Hospitals welcome shutdown’s end, but seek renewal of Affordable Care Act tax credits

Hospitals and health systems had implored Congress and President Trump’s administration to end the shutdown, and they got some of what they wanted.

Trump signed legislation to reopen the government Wednesday night, and the bill included some important priorities to hospitals, including an extension of waivers for telehealth and hospital-at-home programs.

But the measure didn’t include provisions to extend the tax credits for the Affordable Care Act, the core issue at the heart of the shutdown.

Senate Republicans agreed to hold a vote on the issue of renewing the tax credits, but they didn’t commit to passage, and House Republicans have made no commitment whatsoever on extending the credits or even a vote.

Healthcare leaders say Congress must extend the tax credits, or millions of Americans could risk losing coverage. Premiums have risen sharply, as many Americans are discovering as they begin the open enrollment process of securing coverage for next year.

Sister Mary Haddad, president and CEO of the Catholic Health Association of the United States, called extending the tax credits “a vital safeguard for millions of families who depend on stable, affordable health care.”

“With the government finally reopened, Congress should move immediately to extend the health tax credits before they expire at the end of the year,” Haddad said in a statement. “Open enrollment is underway, and many families are experiencing significant sticker shock as they search for coverage. For households already stretched thin by inflation and rising everyday expenses, the prospect of even higher health care costs is unsustainable.”

Charlene MacDonald, executive vice president of public affairs for the Federation of American Hospitals, also issued a statement imploring lawmakers to extend the tax credits.

“No more posturing, no more politics - it is time for pragmatic lawmakers to come together, focus on lowering costs for their constituents, and extend the health care tax credits,” MacDonald said in a statement.

"A bipartisan extension of the tax credits is the only mechanism to immediately cut costs for hardworking families already struggling to make ends meet. The solution to this cost-of-living crisis is simple and urgent: Congress must extend the tax credits now,” she said.

Healthcare say millions of Americans will lose insurance coverage without an extension of the tax credits for the Affordable Care Act. For 2026, if the enhanced tax credits lapse, KFF has estimated that those looking to enroll on the marketplace will see premiums more than double, rising by 114%, on average.

Those higher premiums would affect 22 million Americans, the Catholic Health Association says.

Florida residents are among those most at risk if the tax credits lapse. Florida has 4.7 million residents enrolled in Affordable Care Act plans. Mary Mayhew, president of the Florida Hospital Association, told Chief Healthcare Executive in a recent interview that the loss of tax credits will put insurance out of reach of many in the Sunshine State.

“We estimate over a million Floridians will not be able to afford the skyrocketing increases in their monthly premiums,” she said.

Hospital and healthcare leaders have argued that the Affordable Care Act subsidies are even more important in light of looming changes to Medicaid programs that are projected to see more than 10 million Americans lose coverage in the next decade.

Senate Republicans have said they will have a vote on extending the Affordable Care Act in mid-December, but House Majority Leader Steve Scalise said Wednesday that he wouldn't commit to a vote, CBS News reports.

The legislation reopening the government does address some hospital concerns. The measure blocks cuts to the Medicaid Disproportionate Share Hospital program, which provides aid to hospitals with a high percentage of patients relying on Medicaid.

The American Hospital Association said it was grateful that Congress acted to reopen the government.

“In the months ahead, the AHA will work with Congress to build on this progress and make sure that patients can access the care they need without disruption,” an AHA spokesman said late Wednesday night.

Two Medicare programs supporting rural hospitals also received short-term extensions of funding. The bill offers funding for the Medicare-dependent Hospitals and Low-volume Adjustment programs through Jan. 30.

The legislation also included extensions of funding for Community Health Centers, the National Health Service Corps, and the Teaching Health Centers Graduate Medical Education Program. Those programs are funded through Jan. 30.