Barack Obama’s signature health law passed more than 15 years ago — but the government shutdown shows it remains one of the sharpest dividing lines in US politics.
Opposition to the Affordable Care Act drove a Republican wave in 2010, a federal government shutdown in 2013, and a failed repeal effort in 2017. A backlash to that repeal attempt, in turn, fueled massive Democratic wins in 2018.
Now it’s back in the maelstrom as the centerpiece of the current shutdown, demonstrating its far-reaching effects. Each fight resurfaces long-running tensions and drives some of Congress’ most acrimonious attacks.
In this chapter, Democrats refuse to vote to fund the government unless Republicans agree to renew expiring subsidies that help millions of people purchase health insurance through the ACA.
Republican leaders have routinely said that could be discussed after the government reopens, though Majority Leader
Democrats also plan to put the ACA front and center in next year’s congressional elections, hoping to again use it to win back power in Congress and ensuring the law will remain a prominent fissure.
“I don’t know why Republicans hate health care so much,” Sen.
Speaker Mike Johnson (R-La.), meanwhile, described the law as a “sinister” effort secretly designed by Democrats to implode.
“They wanted full government control of health care,”
The ACA is now deeply intertwined with many facets of US policy. Health care represents about 18% of the US economy and is a tangible part of everyday life, affecting families, their wallets, and their well-being.
That’s made it a potent rallying point for both parties.
“This is something that actually touches people’s day-to-day lives,” said Liz Hamel, vice president and director of public opinion research at KFF, a nonpartisan health research organization.
It also elicits some of each party’s most vehement critiques of one another, pitting Republican complaints about big government intervention against Democratic accusations of indifference to regular people’s needs.
“Republicans are the ones who have been continuously obsessed” with the ACA, House Minority Leader
He and other Democrats see it as a policy that has helped millions afford health care and end insurance rules that made it nearly impossible for people with pre-existing conditions to get coverage.
Since the law passed the number of uninsured fell by more than 40%, to about 25.3 million in 2023, according to KFF.
Republicans, though, see the ACA as an example of sprawling and expensive intrusion into private businesses and personal decisions.
“The affordable part hasn’t lived up,” said Sen.
The GOP points to an estimated $350 billion price tag over the next decade just to permanently extend the expiring subsidies, as Democrats are demanding.
The law has been on a roller coaster of public opinion, according to KFF, which has polled on its popularity throughout its existence.
It started unpopular, but perceptions flipped after the 2017 repeal attempt. Attention in that fight shifted from the law’s mandates to its protections, including help for people with pre-existing conditions, Hamel said.
The ACA has been on a steadily upward trajectory ever since, including among Republicans, millions of whom purchase coverage through the law’s health marketplaces.
Now, 64% of adults favor the law, against 35% who oppose it, KFF found in September. That includes support from 36% of Republicans, up from 13% when it first passed.
Those numbers help make clear why Democrats are eager to stake out this fight, and carry it into next year’s elections. It won’t be the last word in an argument that has never abated.
News From the Hill
Conversations, Not Negotiations: Though a bipartisan group of senators is talking to each other behind the scenes during the government shutdown, expectations are low, Jack Fitzpatrick reports. Democrats are seeking “not even pinky promises, but like general conversations,” Sen. Ruben Gallego (D-Ariz.) told reporters. Read More
Dems Look to Nov. 1: House Democrats’ internal discussions on the shutdown are centering on warnings of increasing health-care premiums and the Nov. 1 start of ACA open enrollment, Rep.
Energy Permitting: Magaziner also said President Donald Trump’s attacks on renewable energy projects remain one of the biggest obstacles to a bipartisan permitting overhaul getting through Congress, Kellie Lunney reports. The Rhode Island Democrat, whose district is home to a wind project paused by the president, said members of his party are worried about cutting a deal because Trump might honor only the parts he agrees with. Read More
Rare Break With Trump: Senate Finance Chairman Mike Crapo (R-Idaho) is circulating a letter urging the Trump administration to reconsider laying off roughly 80 staff for the Treasury Department’s Community Development Financial Institutions Fund, Emily Flitter and Caitlin Reilly report. Read More
- Industry groups are also pushing back on the planned firings, Evan Weinberger reports. Read More
Disclosure Request: Members of the Senate Democratic Caucus are asking the CEOs of Google and YouTube for details on YouTube’s recent $22 million settlement with Trump. They want to know how the deal relates to other regulatory issues pending before the administration, Bryan Pietsch reports. Read More
Markey Gets Primaried: Greg Giroux reports that the generation gap will be front and center now that Massachusetts Sen. Ed Markey (D), 79, is being challenged by Rep. Seth Moulton, 46. “I don’t think someone who’s been in Congress for half a century is the right person to meet this moment and win the future,” Moulton said. Read More
Redistricting Suit: The Missouri general assembly sued to block a state referendum targeting its effort to implement new congressional maps, Quinn Wilson reports. Read More
Today’s Agenda
Senators will take procedural votes on the GOP stopgap spending plan (
It’s unclear whether Democrats will support moving to the Defense measure, which would run through all of fiscal 2026, as Ken Tran reports in today’s BGOV Budget. The measure could become the vehicle for additional spending bills, with Appropriations Chair Susan Collins (R-Maine) eyeing the Labor-HHS-Education, Commerce-Justice-Science, and Transportation-HUD bills. Attaching other bills would require unanimous consent. Read More
The chamber will also vote on limiting debate on Harold D. Mooty III’s nomination to be a district judge for the Northern District of Alabama.
Off the floor, the Senate Judiciary Committee scheduled votes this morning on nominees for district judge and US attorney positions in Indiana, Mississippi, and Missouri.
The House isn’t in session.
Click here for more on this week’s events.
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