The federal government is on the brink of an end-of -the-month shutdown as Congress debates a stopgap spending measure. One of the sticking points is a Democratic demand that the health subsidies be extended.

Created in 2021, they were intended to make health coverage on the Affordable Care Act marketplaces more affordable. 

Known as an “enhanced premium tax credit,” it’s available to people making up to 400% of federal poverty guidelines.

For a family of three, that’s between $26,650 and $106,600 a year. Nearly 20 million Americans and 530,000 Ohioans receive it.

The subsidies save the average recipient about $700 a year, but those savings can be nearly $20,000 for some households.

Their existence is credited with helping to push the percentage of uninsured Americans to an all-time low.

With President Donald Trump’s One Big Beautiful Bill Act, Congressional Republicans this year extended tax cuts heavily skewed toward the wealthy, and they cut nearly $1 trillion in Medicaid spending over 10 years. 

At this point, they seem uninterested in extending subsidies to buy health insurance.

Asked about the matter last month, the offices of Ohio’s Republican U.S. senators, Jon Husted and Bernie Moreno, didn’t respond.

A report released last week by the Urban Institute said that if the subsidies are allowed to expire, it could have bad consequences for all Americans.

Ironically, the worst consequences would be felt in Republican-ruled states such as Florida and Texas that didn’t expand Medicaid under the Affordable Care Act. That’s because a higher percentage of their residents had to turn to the insurance marketplace for coverage. 

Florida will see demand for uncompensated care go up by 18%, the report said. That’s care provided to those who can’t pay. 

Costs for such care fall on the government or hospitals themselves.

Ohio’s emergency physicians have warned that big increases in such costs will result in longer wait times, reductions in services, and more stress on rural and safety net hospitals.

Nationally, expiration of the subsidies will result in 7.3 million fewer people insured on the marketplace and 4.8 million more uninsured Americans, said the study, which was done with support from the Robert Wood Johnson Foundation.

In Ohio, that will mean 0.4% less health spending on the non-elderly, or $363 million less a year. Increased demand to hospitals for uncompensated care will go up 8.9%, it said.

The report said the loss of the subsidies — and the consequent loss of health spending on low-income workers — would be bad for everybody.

“Because lower spending on health care services means lower revenue for health care providers and fewer services rendered, the resulting decline in revenue could have adverse consequences, particularly for already financially at-risk hospitals and the communities they serve,” it said.

“This loss of health insurance coverage could have significant negative consequences for individuals, as health care use declines and unmet health care needs increase when people become uninsured.”

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This story is provided by Ohio Capital Journal, a part of States Newsroom, a national 501(c)(3) nonprofit. See the original story here.