By Dr. John Petrone
Let’s call this what it is: a political death knell for millions of Americans. The moment Republicans allow enhanced ACA tax credits to expire is not a policy shift it is a betrayal. A deliberate, cold calculation in which working families become collateral damage so the wealthiest can keep their breaks.
And make no mistake: the public sees it.
Who Loses and How Badly
Across the ACA marketplace, enrollees stand to see their out-of-pocket premiums more than double next year without those enhanced credits. For many at or just above 400% of the federal poverty line, losing assistance means going from paying a manageable fraction of income to shouldering the full cost of benchmark plans. Older couples in mid-cost states could be hit with $1,500–$2,500 a month insurance bills. That isn’t a scare tactic it’s math.
Rural families, small business owners, gig workers, and middle-income households are the ones who will be crushed. These are the very people Republicans claim to champion. Instead, they are being thrown into the fire to satisfy an ideology that treats health care as a privilege, not a right.
Why the GOP Is Willing to Burn It All
Republicans see health care as a political cudgel, not a moral contract. They believe many Americans don’t yet realize what’s coming and by the time premiums explode, they can spin the blame. Their strategy is clear: force coverage collapse, then declare that the ACA has failed. It’s the same old playbook of sabotage and scapegoating, only this time the stakes are higher.
This isn’t about fiscal responsibility. It’s about manufacturing a crisis to dismantle health care for ordinary Americans.
Democrats’ Hard Line and Why It Might Work
Democrats refusing to cave on extending tax credits during the shutdown is not reckless it’s leadership. They know the public is overwhelmingly with them. Large majorities, including independents and even many Republicans, want the credits preserved.
They also know that polls show most Americans already blame Republicans and Trump for the shutdown. The GOP can scream about “Democrat dysfunction” all they want, but voters understand who is holding the government hostage. Democrats are holding firm because they have both the moral and political high ground: you cannot force families to choose between bankruptcy and losing health care.
Why the Government Is Shut Down
This standoff isn’t about budgets it’s about weaponized cruelty. Republicans are demanding Democrats agree to cuts in health care and food programs in exchange for reopening the government. Democrats refuse, because they understand that agreeing to these terms means signing the death warrant for millions of Americans’ coverage.
What’s at Stake for the Average American and for Democracy
Health care is not a bargaining chip. Stripping away these tax credits will force millions off coverage, drive families into medical debt, worsen chronic illness, and cost lives. It is also a massive assault on working-class stability, targeting the very people already struggling with inflation and stagnant wages.
This shutdown is a test of political will. Are we willing to allow one party to deliberately use the suffering of ordinary people as leverage? Or do we demand that leaders hold the line and protect the most basic of human needs?
How We Fight Back
We fight back first by refusing to accept silence. Every voter needs to understand what these cuts mean in real numbers: premiums doubling, tripling, or vanishing coverage altogether. Talk to your neighbors, coworkers, church members, and family many don’t know what is coming, and awareness is our greatest weapon.
Second, we fight by flooding our representatives with calls, emails, and visits. Demand that they extend the enhanced credits and reopen the government without ransom. If your member of Congress is a Democrat, give them the reinforcement they need to hold the line. If they are a Republican, remind them they are gambling with the lives of their own constituents.
Third, we fight at the ballot box. This shutdown is a rehearsal for what comes next. If Republicans are willing to gamble with health care today, what will they cut tomorrow? Social Security? Medicare? Veterans’ benefits? Elections are not abstract they are life and death. Mobilize, register, volunteer, and make sure turnout reflects the urgency of the moment.
Finally, we fight back by standing together. Health care insecurity touches every family, every community. The stronger our collective voice, the harder it becomes for politicians to divide us. This is not charity it is solidarity.
If Democrats stand firm extend the subsidies, reopen the government, and force Republicans to own this disaster it could mark the moment the GOP finally lost its grip on health care as a political weapon.
Because no family should ever pay more than their mortgage just to survive.