Shutdown Standoff: DEMs Oppose Hiking HSRI Bills

PROVIDENCE, RI — The Oct. 1 federal shutdown trods on as Democrats insist on averting expiring Affordable Care Act (ACA) subsidies that’ll double monthly health insurance bills for more than 24 million people, including more than 40,000 Rhode Island HSRI customers.

A poll by the non-partisan health research firm KFF showed 78 percent of adults support extending the subsidies.

Tuesday, Rep. Seth Magaziner (D-02) met with health care workers at the Cambridge Innovation Center to discuss Democrats’ refusal to sign off on a federal budget that will further burden people already struggling. Republicans hold the bulk of federal power, but lack the 60-vote Senate majority needed to override Democratic opposition. Without Democratic insistence on extending the subsidies, their expiration would be unavoidable in 2026. Rhode Islanders begin open enrollment for 2026 on Nov. 1.

“Health care costs are skyrocketing,” said Magaziner. “It is time for Republicans in Congress to stop playing political games and extend Affordable Care Act funding, because every day people cannot afford to have their health insurance costs go up by thousands of dollars a year.”

While the shutdown lasts, federal agencies must discontinue non-essential functions, including furloughing non-essential workers. Magaziner’s office has posted a comprehensive guide to what is shut down on their website. A summary follows here:

Federal Shutdown: What’s NOT affected

• Medicare and Medicaid current beneficiaries will continue to receive their benefits
• Veterans Affairs (VA) medical facilities and clinics will remain fully operational
• Recipients will continue to receive their Social Security and Supplemental Security Income benefits.
• The U.S. Postal Service is not affected by a shutdown
• FEMA staff will still respond to emergencies
• Criminal litigation will continue without interruption
• Federal Retirees under the Civil Service Retirement System (CSRS) and Federal Employees Retirement System (FERS) will continue receiving their scheduled pension payments on time
• Active-duty U.S. military personnel remain on the job and will receive backpay.
• U.S. Citizenship and Immigration Services (USCIS) activities, which are funded by the Immigration Examinations Fee Account, will continue.
• ICE Enforcement and Removal Operations (ERO) will continue during a shutdown.
• Open-air parks and monuments in Washington, D.C. will remain open.
• SNAP food assistance benefits will last as long as funding remains, and the USDA has $6 billion in contingency funds to cover SNAP in November. The Trump Administration position that this funding cannot be used for this purpose contradicts the administration’s own position during previous shutdowns, according to the Center on Budget and Policy Priorities.

Federal Shutdown:  What IS affected

• Air traffic controllers and Transportation Security Administration (TSA) officers work unpaid till the shutdown ends, which may lead to staffing shortages.
• The Office for Civil Rights has paused its review of civil rights complaints.
• Civil litigation will be curtailed or postponed until funding is available
•  Internal Revenue Service will be closed and will limit taxpayer services, including answering calls. The Taxpayer Advocate Service, an independent organization within the IRS, will also be closed.
• National Park Service In previous shutdowns, the majority of NPS sites closed to public access during a government shutdown. The ones that remained open were left understaffed and unprotected, and the damage that occurred was irreversible or took parks many months to recover from. Prehistoric petroglyphs were vandalized, battlefield artifacts were stolen, Joshua trees were cut down and illegal off-roading vehicles drove through fragile archaeological sites.
• The Small Business Administration (SBA) cannot accept, review, or approve any new business loans (including SBA’s primary loan).

“The shutdown is already hurting Rhode Islanders, but the consequences will be far greater if ACA subsidies disappear. We share Congressman Magaziner’s concern that losing this support would devastate families and further strain an already fragile health care system,” said Michael Migliori, MD, Chair Rhode Island Medical Society Public Laws Committee.

HSRI: Health Care Cost Increases Will Hurt Everyone in RI

According to Health Source Rhode Island, If no changes are made, the effects would begin to be felt among HSRI customers as early as Fall 2025, but will be noticeable across the health care system starting in January 2026.

“A recent report from the Urban Institute projects a decrease in health care spending of $1.03 trillion between 2025 and 2034, three-quarters of which is attributable to the House-passed reconciliation bill.  Forty percent of that would impact hospitals ($408 billion) and eleven percent would hit physician services ($118 billion).  Further, the report indicates that for the same time period, uncompensated care would spike $278 billion, most of which would be due to the reconciliation bill, and again most of that increase would be attributable to hospital services ($83 billion), followed by physician services ($34 billion).  While each of the proposed changes to ACA provisions chisel away at its effectiveness and efficiency, taken together, these changes interact with and compound on one another, harming customers and the system underpinning the offering of affordable health coverage,’ the health exchange reports.

The healthcare exchange estimates about 13,000 Rhode Islanders will likely drop health insurance altogether rather than attempt to absorb the added cost.

“Today we are just four days from the start of Open Enrollment, when the grim reality of the APTC expiration coupled with rate increases will hit tens of thousands of Rhode Islanders who purchase health coverage through the state marketplace,”said  HSRI Director Lindsay Lang.“Without action on these tax credits, we will all soon begin to see the effects of rising uninsurance, with sicker patients, strained emergency departments, and a cycle of further elevated costs. Keeping the 13,000 or more Rhode Islanders at risk connected to coverage protects not just them, but every Rhode Islander who relies on our fragile healthcare system.” ACA-subsidies-expire-HSRI-impact-shutdown-2025-4