Democrats Are Winning the Shutdown Fight
Turns out Republicans still haven’t figured out the politics of health care.
HERE’S HOW YOU CAN TELL Democrats have the upper hand in the week-old shutdown fight: Marjorie Taylor Greene just endorsed their key demand.
“WE HAVE TO DO SOMETHING ABOUT THE ABSOLUTELY INSANE COST OF INSURANCE FOR AMERICANS,” the Georgia House Republican tweeted Monday evening. And she made clear that “something” in this case means extending the temporary Affordable Care Act subsidies set to expire at year’s end, which is the most visible item on the Democratic agenda.
“I was not in Congress when all this Obamacare, ‘Affordable Care Act’ bullshit started,” Greene wrote, describing herself as “not a fan” of the 2010 health care law that Republicans spent more than a decade trying to repeal. But, she went on to explain, “when the tax credits expire this year my own adult children’s insurance premiums for 2026 are going to DOUBLE, along with all the wonderful families and hard-working people in my district.”
For that reason, she said, she is “going against everyone on this issue”—i.e., going against her fellow Republicans, most of whom oppose an extension. And, she added, she doesn’t care a whit if it bothers GOP leaders trying to hold the line against negotiations. “Not a single Republican in leadership talked to us about this or has given us a plan to help Americans deal with their health insurance premiums DOUBLING!!!”
Greene’s claim about insurance costs checks out: If those extra subsidies expire, premiums for more than 20 million people buying coverage through Obamacare’s marketplaces will more than double on average, according to analysis from the research group KFF.1
Greene’s characterization of GOP leadership also has the ring of truth. The political challenge for Republicans at this moment was entirely foreseeable, given that analysts were warning about the subsidy cliff more than a year ago and that Democrats were trying to raise it as an issue throughout the 2024 presidential campaign.
But despite all the indications that an Obamacare premium hike would be particularly tough on red districts and states, and on Republican-leaning constituencies like farmers and small business owners, GOP leaders seem to have thought they could tough out a standoff. They have refused even to discuss an extension in the context of a government shutdown fight, leaving unclear whether they are set on blocking one altogether (as more conservative members would prefer) or delaying a solution until the end of the year (as others seem inclined).
And maybe that recalcitrance will turn out to be a smart political play. The contours of this fight remain fluid, with the polls somewhat ambiguous and the insider machinations predictably opaque. But one week into the shutdown fight the signs of Republican weakness are impossible to miss, up to and including Trump declaring from the Oval Office on Monday that, “We have a negotiation going on right now with the Democrats that could lead to very good things. I’d like to see a deal made for great health care.”
He later walked that back a bit, with a Truth Social post on Monday evening saying negotiations have to wait until Democrats vote to reopen the government. But his own pollsters have been warning Republicans they let the subsidies lapse at their own political peril—a warning that appears to have registered with at least some House and Senate Republicans, even as their leaders have said no to negotiations.
These cracks in the Republican wall are conspicuous because the fissures on the other side have been nearly invisible. Democratic Senate leaders have been losing just three caucus members on votes to reopen the government under the GOP’s terms, with one of them being Pennsylvania Democrat John Fetterman (who dissents on such matters routinely) and another being Maine independent Angus King (who caucuses with the Democrats and has said he might soon start voting with the rest of them).2
This relative Democratic unity is not something a lot of people would have predicted. The party’s brand is in the tank, according to polls, thanks in part to extreme disappointment among base voters. High on their list of grievances is the way Senate Democratic Leader Chuck Schumer capitulated on a spending deal in March, when Trump’s unprecedented and unconstitutional power grabs and the destructiveness of Elon Musk’s DOGE gave Democrats a perfectly rational pretext for refusing to negotiate.
Trump’s authoritarianism is an even more valid pretext now. And if you read the actual Democratic position, you’ll see that putting new restrictions on Trump’s use of executive power is among the party’s demands. But it’s health care at the center of this debate, and it’s health care that has upended the dynamics so that even well-connected GOP strategists are now predicting their party will “cave.”
Which on second thought maybe isn’t so surprising—or shouldn’t be, if you know anything about the politics of health care.
THE PARAMETERS AND BOUNDARIES of debate over health care policy in the United States have changed a lot since the 1940s, when Harry Truman campaigned for a national health care plan. But the basic political divide has remained the same.
Democrats have made the liberal case, seeking to create something like one of the higher functioning health systems abroad, in which the government guarantees some form of insurance for everybody and then puts some kind of controls on spending. Republicans have made the conservative case, which is that government intervention will do more harm than good—and that a system with less control will ultimately be more efficient, less expensive, and promote better outcomes.
The GOP’s case is intellectually coherent, with plenty of serious conservative and libertarian thinkers to defend it. But Republicans have had a tough time selling it. The operating assumption in politics is that voters tend to trust Democrats more on health care, and polling going back to the 1990s backs that up, with the exception of moments when Democrats have spooked voters with ambitious plans or—as in the rollout of Obamacare in late 2013—presided over an implementation calamity.3
Even in those moments, the Republican polling gains were fleeting.
That goes a long way towards explaining the Republican strategy at key junctures: lie about what Democrats want to do. The 2009 version of that, during the original Obamacare debate, were accusations that health care reform would lead to “death panels” rationing care to the elderly and people with disabilities.4 Today’s analogue is the equally false GOP claim that what Democrats really want out of the shutdown is to fund “free care for illegal aliens.”
The political logic is obvious enough: Republicans lately have enjoyed the kind of polling advantage on immigration that Democrats have traditionally enjoyed on health care. But the argument doesn’t appear to be resonating—at least not yet and not enough to change minds around the shutdown.
That might explain why GOP leaders keep trying to find new, equally dishonest iterations that might work—including a weekend social media post by House Speaker Mike Johnson alleging “Democrats want hospitals paid MORE to treat illegal aliens than American citizens.”
Johnson appears to have been invoking a popular but highly dubious conservative argument, which is about how the federal government (which supplies the majority of Medicaid funding) pays more for people who get Medicaid through Obamacare’s expansion than through the older, previous criteria.5 But that’s an argument about how money gets from the federal government to states, not to hospitals—as Georgetown University research professor Andy Schneider confirmed to me this week.
“What a state (or a managed care organization on the state’s behalf) pays a hospital for emergency care can get complicated, and there are often variations in rates from hospital to hospital, but those variations are not tied to eligibility pathways,” said Schneider, who spent literally half a century working on Medicaid as a congressional staffer, federal employee, and independent contractor.6
REPUBLICANS AREN’T JUST RELYING on misleading propaganda to try and break Democratic unity in the shutdown fight. Budget Director Russ Vought has nixed federal funding from blue state projects, while his office has produced a memo suggesting that furloughed workers might not get back pay once the government reopens.
And that assumes they still have jobs at all. Vought has also threatened mass firings.
But Vought’s intimidation tactics have plenty of Republicans anxious, with some openly suggesting that the administration will restore the canceled federal project funding. Even Speaker Johnson has said he hopes that furloughed workers would be compensated for their time away from work.
Democrats, by contrast, appear more emboldened than ever: On Tuesday, House Democratic Leader Hakeem Jeffries reaffirmed his party’s insistence that an Obamacare subsidy extension be permanent, not temporary, as some Republican lawmakers have been urging.
That’s not to say Democrats will stay so confident or steadfast. Even if they do, and even if Republicans start coming to them with serious compromise offers, Democrats will have to figure out how to handle them.
Already some Republicans are talking up a proposal to alter the structure of the Obamacare subsidies, so that it’s no longer possible for low-income buyers to get plans with zero premiums—a feature Republicans say encourages fraud and Democrats say has made coverage affordable for the people who need it most. And that’s to say nothing of broader questions Democrats are likely to confront, like whether to insist Republicans reverse those Medicaid cuts in Trump’s Big Beautiful Bill—or to stand by those demands of meaningful constraints on Trump’s executive power.
One factor in these calculations will be what “winning” and “losing” in the political sense really look like. A big premium spike can be a political nightmare for the party in charge, as anybody who lived through the Obamacare rollout can attest. That’s the whole reason Republicans seem so uncertain about their current position—and why now even MAGA stalwarts like Greene are suggesting Republicans sign on to an extension. If nothing else, that would seem to give Democrats leverage to demand even more.
The counterargument is that many Democrats actually do care passionately about making health care more affordable. If the subsidy boost lapses, the higher costs will mean real hardship for many millions, and 4 million more Americans with no insurance at all. Extending the subsidy boost would prevent most or all of that from happening. And insofar as Republicans are bound to support some kind of extension eventually—precisely because the blowback to the spike could be so strong—forcing a deal now, in this high-profile debate, would allow Democrats to claim (legitimately) it was their doing.7
Where and how successfully Democrats ultimately make their stand will depend on these calculations, as well as on the success of party leaders whose messaging ability has been less than stellar. But at the moment, Democrats seem to be united and determined in a way the Republicans are not. For a party that’s seemed so hapless, so helpless ever since Trump took office, that’s a big improvement.
It’s about the time of year when insurance buyers start learning this firsthand: Prices are available on HealthCare.gov, notices are going out, and open enrollment begins in November. And already polling shows extension of the subsidies is popular, even among President Donald Trump’s supporters.
The third Democrat senator breaking ranks has been Catherine Cortez Masto of Nevada.
Democrats and their allies would say they have the public’s trust because health care is so important—and because Americans value their government doing for them what governments of France, Germany, and every other peer country do for their people. Republicans and their supporters say the trust gap is simply proof that entitlements become addictive—that, once given, they can’t be scaled back even if they become unsustainable and even if they are inferior to what conservatives would enact instead.
Democrats are plenty capable of distortion as well, and Obama’s claim that you can “keep your plan” under the Affordable Care Act was not true, which is why Politifact called it the “lie of the year.” I’m of the opinion that was less a case of deliberate deception than of not fully anticipating the way the law would change insurance markets—or how the promise would be received. And you can read chapter 22 of my book if you want my full explanation why, though I recognize plenty of people disagree with me on that.
I say “appears” because it’s hard to be sure exactly what Johnson meant, and his office did not respond to my request for clarification.
Just to make sure I wasn’t missing anything, I checked with another Medicaid expert, Georgetown professor Edwin Park. “The reimbursement rate itself for the emergency services provided by the hospital will be the same irrespective of eligibility group or matching rate,” he told me.
Conversely, if no subsidy extension is passed and the premium hikes do happen, Democrats can tell the public they tried to fix the problem but Republicans refused to do so.
Didn't MTG vote for the big beautiful bill the first place? Kinda hypocritical to complain after the fact.
If we can afford to subsidize billionaires and their businesses, we can afford to provide people with subsidized healthcare.