OLYMPIA, Wash. — The government is fully open again and slowly returning to normal after the longest shutdown in U.S. history.

However, although the government has reopened, questions still loom about the future of the Affordable Care Act (ACA), otherwise known as Obamacare.

How we got here

One reason the government was shut down for 43 days was over a healthcare dispute.

Democrats in the Senate voted down the spending bill several times, extending the shutdown, because it did not include an extension to ACA subsidies for more than 22 million Americans.

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Ultimately, Democrats and Republicans in the U.S. Senate came to an agreement to reopen the government and vote on the ACA subsidies by mid-December.

However, House Speaker Mike Johnson (R-LA) is not fully convinced of the plan yet.

“Am I gonna guarantee a vote on ACA unreformed, COVID era subsidies that are just a boondoggle to insurance companies and rob the taxpayer? We got a lot of work to do on that,” he said. “The Republicans would demand a lot of reforms before anything like that was ever possible.”

That means even if the U.S. Senate did pass the subsidies, there is no guarantee it would even be taken up for a vote in the lower chamber. Johnson said Republicans are working on other plans, and it is too soon to commit to the extension now.

This matters because without extending those subsidies, ACA premiums are expected to more than double next year, according to KFF.

And with those higher costs, about 4 million people are likely to drop coverage entirely, according to estimation by the Congressional Budget Office.

How Gov. Bob Ferguson is reacting

Back home in Washington State, Governor Bob Ferguson said that if subsidies are not extended, it is going to put the state in a difficult position.

“The reality is, the state’s not in some position to backfill billions of dollars of cuts from the federal government,” Ferguson stated.

Ferguson said now the state is preparing in case subsidies are not extended by the start of next year. He said that while the state cannot solve the issue, it will work to ensure as little harm as possible to residents.

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“What we have to do is do whatever we can to mitigate the harms that people are experiencing,” he said. “We’ve been able to navigate SNAP, successfully so far, so it’s one thing at a time, but we’re mindful of when it comes to healthcare, the impacts it is having on people right now.”

Ferguson said if subsidies are not extended, “it’s going to be a big impact” on the residents in the state.

“It makes me sick inside that this is happening,” he said.

But it is not just possible ACA premium increases: combine that with changes to Medicaid coming next year, and Ferguson said the impact will be profound to people and to the state’s bottom line.

“Cuts to Medicaid that are coming next year, that’s a $3 billion hit to the state every single year,” he said. “We don’t have $3 billion lying around.”

The cuts to Medicaid come from the Trump administration’s “Big Beautiful Bill,” or HR1. Under HR1, it is estimated that up to $1 trillion in federal spending will be made to Medicaid over 10 years.

Starting in 2027, the bill will also require that eligible Americans, age 19-63, must be working, attending school, or volunteering at least 80 hours per month in order to maintain coverage.

An estimated 30,000 people in Washington state alone could lose Medicaid coverage under HR1.