Democrats’ Healthcare Hopes Dim as Shutdown Comes to a Close. What’s Next.

The federal government shutdown is set to end without a commitment to extend healthcare subsidies that Democrats have sought. (Eric Lee/Bloomberg)

The shutdown is ending without Democrats achieving their main goal, an extension of health-insurance subsidies that would prevent costs from spiking for millions of Americans next year. The prospects seem fraught for a resolution of that issue that avoids premium price hikes, but the healthcare battle is far from settled.

Seven Democratic senators and independent Angus King of Maine joined with Republicans Sunday evening to advance a bill to fund the government and end the longest-ever U.S. shutdown, which entered its 41st day on Monday.

The deal is likely to proceed despite opposition from some prominent Democrats, including Senate Minority Leader Chuck Schumer (D., N.Y.). The agreement funds the government through January, and includes a reversal of shutdown-related government layoffs by President Donald Trump and provides full-year funding for a handful of government departments. The deal merely promises a Senate vote this year on a Democrat-written bill to extend Affordable Care Act Subsidies rather than the actual extension that Democrats said was crucial to ending the shutdown.

It still could take days for the government to reopen. Senate Majority Leader John Thune (R., S.D.) says he’d like to move the bill forward as soon as today, though any one senator could delay that process. Then the House of Representatives would have to send the bill to Trump’s desk. Under a speedy scenario, that could happen as soon as Wednesday, said Beacon Policy Advisors analyst Christopher Niebuhr, while any delays could push final approval until early next week.

The deal is unlikely to prevent shutdown-related travel problems this week. Because of air-traffic control staffing issues, airlines are required to cancel 4% of their flights at some airports today, a figure that rises to 10% by Friday. Trump in a social media post on Monday said air-traffic controllers “must get back to work, NOW!!!”

It is also unclear whether the end of the shutdown will be able to prevent further disruption in some government economic data. The Bureau of Labor Statistics this week usually would be surveying households on their employment status for the jobs report that would be released in early December. That data could be collected next week instead. A BLS spokesperson didn’t immediately respond to a request for comment.

Most important to Democrats, the shutdown is ending without their main objective—an extension of the Affordable Care Act premium subsidies that started during the Covid-19 pandemic. Even though the Senate will now hold a vote to extend them, some Democrats are skeptical that their plan has any chance of passing.

The subsidy extension “will surely go nowhere because it requires 13 Senate Republicans to support it,” wrote Bharat Ramamurti, a former staffer for Sen. Elizabeth Warren (D., Mass.) and deputy director of the National Economic Council during President Joe Biden’s administration. “There will be no relief for the millions of people who had relied on the ACA subsidies to stop their health insurance costs from spiking.”

Shares of insurers and hospital stocks plummeted on Monday as investors saw little chance of an extension.

A few factors could put pressure on Republicans to support a compromise. For one, voters in Republican states and districts disproportionately rely on the Affordable Care Act. In 2025, 18.7 million of the 24.3 million ACA marketplace enrollees lived in states that Trump won last year, according to KFF, a nonprofit health organization. About six in 10 enrollees live in a district represented by a Republican, and if the subsidies aren’t reinstated annual premiums will rise 114% on average, KFF said.

The White House and some Republican leaders have said that they’re open to a deal once the shutdown ends.

“It’s bad healthcare at far too high a price. We should fix that. We should fix it. And we can fix it with the Democrats. All they have to do is let the country open and we’ll fix it,” Trump said in an interview on CBS’s 60 Minutes that aired last week.

Speaker of the House Mike Johnson (R., La.) on Monday told reporters “we have always been open to finding solutions to reduce the oppressive cost of healthcare under the unaffordable care act.”

Trump would be crucial to any deal and has been inconsistent with what he wants to see.

In a series of social media posts over the weekend, Trump asserted that the Affordable Care Act has led to the “enrichment of Health Insurance companies” and that lawmakers should send Americans money instead.

“I stand ready to work with both Parties to solve this problem once the Government is open,” Trump wrote.

The White House pointed to a social-media post that quoted deputy chief of staff James Blair in response to a request for comment. “President Trump and the Republicans have been focused on healthcare all year,” Blair said in the post.

Counterintuitively, it could ultimately be Democrats rather than Republicans who stymie a healthcare deal, wrote Barclays analyst Michael McLean in a research note last week. In 2024, Republicans tanked a bipartisan border security bill in part because they wanted to keep the immigration crisis as an election issue that year.

“We think the same political calculus could be true for Democrats with respect to the ACA and healthcare in advance of the 2026 midterms,” McLean wrote.

Write to Joe Light at joe.light@barrons.com