Whether it’s affording a doctor’s visit, filling a prescription or keeping health insurance within reach for working families, affordable healthcare is on the line. Trump and MAGA Republicans are threatening to shut down the government rather than renew the tax credits that keep ACA marketplace plans affordable, just as private insurers announce steep premium hikes for 2026. Without these subsidies, millions will lose coverage and millions more will face skyrocketing costs. Unless Congress acts to renew the credits, keep costs down and protect families, our communities will pay the price.

This guide provides clear messaging, key talking points, and resources to push back against these attacks, expose Republican lies, and urge Congress to put families first by protecting affordable healthcare.

• Tell the government to renew the ACA tax credits, keep costs down and protect affordable healthcare.

• Stand firm against Trump and MAGA Republicans’ threat to shut down the government to strip away healthcare. They are refusing to renew the tax credits that keep marketplace coverage affordable, all so they can push tax cuts for billionaires and side with insurance companies.

• This fight is about healthcare affordability, full stop. Without action, premiums will skyrocket, millions will lose coverage and families will pay thousands more out of pocket.

• Show the impact:

  • Over 4 million people are at risk of losing their health insurance if premium tax credits expire

  • Small businesses, contractors and the self-employed will be hit especially hard

  • Families already facing average premium hikes of 18% in 2026 will see even bigger bills without tax credits
    

• Millions are losing Medicaid coverage due to Republican budget cuts earlier this year, compounding the crisis. Now Trump is even promising to double some prescription drug costs with tariffs. Everywhere you look, Republicans are raising costs on working families

• Demand that Congress renew the tax credits, stop the shutdown and put families–not billionaires and insurance companies–first.

• The President and the GOP are willing to shut down the government rather than renew the ACA premium tax credits that 22 million Americans rely on for affordable marketplace coverage.

• Trump and GOP leaders are refusing to extend the premium tax credits set to expire at the end of this year. 4.6 million people will lose their health care coverage. [URBAN 09/2025]

• Even those who don’t lose coverage will pay far more. Insurance companies are already announcing average premium increases of 18% for 2026, the steepest increase in nearly a decade.

• Democrats are working to renew the tax credits and keep healthcare affordable. Republicans are refusing to act, and that’s what’s driving this shutdown fight. 

  The GOP’s recent tax and spend package also cut Medicaid and Medicare, stripping coverage from low-income families, seniors and people with disabilities. Those cuts compound the harm, especially in communities already struggling with access. 

• Nearly $1 trillion in cuts to Medicaid were included in the “One Big Beautiful Bill Act,” which President Trump signed into law on July 4, 2025, to help offset the cost of trillions in tax breaks. [URBAN 08/07]

• The White House has told its agencies to prepare for mass firings if Congress does not avert a government shutdown, showing just how reckless and disruptive this standoff has become. “The warning came after Trump on Tuesday refused a meeting with Democrats who are seeking to secure healthcare funding as part of budget negotiations.” [BBC 09/25] This is a threat and we must remind people that our livelihoods are on the line.

SOUND THE ALARM:  

• Share the truth: Republicans are threatening a government shutdown because they refuse to renew the tax credits that keep health insurance affordable.

• Let people know what’s at stake: Millions could lose coverage and millions more will face skyrocketing costs.

• Use your voice to call out the lies, highlight the stakes for families and make clear that the fight is about protecting affordable healthcare.

Government Shutdown Content

• Democrats bet the House on health care - The Hill

• White House to agencies: Prepare mass firing plans for a potential shutdown - Politico

• White House says to prep for mass firings if government shuts down - BBC

• Leading Organizations Launch Ad Campaign to Defend Healthcare in Face of Potential Republican Government Shutdown - Citizen.org

• Americans in the Battleground Want Congress to Protect Health Care — Even If It Means Shutting Down the Government - Navigator

• NEW: Updated State-by-State & Congressional District Data on Health Insurance Losses from Medicaid, ACA Cuts - JEC

• 4.8 Million People Will Lose Coverage in 2026 If Enhanced Premium Tax Credits Expire - URBAN