Healthcare, one of the most stubborn issues in Congress, is at the center of the shutdown fight

"Democrats believe health care is an issue that resonates with a majority of Americans as they demand an extension of subsidies in exchange for their votes to reopen the shuttered U.S. government. But it is also one of the most intractable issues in Congress - and a real compromise amid the government shutdown will not likely be easy, or quick."

"There are some Republicans in Congress who want to extend the higher subsidies, which were first put in place in 2021 amid the COVID-19 pandemic, as millions of people who receive their insurance through the Affordable Care Act marketplaces are set to receive notices that their premiums will increase at the beginning of the year."

"Republicans have been railing against the Affordable Care Act, former President Barack Obama's signature health care law, since it was enacted 15 years ago. But while they have been able to chip away at it, they have not been able to substantially alter it as a record 24 million people are now signed up for insurance coverage through the ACA, in large part because billions of dollars in subsidies have made the plans more affordable for many people."

""If Republicans govern by poll and fail to grab this moment, they will own it," wrote Texas Rep. Chip Roy, a Republican, in a letter published in the The Wall Street Journal over the weekend. He encouraged senators not to go "wobbly" on the issue. "The jig is up, the pandemic is over and my colleagues shouldn't blink in any other direction," Roy wrote."

Health care is central to Democrats' strategy to secure votes to reopen the shuttered federal government by seeking an extension of Affordable Care Act marketplace subsidies. The enhanced subsidies began in 2021 during the COVID-19 pandemic and many recipients face premium increases early next year. Some Republicans support a temporary extension, while others oppose further subsidies and aim to scale back the ACA entirely. Republicans have long opposed the law but have not substantially undone it; roughly 24 million people now enroll through the ACA, helped by billions in subsidies. The government shutdown complicates negotiations and increases political pressure on leaders.

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