Don’t let a shutdown crisis go to waste: Fix Obamacare

Washington again finds itself in a government shutdown crisis. Obamacare, by contrast, is in a permanent state of crisis. This time, lawmakers can trade brinkmanship for genuine progress by fixing the broken economics of the Affordable Care Act.

The ACA undeniably reduced the number of uninsured Americans. Roughly half of that gain came from Medicaid expansion, and half from enrollment in the ACA’s private insurance marketplaces. Yet this success came at a steep and growing price. Roughly 92% of marketplace enrollees, 19.7 million people, received federal premium subsidies in 2024, and the total cost of those subsidies has far outstripped early projections.