Shutdown Continues Over Obamacare Subsidy Fight

The U.S. government shutdown has entered its second month as Democrats use budget leverage to press for an extension of Affordable Care Act tax credits and to shore up the law. Senate Democrats largely blame House Republicans and former President Donald Trump for the impasse, saying Republicans refuse to negotiate while federal workers remain unpaid and benefits lag. Conservative critics argue the ACA is failing, pointing to rising “zero-claim” exchange enrollees, alleged fraud, and gaps between coverage and care. The dispute has widened into debates over pharmacy benefit managers, with some warning that constraining PBMs could weaken bargaining power that helps lower drug costs. Observers also cite mounting strains in the global health-insurance sector from medical inflation and underwriting problems, and regulators in markets such as India say insurer sub-limits and hostile portability underwriting are leaving many patients underinsured.