On the Senate floor Thursday, Sen. Elizabeth Warren issued a warning to Republicans: reverse deep cuts to healthcare or be prepared to face public outrage if the government shuts down. Warren told her colleagues they had a choice: undo what she described as a crisis caused by GOP policies, or explain to millions of Americans why their healthcare is being sacrificed to partisan maneuvering.
The Massachusetts Democrat spoke in support of a proposal released by Senate and House Democrats on Wednesday night to avert a shutdown by keeping the government running through Oct. 31—on the condition that Republicans agree to restore about $1 trillion in Medicaid cuts and extend Affordable Care Act (ACA) subsidies. Without that extension, premiums for millions of people purchasing insurance through the ACA marketplace are expected to rise by an average of 75 percent.
“Before working moms go broke from a cancer diagnosis, Congress must act. Before community hospitals are forced to shut down, Congtess must act,” Warren said. “That is why Democrats are saying: ‘If Republicans want our votes, they need to restore healthcare for Americans.‘”
A new analysis released Thursday by the Congressional Budget Office estimated that making the ACA subsidies permanent would increase the number of insured people by nearly 4 million. Democrats say this makes action urgent, especially with insurers preparing to send out premium notices in October and open enrollment beginning on Nov. 1.
House Minority Leader Hakeem Jeffries and Senate Minority Leader Chuck Schumer have made clear that Democrats will not vote for the Republicans’ current proposal, known as the One Big Beautiful Bill Act, which funds the government at existing levels through November 21 while leaving healthcare cuts intact. “The House Republican-only spending bill fails to meet the needs of the American people and does nothing to stop the looming healthcare crisis,” Schumer and Jeffries said in a joint statement. “By refusing to work with Democrats, Republicans are steering our country straight toward a shutdown.”
Republicans, led by Speaker Mike Johnson, unveiled their plan earlier this week. The short-term continuing resolution includes $30 million in new funding for lawmaker security, added in response to the recent fatal shooting of conservative activist Charlie Kirk. But it excludes the healthcare provisions Democrats are demanding.
Johnson rejected calls to roll back cuts. “Zero chance that we will do that,” he said. On the ACA subsidies, he added that the issue is “a December policy issue, not a September funding issue.”
Warren pressed the point again as she walked to the Senate floor. “if Republicans want our votes for this budget, they’ve got to restore healthcare for millions of Americans,” she said. “It’s really that simple.”
Democrats are also pressing for language to block what they say is Trump’s illegal practice of rescission—selectively withholding or redirecting funds approved by Congress. “They have to stop, once we come to an agreement, stealing funds that we have agreed on,” said Rep. Rosa DeLauro, the senior Democrat on the Appropriations Committee. “We can’t go down that road again.”
Advocates outside Congress have echoed the urgency. Lisa Gilbert, co-president of Public Citizen, said the moment was one of leverage for Democrats to secure real gains. The “alignment of Democratic leadership and appropriators in recognition of this moment of leverage is heartening,” she said. “A budget deal should be contingent on addressing Americans’ top economic priority—the cost of and access to healthcare. If Republicans refuse to negotiate and move away from their cost-increasing agenda, then they are the ones who will be forcing a government-wide shutdown. There should be no deal without assurances that the budget will be honored and not impounded, and that it will begin to return care to the American people.”
Kobie Christian of Unrig Our Economy was more direct about Republican intentions. By refusing to engage in talks, he said, GOP leaders have shown that “if it isn’t about giving the ultrarich another tax break, Republicans in Congress aren’t interested.” Christian added, “Every day that Congress does not take action to prevent increases in health insurance premiums, more and more Americans are at risk of facing higher healthcare costs and losing coverage. It’s time that congressional Republicans come to the table and find a solution to help all Americans, not just the ultrawealthy.”
Other Democrats have highlighted the stakes for their constituents. Rep. Pete Aguilar, head of the House Democratic Caucus, said, “If they don’t want to address the impending health care crisis, they can explain that… But they control the levers of government. It’s on them to put forward a plan that funds the government.” Rep. Stephen Lynch of Massachusetts added, “The harm that will visit the American public if we don’t get something changed on health care is far greater than the reputational damage that we might suffer for voting no. Our moments of leverage are few and far between here. So this is an opportunity for us to deliver.”
For Rep. Juan Vargas, the additional security funding in the GOP bill does not outweigh the health care risks. “We live in a dangerous situation, we always have,” Vargas said. “But not because of that are we going to vote for some crappy bill that hurts people and their health care—that continues to take us down this road to perdition.”
Despite divisions within the Republican caucus, including opposition from members such as Thomas Massie, Victoria Spartz, Marjorie Taylor Greene, and Warren Davidson, Johnson is pressing forward. With Democrats united in opposition, the House leadership can only afford two defections—three if Democrat Jared Golden again crosses the aisle.
The deadlines are fast approaching. Without an agreement, the government will shut down at midnight on Oct. 1. Democrats are attempting to use this narrow window to force restoration of health protections they say are essential for millions of Americans, while Republicans insist they will not reverse course.
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