The news: The US Senate is moving to end the government shutdown, but the compromise deal leaves out guarantees to extend the Affordable Care Act (ACA) healthcare tax credits.

Catch up quick: The federal government shutdown on October 1, when Democrats refused to agree to a resolution unless Republicans agreed to extend ACA healthcare tax credits.

• Republicans, encouraged by President Trump, rejected any negotiations on ACA tax credits until the government was opened again.
• Under the deal approved 60-40 on Sunday, the Senate would vote on the federally funded healthcare credits by mid-December.
• The current healthcare subsidies will expire on January 1.
• Almost three quarters (74%) of US adults still support extending the subsidies, per a KFF survey last week. That’s only slightly below the 78% who agreed before the shutdown began, with the largest declines in support from Republicans at 50% (down from 59% in September) and MAGA group members at 44% (down from 57%).

Why it matters: About 24 million Americans who use subsidies to help pay for health insurance are now facing major premium increases.

• The average subsidized household’s premiums will more than double from $888 this year to $1,904 in 2026, per KFF.
• More than 4 million people would lose ACA insurance coverage if the subsidies expire, per analysis by the Congressional Budget Office (CBO).

Implications for the healthcare market: Without ACA subsidies, younger and healthier consumers will likely drop out of the insurance pool, leaving older and higher-risk enrollees behind. That would drive up premiums and further reduce plan enrollment, putting pressure on insurers and shrinking consumer choice.

Across the healthcare landscape, insurers, pharma, and retail health brands are facing a more price-sensitive 2026. Hospitals and public health clinics could see higher uncompensated care as more people delay treatment until emergencies arise, creating financial ripple effects throughout the system. Providers and payers both may respond with price increases, raising costs for everyone. All healthcare stakeholders need to emphasize affordability, payment flexibility, and value as consumers shoulder more of their healthcare spending.