U.S. Rep. Nikki Budzinski of Illinois says some of her constituents will pay double for health insurance if Congress doesn't vote to extend a subsidy program that helps pay for premiums.
The issue is at the heart of the federal government shutdown, now in its second week.
Democrats in Congress have held off voting on a spending bill unless legislators agree to again approve the tax credits for people who buy insurance on healthcare.gov.
That's the marketplace where people who don't receive employer health benefits or who don't have Medicaid or other government-supported plans can buy health insurance.
Budzinski, a Democrat whose 13th District comprises much of the Metro East, says people in her district can't handle higher health care costs along with higher food and energy bills.
"It's all very compounding. And so that's what's put this to such a crisis point," she said during a virtual roundtable Thursday.
The subsidy program expires at the end of the year, but the six-week open enrollment period in which people can choose new plans begins Nov. 1.
In 2025, close to 466,000 people in Illinois, 3.6% of the state's population, bought plans on healthcare.gov. The site is sometimes called the Affordable Care Act Marketplace after the law that established it.
Around 7% of Missourians, or 416,000 people, bought plans in 2025, according to the health policy research organization KFF.
The vast majority of people who buy such plans use subsidies, said Kathy Waligora of Protect Our Care Illinois, a health advocacy organization.
She said households could pay hundreds of dollars more each month without them.
"When folks are seeing these bills and having to make decisions about what to do with that … they're looking at the rising cost of child care, of health care, of utilities, of rent or mortgages," she said. "[People] are starting to contemplate how they're going to make this work. They're very seriously considering whether they can enroll in health insurance."
During the roundtable, Laura Petty of Alton said her family's premiums would skyrocket without the subsidies.
"We currently pay $310 a month for a Bronze plan, and without the enhanced subsidies, currently, we would be paying $800 a month for a Bronze plan on the ACA," said Petty, who works cleaning houses. Her husband is a carpenter.
According to KFF, around half of the people who buy insurance plans on the marketplace are self-employed or small-business owners or employees.
As of Friday, the government shutdown has stretched into its 10th day.
More than a half-dozen votes have failed to end the shutdown as Republicans and Democrats continue to lock horns on Capitol Hill, with Republican leaders saying they're willing to discuss health policy but not before lawmakers vote to end the freeze.
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