On October 1, 2025, the federal government shut down after Congress failed to reach agreement on a continuing resolution to fund the government and protect affordable healthcare. This shutdown was entirely avoidable. It stems from the refusal of Congressional Republicans to work with their Democratic colleagues to extend and restore critical healthcare protections that millions of people rely on.
At the center of this impasse are the enhanced premium tax credits (ePTCs), which help more than 22 million Americans afford health coverage. Without immediate action to extend these credits, premiums are projected to increase by an average of $700 — with many families facing spikes of hundreds or even thousands of dollars. Millions could see their premiums double or more, and at least 4 million people are expected to lose coverage altogether. For people living with HIV and others managing chronic health conditions, the consequences of losing access to care are dire.
Families across the country are already struggling with the rising cost of food, rent, and child care. Premium spikes of this scale will create devastating sticker shock as open enrollment begins, pushing millions off coverage at the very moment they need it most. These increases will be on top of the effects of H.R. 1 – the largest Medicaid cuts in history, which will result in at least 17 million more people losing their right to healthcare, if the cuts are not reversed.
Let’s be clear: no one benefits from a government shutdown. While both parties have voiced opposition to this outcome, Republican leadership’s refusal to act on the enhanced premium tax credits or meaningfully address threats to our nation’s healthcare system in their reconciliation bill and the appropriations process, has placed affordable coverage at risk for millions of Americans. Congress has the opportunity and responsibility to prevent further harm by coming together to extend the enhanced premium tax credits and protect access to affordable coverage. Healthcare is worth fighting for — and the well-being of our nation depends on it.
The effects of this shutdown will touch us all, including AIDS United staff and the communities we serve. Just as earlier cancellations of federal grants have already placed jobs and programs at risk, this shutdown creates additional uncertainty for organizations working every day to end the HIV epidemic. But we cannot allow this disruption to deter us from speaking up: too much is at stake.
Take Action: We urge Congress to act immediately to extend the enhanced premium tax credits and protect the health of over 22 million individuals. We encourage advocates and community members to contact their elected officials and remind them that preserving affordable, accessible healthcare is essential to the health and security of our nation.
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About AIDS United: AIDS United is dedicated to ending the HIV epidemic in the United States through strategic grantmaking, capacity building, and policy and advocacy efforts. With more than $160 million in direct funding awarded and an additional $184 million leveraged, AIDS United supports organizations and communities most impacted by the HIV epidemic. To learn more about our work, visit www.aidsunited.org.