Bay Area Lawmakers Say GOP to Blame as Shutdown Threatens Affordable Care Act

When the federal government shut down on Wednesday, official channels moved quickly to send a clear, united message to panicked Americans: the “Radical Left in Congress” was to blame.

Bright red banners went live across federal agencies’ homepages with the message, and over the first two days of the shutdown, Republican lawmakers flooded social media, issued statements and made TV appearances, accusing Democrats of “derailing appropriations bills” and “[shutting] down the government.”

But Bay Area Democrats aren’t taking the heat, instead pointing the finger at Republicans.

“Trump and Republicans are now inflicting a painful shutdown on the American people because they refuse to protect America’s health care,” Speaker Emerita Nancy Pelosi said Thursday at San Francisco’s North East Medical Center in North Beach. “If Congress doesn’t extend the Affordable Care’s enhanced premium tax credits immediately, hundreds of thousands of families [in] California [alone] will lose their health care. Millions more will see their costs skyrocket.”

Since the Affordable Care Act passed in 2010, it has provided health care premium tax credits to more than 20 million people, along with expanding coverage to low-income Americans through Medicare and Medicaid.

Beginning in 2014, the federal government subsidized health plans for people who purchase insurance through the ACA marketplace. Premiums are capped on a sliding scale based on income, according to the Kaiser Family Foundation. In 2021, the Inflation Reduction Act expanded those credits to middle-income Americans and significantly increased them for existing enrollees.

But the enhanced premium tax credits, which more than doubled ACA marketplace enrollment in the past four years, are set to expire at the end of December.

Pelosi said that invoices that began going out Oct. 1 show premiums for millions of Americans could double next year. Rep. Kevin Mullen, who represents parts of San Francisco and the Peninsula, said some of his constituents could see increases up to 600%.

That could drastically change coverage rates for tens of thousands of Bay Area residents who rely on the capped premiums, like Lori Bremner.

Bremner, diagnosed with Leukemia in college, said she survived because she had coverage through her parents. She has since struggled to maintain affordable insurance.

“My situation is not uncommon,” she said, standing alongside the Bay Area lawmakers on Thursday. “I’m a single mother, I’m self-employed, and I have a pre-existing condition.

“I was denied coverage over and over again until the passage of the Affordable Care Act.”

Because she is self-employed, Bremner, who is the sole provider for her family of four, doesn’t have access to a workplace health plan. She doesn’t qualify for Medicare or Medicaid. Without ACA subsidies, coverage would be out of reach.

“I can still feel the excitement I felt on that day when I navigated the newly live Covered California website,” she said. “I was nervous, too. What was it going to cost? Could I afford it? … Then I saw it: I qualified for a significant tax credit. That tax credit was life-changing.”

Once the enhanced credits expire, the premium costs will be completely out of reach for some, said Amanda Webb, who spoke on behalf of a family friend who lives in the Bay Area. The family is not eligible for Medicare or Medicaid, but the father, a contingent worker at a tech company, doesn’t receive the same benefits as full employees.

“They’ve done everything right,” Webb said. “They’ve worked hard, applied for coverage, made responsible choices, and yet without these subsidies, they could still fall through the cracks.”

Some Republicans say that extending the tax credits, which would cost an estimated $350 billion over the next decade, is too expensive. Others, including Senate Majority Leader John Thune, have said they’re willing to continue discussions around the program but have refused to tie it to the annual spending plan.

After some Democrats broke ranks in March to help pass a Republican spending bill and avert an earlier lapse in funding, party leaders appear to be using the current shutdown as one of their few bargaining chips with a Republican-controlled Congress and White House.

“This is the way [Trump] negotiates,” East Bay Rep. Mark DeSaulnier said Wednesday on KQED’s Forum. “And we’re not having it because every time we try, he wants more. The cost is to the American public and in this instance to the health of this country.”

KQED’s Juan Carlos Lara contributed to this report.