With government shutdown imminent, Cantwell highlights Democrats' key demand: Stopping sharp increase in health insurance costs

Sep. 26—WASHINGTON — Congress headed into the weekend with a government shutdown all but certain to begin on Wednesday, as Democrats demand Republican majorities in the House and Senate act to keep health insurance costs from rising while the White House dismissed that condition as "radical left insanity."

Some Republican lawmakers have voiced support for extending health insurance subsidies set to expire at the end of the year, but they say that should wait until after Congress passes a short-term bill to extend government funding, which runs out at the end of September.

But in an interview Friday, Sen. Maria Cantwell said extending the subsidies — which come in the form of a tax credit applied to insurance purchased through Affordable Care Act exchanges, often called Obamacare — can't wait. The open enrollment period in Idaho begins Oct. 15 and ends Dec. 15, and those periods run from Nov. 1 until sometime in January in every other state and the District of Columbia.

"Having less people have insurance is not going to be good," Cantwell said, citing an estimate that 80,000 Washingtonians could lose their health insurance because they cannot afford it without the subsidies. "Everybody's rate goes up because the uninsured rate goes up. And this is an avoidable situation, if people will just sit down and talk."

The Washington Democrat's office published a report on Thursday that highlights the premium increases of each state's leading health insurance provider. That includes an increase of 26.9% for the Coordinated Care Corporation in Washington state and about 7.8% for Moda in Idaho.

While most states have proactively communicated the rate increases to their residents, Cantwell's report found that some of the states with the biggest price hikes, all led by Republicans, haven't done so. Those include Georgia, Kansas, Texas and Mississippi, where the leading insurance providers all requested increases of between 39% and 40%.

Along with the report, Cantwell sent a letter on Thursday to President Donald Trump and to Republican and Democratic leaders of the House and Senate, expressing her "growing concern over the looming health insurance affordability crisis that could affect the 24 million Americans who currently purchase health insurance on the marketplace exchange."

"Unless Congress acts within the next few weeks, these millions of Americans will collectively pay an estimated $23 billion more next year just to maintain the same level of coverage they currently rely on," Cantwell wrote. "Congress must immediately begin working with the Administration in a bipartisan, good faith effort if we are going to have any chance at extending these crucial credits in time for beneficiaries to decide whether or not they can afford health insurance next year."

So far, Trump and his GOP allies in Congress have shut down the idea of meeting any of the Democrats' demands to fund the government, which also include undoing the roughly $1 billion cut to Medicaid funding Republicans made in the One Big Beautiful Bill Act they passed in July. Each party is betting that more Americans will blame the other for a government shutdown, which could result in some federal employees going unpaid and the closure of National Parks and other government services, depending how long a funding lapse continues.

The White House's Office of Management and Budget raised the stakes of such a shutdown by directing federal agencies in a memo on Wednesday, first reported by Politico, to identify employees to be terminated, not just furloughed for the duration of a shutdown. The memo accuses Democrats of making "insane demands" and breaking a "bipartisan trend" of passing short-term spending bills to avert government shutdowns, although Republicans have routinely used the threat of a shutdown to make demands when they have been in the minority.

Sen. Patty Murray of Washington, the top Democrat on the committee in charge of government funding, reacted to the memo with a statement calling Trump "a petty wannabe tyrant."

"Instead of sitting down with Democrats to prevent a shutdown and protect Americans' health care, President Trump is threatening to inflict more pain on the American people — in red and blue states alike," Murray said. "President Trump will try to abuse a shutdown — just like he's trampled our laws for months — but that doesn't mean he gets whatever he wants as a result."

Cantwell, who has spent more than two decades in the Senate working with Republicans on bipartisan priorities, said she was motivated to release the report on premium increases to help her GOP counterparts understand how letting the insurance subsidies expire at year's end could hurt their constituents.

Asked what Republican colleagues in the Senate are telling her privately, Cantwell said, "I think he's trying to intimidate even them."

Unlike the Medicaid spending cut, the Republicans' signature tax-and-spending bill didn't touch the insurance subsidies, but Cantwell said Republicans quietly agreed to add bipartisan measures to their partisan bill and could have done the same to extend the premium tax credits.

"I think it's time for my Republican Senate colleagues to stand up and say, 'Enough is enough,'" she said. "I need colleagues in the Senate who will stand up and say these are priorities on behalf of our consumers, when we're seeing the high cost of inflation drive up prices — in groceries and electricity and now in health care and the tariff issue. Are we going to do something about it or are we just going to roll over and say the president dictates the Senate?"

Although Republicans control the House and the Senate, the upper chamber's filibuster rule means at least seven Democrats would have to vote with Republicans to keep funding the government. Senate Minority Leader Chuck Schumer, D-N.Y., opted to do that when Congress last faced a potential shutdown in March, but that move upset Murray and other senior Senate Democrats, and Schumer appears far more willing to let government funding run dry this time around.

Just eight months into Trump's second term, Democrats are facing pressure from their political base to use what limited leverage they have to slow the progress of a president who is rapidly reshaping the federal government more thoroughly than he did in his first term. Yet Democrats, traditionally the party that's more interested in a robust federal government, must consider the possibility that a shutdown could help the Trump administration hollow out federal agencies and assert even more power over increasingly compliant legislative and judicial branches.

Along with her fellow Democrats, Cantwell hopes the specter of rising health care costs could motivate Americans — and perhaps even Republicans in Congress — to resist the president's policy agenda. She gave the example of a small business owner who's already struggling with the added costs of tariffs, Trump's favorite economic and diplomatic tool, and will now have to pay extra for health insurance.

"On top of the Medicaid cuts, we are really destabilizing the system," she said. "I just know it's not a good idea, and it could be solved. We've just got to quit makings things more expensive for everybody."

Orion Donovan Smith's work is funded in part by members of the Spokane community via the Community Journalism and Civic Engagement Fund. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper's managing editor.

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