The federal government could shut down Wednesday, with Democrats and Republicans in Congress at an impasse over health care policies.
Democrats want to extend enhanced premium tax credits that help people pay for health care through the Affordable Care Act marketplace. Those credits are set to expire at the end of the year.
Some Arizonans who benefit from the credits say the cost increases they are facing are so astronomical that they support shutting the government down.
Phoenix resident Sue Hutchison’s family picked an ACA marketplace health plan after her husband retired. They are a few years too young for Medicare and earn too much to qualify for Medicaid. Hutchison said she pays about $500 per month now for health coverage. If premium tax credits disappear next year, Hutchison said she expects her plan would cost more than $2,000 per month, which she said would be about half her family’s retirement income.
“At our ages, I think going without health insurance is a bad gamble,” Hutchison said. “Even if we choose a catastrophic care plan with a very low premium, we’re going to be paying significantly more out-of-pocket.”
Hutchison said she is in favor of the government shutdown, because she wants lawmakers to negotiate to extend the tax credits.
More than 400,000 Arizonans get health care through the ACA marketplace. The Arizona Department of Insurance and Financial Institutions projects the costs for those plans will increase 2.5% to 55% next year. But that’s just the baseline cost of the plans. About 90% of Arizona enrollees also benefit from the soon-to-expire enhanced premium tax credits that keep their out-of-pocket costs lower. Without enhanced premium tax credits, some people could see costs more than double, according to the health policy research organization KFF.
Steve Gomez of Gilbert relies on the ACA marketplace because he’s self-employed as a construction manager in the wireless and telecommunications industry. He also said he supports Democrats shutting down the government as a way to demand an extension of the credits.
“Realistically, the way I feel is that they need to do it,” Gomez said. “[Democrats] should run on it — that the Republican party and Trump are shutting these things down because their tax breaks and everything that they have are worth more to them than the lives and the health care of the American public.”
Gomez has three young children, one of whom had a heart transplant as an infant and now has epilepsy and a range of other serious health issues. So Gomez said he would have no choice but to pay, even if the cost of his plan skyrockets.
“This is health care. This is life and death for millions of Americans and hundreds of thousands of children. It's appalling,” Gomez said.
KFF offers an online calculator to help ACA marketplace enrollees estimate cost differences for plans if enhanced premium tax credits expire.
The tax credits were introduced in 2021 as part of the pandemic relief package, the American Rescue Plan Act. The cost savings created by the credits contributed to record enrollment in ACA marketplace plans in the years since. Arizona's ACA marketplace enrollment increased 177% from 2020 to 2025, according to KFF.
Some congressional Republicans have signaled willingness to extend the tax credits. Others in the GOP argue the credits are too costly and were only meant to be temporary in response to the pandemic.
