As the federal government shutdown enters its third week, some Americans are worried about the future of the Affordable Care Act (ACA) subsidies.The subsidies, or premium tax credits, help lower or eliminate the out-of-pocket cost of monthly premiums for those who purchase insurance through the health insurance marketplace.They were enhanced during the COVID-19 pandemic and are currently set to expire at the end of 2025.How Affordable Care Act subsidies became a sticking point in the government shutdownDemocrats have been demanding that Republicans pass extensions of the subsidies before the government is reopened, while the GOP says it won't negotiate until a clean funding bill passes and the government reopens.A recent analysis from KFF found that premium payments could more than double in 2026 if the ACA enhanced premium tax credits expire.Some Americans who rely on the tax credits to help pay for some or all of their or their family's premiums told ABC News they're worried that if the subsidies expire, they may be forced to choose a less comprehensive insurance plan or they may not be able to cover the cost of their premiums.House Speaker Mike Johnson speaks during a press conference, weeks into the continuing government shutdown on Capitol Hill, Oct.20, 2025.Kylie Cooper/ReutersWe 'can't afford to not have insurance'Doug Butchart, 67, from Eglin, Illinois, told ABC News that his wife, Shadene, has amyotrophic lateral sclerosis (ALS), and currently receives her insurance through the health insurance marketplace.Shadene Butchart, 58, started off on a Blue Cross bronze plan -- or the lowest tier -- but, as her disease progressed, the couple decided to upgrade to a gold plan, the highest tier, which covers a higher percentage of her health care costs.The premium under this plan is $1,273.82 per month.
The Butcharts receive enhanced premium tax credits that cover $670 of the monthly premium, leaving them to pay $603.82 per month themselves.Without the premium tax c...