John,

The shutdown ended only because Trump and Senate Republicans promised a December vote to extend the Affordable Care Act subsidies millions of families rely on to afford coverage. But they didn’t include the extension in the actual budget deal. Instead, they offered a promise without protection, and now key Republicans are already hedging, stalling, and looking for ways to rewrite or weaken the support people depend on.

These ACA subsidies are the only reason premiums didn’t explode after Trump tried to dismantle the law again. If Congress fails to act, millions will be hit with unaffordable insurance costs. Some Americans could see their premiums more than double, and millions could lose their coverage entirely. Older adults, rural families, self-employed workers, and anyone without employer insurance will be among the hardest hit.

Trump keeps attacking the Affordable Care Act, but he still has no actual plan to replace it. While he plays politics, families are already deep into open enrollment without knowing whether their subsidies will be there or whether 2026 will bring an impossible bill. This uncertainty creates confusion, discourages enrollment, and chips away at the ACA piece by piece.

The Senate has a responsibility to fix what it broke. They promised a vote. They must pass a clean extension with no new restrictions, cuts, or backdoor sabotage. Millions of lives depend on this vote happening.

This fight won’t end with one vote. It will require sustained pressure from every state and every district to stop Republicans from gutting the ACA through delay, sabotage, and confusion.

If these subsidies expire, over 22 million people will face sharply higher premiums. More than 4 million could lose insurance entirely. Hospitals, especially in rural areas, will face higher uncompensated care costs. Insurance markets could destabilize. Families will make impossible choices between paying a premium or paying rent.

Without enhanced subsidies, the “subsidy cliff” returns. A small raise or bonus could suddenly trigger thousands of dollars in extra premium costs. People who finally found coverage they can afford will be thrown back into a broken system that punishes working families for earning just a little too much.

This should not be a negotiation. This should not be another round of shutdown brinkmanship. The Senate must pass a clean extension before millions get priced out of the care they rely on.

Demand the Senate pass the ACA subsidy extension without cuts, conditions, or sabotage.

Let’s stand up and fight for affordable care.

- DFA AF Team