

The nation deserves open debate about the future of health care policy. But it also deserves a government that remains open while that debate continues. Congress, we're watching.