The strangest thing about the recent shutdown fight in Congress is that a quarrel ostensibly about health-care subsidies failed to stir any real debate about health-care reform. Washington prefers not to open that can of worms. The fact remains, this system’s defects weren’t just the proximate cause of the past month’s paralysis. They also help drive the country’s deeper political and fiscal dysfunction.
Democrats refused to keep the government running unless so-called enhanced Affordable Care Act subsidies — introduced in 2021 in response to the pandemic and scheduled to expire at the end of this year — were extended. Letting the additional subsidies disappear would raise the cost of insurance for many Americans and impose especially steep increases on families making between 400% and 500% of the poverty line (that is, between $129,000 and $161,000).