By McKenzie Jackson
A clash between Congressional Democrats and Republicans over key provisions of the nation’s health care policy continues to be a point of contention as the federal government shutdown, which began on Oct. 1, drags on.
U.S. Rep. Pete Aguilar (D-CA-33) told constituents during a virtual town hall meeting hours before the shutdown began that the lapse in appropriations occurred because Republican lawmakers refused to reverse health insurance cuts introduced in the president’s signature “One Big Beautiful Bill,” signed into law in July.
The measure, Aguilar said, gives billionaires and wealthy corporations tax cuts at the expense of what he called the biggest health care cut in U.S. history.
“As a result, 15 million Americans will lose health care — including 3.4 million Californians on Medi-Cal,” he said. “These sound like big numbers, but they have very real consequences. Hospitals will close; children won’t get their medication; seniors won’t be able to see their doctor; and your neighbors will get sick.”
The legislation cuts up to $1 trillion from Medicaid, the nation’s safety net health service, known as Medi-Cal in California, and food assistance to offset increased federal spending and reduced tax revenue.
Another key point of contention is the rising premiums for health care plans sold on the Affordable Care Act (ACA) marketplaces, popularly known as Obamacare. Enhanced tax credits for the health insurance program are set to expire at the end of the year. Those tax credits have kept ACA plans affordable for at least 22 million people — including two million Californians — since 2021.
Democrats want to extend the expiring subsidies and reverse the Medicaid cuts in the legislation Trump often touts as his “Big Beautiful Bill.” Republicans have balked at the proposal, claiming it would cost Americans more than $1 trillion.
According to the Congressional Budget Office, approximately four million people are expected to go without health coverage next year because they can no longer afford it. Extending the subsidies would cost the federal government around $350 billion over the next decade.
Aguilar, chair of the House Democratic Caucus since 2023, said during his online town hall that the health care crisis will worsen if Congress fails to extend the tax credits.
“For example, a 60-year-old couple earning $82,000 a year will see their annual premiums rise to nearly $14,000,” he explained. “This is unacceptable. At a time when Californians are already struggling to afford everything from gas to groceries, we can’t allow health care to be another basic necessity that is out of reach.”
The shutdown began at midnight on the first day of the new fiscal year in the wake of Democrats and Republicans falling short of reaching a short-term spending agreement for government agencies.
The partisan tensions escalated on the first day of the shutdown when the White House released a memo that said Democrats want to repeal Trump reforms to allow California to use a “loophole” so federal monies can be used to pay for the health care of undocumented immigrants.
Former Fox News host Steve Hilton, who is running to be California’s governor, told the network that California has been using a Medicaid provision to get matching federal dollars to pair with state funds to provide undocumented people with health care.
“When Democrats say — as they keep saying — that there is no federal money or any taxpayer money going for illegal immigrant health care — because it’s illegal and barred by federal law — it’s simply not true,” he said.
California Gov. Gavin Newsom has denied the White House and Hilton’s assertions.
The Senate rejected two competing proposals to reopen the government on Oct. 3, with both parties saying they wouldn’t succumb to the other’s demands.
Rep. Kevin Kiley (R-CA-3), blamed both parties for the shutdown last week, but told the media that Democrats’ demands aren’t realistic.
“We can’t even keep the government open,” he said. “We can’t even use the funds that our taxpayers have provided to provide the basic services that government is supposed to provide. That can only serve to reaffirm that lack of faith people have in government.”
Kiley also said a rise in the price of health care premiums is an issue.
“If we see that kind of premium increase on top of the already soaring cost of living in California, that’s very concerning to me,” he said.
The shutdown has caused multiple federal agencies including the Centers for Disease Control and Prevention, the Cybersecurity and Infrastructure Security Agency, the Federal Trade Commission, the National Park Service, and the National Institutes of Health to halt or reduce activities significantly. Many federal workers are furloughed, while essential personnel like air traffic controllers, postal employees, TSA screeners, and military service members are working without pay.
There have been 14 shutdowns since 1980. The last government shutdown lasted 34 days in 2018.
The health care cuts in Trump’s signature legislation don’t go into effect until 2027. Aguilar said Republicans composed the mega tax and spending bill that way, so the fallout wouldn’t become a political issue before the 2026 midterm elections.
“They want everyone to think things are ok when you go in to vote for Congress, and you vote for federal offices next year,” he said. “They have tried to insulate themselves from the political attack by making all these cuts happen in 2027. What they failed to calculate is that health insurance companies have to set these premiums. They have to set them based on what the conditions look like in the years ahead, so premium increases are going to continue to happen.”