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Health Insurers Are Left Behind as Shutdown Fight Winds Down

Nov 10, 2025 11:30:00 -0500 by Josh Nathan-Kazis | #Healthcare

A pedestrian walks their dog across the East Front Plaza on Capitol Hill in Washington, D.C., om Monday. (Tom Brenner/Getty Images)

Key Points

Insurers and hospital stocks were tanking on Monday as a deal to end the government shutdown moved ahead without a clear path toward the extension of health-insurance subsidies the Democrats have demanded.

The subsidies, set to expire in less than two months, have dramatically reduced the cost of premiums for insurance plans bought on the Affordable Care Act marketplaces.

Now, open enrollment for next year’s plans is well under way. The more than 90% of enrollees in ACA plans who have benefited from the subsidies in recent years are being quoted premiums for 2026 that are more than twice what they have been paying.

Without an extension, millions are expected to drop off the marketplace plans, which now cover 24.3 million Americans. That could drive the number of uninsured people in the U.S. up by more than five million by 2034, according to the Congressional Budget Office, though the effects will be felt much sooner.

Democrats had refused to vote to fund the federal government unless the subsidies were extended, but late Sunday a breakaway group of Senate Democrats broke ranks to support ending the shutdown. In return, the Republicans said they would allow a future vote on the subsidies, but offered no promise of support.

By Monday, hopes of an extension were dimming. “What we see is Charlie Brown, Lucy, and the football all over again,” Raymond James healthcare policy analyst Chris Meekins told Barron’s early Monday. “At the last minute, it doesn’t happen.”

That means that insurers with exposure to the ACA marketplaces can expect lower enrollment over the coming years. Patients that do enroll in the plans will likely be sicker on average, raising medical costs for the companies. For the hospitals, it means fewer patients as the overall number of insured Americans continues to drop.

Worsening the picture for the insurers was a growing worry that President Donald Trump could be turning on the sector. In a social media post on Saturday opposing the extension of the subsidies, Trump referred to “money sucking Insurance Companies” and “BIG, BAD” insurers.

“The end result of this is a potential real problem where you’re now seeing some on the populist right rail against the health insurance industry, which could open the door to broader problems down the road,” Meekins said.

Insurance and hospital stocks were the worst performers in the S&P 500 on Monday. Centene , the largest plan provider on the health insurance marketplaces, was down 8.2%. Oscar Health , a smaller insurer that is heavily concentrated in the marketplaces, was down 13%. Molina Health, another insurer offering marketplace plans, was down 4.4%.

UnitedHealth Group was down 1.3%, while Cigna Group lost 1.8%.

Other insurers fell as well. Humana, which is virtually a pure play in Medicare Advantage and doesn’t offer plans on the ACA marketplaces, was down 3.9%.

Hospital stocks declined, too. HCA Healthcare was down 5.2%, while Universal Health Services fell 3.7%.

A vote on extending the subsidies could come in the next few weeks, but time is running out. The subsidies are set to expire at the end of 2025, patients are already signing up for next year’s plans, and the mechanics of implementing a late-breaking extension appear enormously complex.

What is more, the prospects of its passage don’t seem all that good. Meekins said that he sees little chance that the promised vote on an extension could succeed. “President Trump opposes extension, and you’re not going to see Republicans get on board when he is proposing not moving forward with the status quo,” he said.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com