The federal
                                  government shut down on October 1, and the
                                  impasse between Congressional Democrats and
                                  Republicans suggest that this may be a long
                                  one. Already, Speaker Mike Johnson has sent
                                  Congress home to do “district work”. This may
                                  have something to do with the fact that newly
                                  elected Democratic Congresswoman Adelita
                                  Grijalva puts another vote in the Democratic
                                  column, but can’t vote until she is sworn in.
                                  Having sent Congress home, Grijalva is in
                                  limbo. Johnson says she will only be sworn in
                                  when Congress is back in session, and they
                                  won’t be back until Democrats vote to reopen
                                  government with a “clean” continuing
                                  resolution, changing nothing from the current
                                  budget. 
                              Here’s
                                  the problem – people will get notices about
                                  the cost of their health care sometime between
                                  October and early December, during the open
                                  enrollment period. They will have to make
                                  choices about their health plan and
                                  affordability – estimates are that costs can
                                  rise by as much between 10 and 15 percent, but
                                  possibly more in some areas. How are people to
                                  make rational decision when they do not know
                                  how much they will have to pay? Premium tax
                                  credits embedded in the Affordable care Act
                                  help millions afford health insurance though
                                  the Marketplace. But these credits are set to
                                  expire  by the end of 2025. Democrats
                                  want to extend the tax credits, and
                                  Republicans say they will “discuss” the issue
                                  once government opens. Republicans have a
                                  record of broken promises. Senate Minority
                                  Leader Chuck Schumer (NY) supported a
                                  Republican move in the spring, and it cost him
                                  both progressive support and leverage to
                                  manage the health care imbroglio.
                              If
                                  Congress fails to act before open enrollment
                                  begins on November 1, many Americans could
                                  suddenly face steeper, perhaps unaffordable
                                  premiums or choose to drop coverage entirely -
                                  worsening health access and market stability.
                                  And if premiums rise, some people won’t be
                                  able to pay them. There are consequences to
                                  denying health care to all. According to a
                                  Harvard University study, more than 45,000
                                  people lost their lives in 2009 because they
                                  did not have health care. While that study is
                                  dated, it provides us with a baseline. Health
                                  care is a matter of life and death, but Mike
                                  Johnson and his Republican cronies don’t seem
                                  to care.
                              Most
                                  low-income households will be hit hard by
                                  premium increases, and because African
                                  Americans are more likely than others to be at
                                  the bottom of the income distribution, we are
                                  most likely to be hard hit. And given current
                                  economic instability, many families will be
                                  imperiled by the hit. This is a matter of
                                  urgency and one of the reasons Democrats have
                                  united around the necessary extension of
                                  subsidies for health care. Republicans want to
                                  waste time and avoid Democrats at the
                                  negotiating table. They are following the lead
                                  of the dystopian orange cult leader, holding
                                  government operations hostage because they
                                  don’t want to fund policies that can saves
                                  lives.
                              The
                                  consequences of this showdown are real and
                                  immediate. Hospitals, particularly in rural
                                  and under-served areas, already squeezed
                                  financially, warn of funding shortfalls. Some
                                  Medicaid programs and payments to providers
                                  hang in limbo. Even if core functions like
                                  Medicare and Medicaid continue (they are
                                  “mandatory spending” and technically shielded)
                                  agencies that administer the ACA marketplaces
                                  or support outreach may face disruptions.
                                  Meanwhile, uncertainty will rattle insurers
                                  and consumers, potentially causing premium
                                  surges, fewer plan options, or coverage losses
                                  - especially in areas where costs were already
                                  high.
                              Republicans
                                  own this shutdown. They control both houses of
                                  Congress and the executive branch. But they
                                  are attempting to shift the narrative by lying
                                  that Democrats want to “give health care to
                                  undocumented immigrants.” Nothing could be
                                  further from the truth. Undocumented
                                  immigrants are not eligible for ACA subsidies
                                  or most federal health coverage, except
                                  emergency care. Meanwhile, emergency rooms are
                                  closing. Where does this leave citizens and
                                  legal immigrants, not to mention those
                                  undocumented who need emergency care?
                              Is
                                  affordable health care a right and moral
                                  obligation, or is it an afterthought? Should
                                  health care be a political football or a
                                  foundation in a humane society? The
                                  partisanship around these issues ignores those
                                  who need health care but are not in the same
                                  party as the oligarchs. Shouldn’t availability
                                  of affordable health care be nonnegotiable?
                              Democrats
                                  have drawn a line in the sand, and Republicans
                                  have, too. They are playing “chicken” with
                                  tens of thousands lives. This is more than
                                  your ordinary shutdown; it’s a matter of life
                                  and death. The longest shutdown that ever
                                  happened occurred during this President’s
                                  first term. It lasted thirty-eight days from
                                  December 22, 2018, through January 25, 2019,
                                  and even though federal workers got back pay
                                  at the end of the shutdown, many were forced
                                  to work without pay. Will their pleas
                                  influence Republicans to relent? Or are they
                                  content to keep imperiling lives?