The longest government shutdown in U.S. history is set to conclude after the Senate approved a new budget bill with the support of eight Democratic senators. President Trump hailed the development on November 11 as a “major victory” for Senate Republicans. The bill, which has been sent to the Republican-controlled House, is expected to pass soon—allowing the government to reopen on November 14.
However, the core issue that triggered the shutdown remains unresolved. The new spending bill does not include provisions to extend Obamacare, which is set to expire at the end of this year. Without renewal, millions of Americans could face sharp increases in health insurance premiums—potentially hundreds of dollars more per month—especially affecting low-income families and those with pre-existing conditions. The Congressional Budget Office (CBO) estimates that about two million Americans could lose coverage entirely next year due to higher costs.
President Trump and the GOP must now find a way to lower healthcare costs or risk significant political backlash in next year’s midterm elections.
On November 10, Trump pledged to introduce a replacement for Obamacare, which currently benefits more than 24 million Americans and remains a top Democratic demand in budget negotiations. However, he has yet to outline a concrete plan, mentioning only a vague proposal to send direct payments to individuals purchasing insurance.
“We want a healthcare system where we pay people directly, not the insurance companies,” Trump said in the Oval Office, offering few details. “We’ll be working very hard on that issue in the near future.”
Trump’s comments highlight the growing pressure on Republicans, who must now produce a credible plan to keep healthcare affordable once Obamacare subsidies expire.
Enacted in 2010, Obamacare expanded access to healthcare for tens of millions of Americans and remains popular among voters. Republicans in Congress have long criticized the law for failing to control costs, which remain higher in the U.S. than in most developed nations. During his first term, Trump tried unsuccessfully to repeal the ACA after Congress refused to back the move.
Under President Joe Biden, Democrats expanded federal subsidies for individual insurance plans during the pandemic, increasing enrollment nationwide.
During last year’s campaign, Trump rarely discussed healthcare reform. When asked about Obamacare during a debate, he said he was open to change “if we can make it cheaper and deliver better care.”
Democrats have made healthcare costs a key political issue this year, insisting that Republicans must extend supplemental subsidies to help Americans afford premiums and reverse recent Medicaid cuts.
Republicans, meanwhile, argue that renewing Obamacare would be too costly. The CBO estimates that extending it would add $23 billion to the federal budget in 2026 and nearly $350 billion over the next decade. Despite their opposition to the ACA, Republicans have yet to propose a viable alternative or reach internal consensus on healthcare reform.
In exchange for supporting the budget bill, the eight Democratic senators secured a promise from Republicans to revisit Obamacare subsidies in December. This move, analysts say, shifts the political burden squarely onto Trump and the GOP. While Democrats’ hopes of passing a full ACA renewal bill remain slim, next month’s vote will force Republicans to confront the politically sensitive issue of healthcare affordability.
Democrats have also used the shutdown to spotlight the issue, accusing Republicans of ignoring the healthcare crisis. A recent NBC News poll found that 10% of voters view healthcare costs as the single most important issue shaping their vote in next year’s midterm elections. Of those surveyed, 49% said Democrats are better equipped to handle healthcare, compared to just 26% for Republicans.
Senator Jeanne Shaheen, one of the eight Democrats who struck the deal, said,
“By ending this standoff, we’ve helped some Republicans recognize that this is a real problem for them. Now we’ll see if they’re truly willing to work with us to ensure Americans can afford their healthcare coverage.”