Will This Government Shutdown Change Your Health Insurance Rates??

Please read below expert policy analysis from the Caesar Rodney Institute Center Director for Health Policy, Dr. C.D. Casscells, M.D.

As the federal shutdown continues, Delaware residents may wonder whether their health-insurance premiums will rise. The short answer is no for most policyholders. The current debate in Washington concerns temporary Affordable Care Act (ACA aka “Obamacare”) marketplace subsidies that affect only a small share of Delaware’s insured population.

What the Law Says

Under the Anti-deficiency Act, federal agencies must pause most operations when Congress fails to pass a budget, according to the U.S. Government Accountability Office (GAO). The GAO notes this is a legal requirement—not chaos.

In Congress, a simple majority in the House and 60 votes in the Senate are generally needed to pass funding measures.

The current dispute involves ACA marketplace subsidies, not Medicaid. These tax credits, broadened during COVID-19 to include some households above 400% of the Federal Poverty Level (FPL) when premium exceed 8.5% of income, are scheduled to expire at the end of 2025 unless extended. According to the Kaiser Family Foundation, these subsidies are key to keeping premiums affordable for many enrollees.

Meanwhile, hospitals remain open. The Emergency Medical Treatment and Labor Act requires emergency departments to treat and stabilize patients regardless of insurance status or a shutdown.

What’s Driving the Shutdown

Supporters of extending the subsidies argue that they are necessary to prevent higher costs for ACA enrollees. Others contend that the subsidies were always meant to be temporary and should end as scheduled.

For the majority of Americans:

Medicare (Basic, Advantage and Supplement) will not be affected, employer-sponsored insurance remains unchanged, and Medicaid coverage—serving individuals earning about 150% of the FPL ($24,000 for an individual or $48,000 for a family of four)—also remains stable. These programs represent the overwhelming majority of insured Americans.

Health Insurance is Not Health Care

Health insurance is a financial product—a way to share the cost of medical care through premiums and deductibles. Health care is the delivery of those services: doctors, hospitals and pharmacies providing actual treatment.

You can have insurance yet still face barriers to care, such as high out-of-pocket costs or limited provider networks. Hospitals must still provide emergency treatment under federal law, regardless of funding delays.

The ACA reshaped the insurance market, but did not directly change how medical care is delivered or priced.

Since its creation, the ACA marketplace has struggled to remain stable without federal subsidies. When subsidies have been reduced or eligibility narrowed, enrollment has consistently declined—evidence that many consumers find full-price premiums unaffordable.

Impact on Rates

For most Americans—particularly those covered by Medicare, Medicaid, or employer-based insurance—premiums will not change as a result of the shutdown or the expiration of temporary subsidies.

According to the Delaware Department of Insurance, which announced in August, Delaware’s ACA marketplace plans could see rate increases averaging 25% to 35% for 2026 if the enhanced subsidies expire. That would primarily affect higher-income households that benefited from the temporary expansion.

If the subsidies continue, they will require additional taxpayer funding—costs ultimately absorbed through higher federal and state spending.

For most Delawareans, including working families, retirees, and low-income individuals, insurance costs will remain stable.

What Consumers Can Do

Review your coverage: If you buy insurance on the ACA marketplace, confirm your subsidy eligibility at HealthCare.gov.

Compare plans: During open enrollment, shop for the plan that best fits your budget and health needs.

Seek guidance: Consult a licensed insurance advisor or use tools like the Health Insurance Marketplace Calculator from the Kaiser Family Foundation or Healthcare.gov to estimate potential changes.

Stay informed: Follow updates from the Delaware Department of Insurance and the Centers for Medicare & Medicaid Services.

The Bottom Line

The government shutdown is a legal budget procedure, not a crisis that will rewrite anyone’s health plan. For most Delawareans—and most Americans—health-insurance rates will remain steady.

While a small portion of ACA enrollees may see higher premiums if temporary subsidies expire, the majority will experience no change. If temporary subsidies expire as scheduled, the marketplace may gradually rebalance as insurers adjust to sustainable pricing and competition.

By C. D. Casscells, M.D.

Director, Center for Health Policy

Caesar Rodney Institute

October 24, 2025

This commentary is provided by the Caesar Rodney Institute, a Delaware-based, nonprofit 501(c)(3) public policy research organization. Dr. Christopher Casscells, Director of CRI's Center for Health Policy, helps Delawareans understand how policy decisions at both state and federal level affect access to affordable, high-quality healthcare.

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