《经济周刊》：政府可能再次停摆

9 January 2026 Richard de Chazal, CFArdechazal@williamblair.com+44 20 7868 4489 Economics Weekly Louis Mukamalmukama@williamblair.com+1 312 364 8867 Another Possible Government Shutdown,Rising ACA Premiums, and Fiscal Cliffs William Blair The two questions most frequently asked by clients overthe last month have been: will there be another govern-ment shutdown, and what will happen with the enhanced Since the government reopened, the Senate has held twovotes on the credits. In mid-December the Democrats intro-duced a bill to extend the credits for another 3 years. Whilethis bill failed by 51 (in favor) to 48 (against)—still short ofthe required 60-vote threshold—four GOP senators defiedthe party line and voted in favor of the bill, including strong Affordable Care Act (ACA) extended tax credits that ex-pired at the end of December?In thisEconomics Weekly, The reality is that the answer to the first question is al-most entirely dependent on the answer to the second. Themain sticking point during the last government shutdownwas the Democrats’ demand for the enhanced premiumtax credits for the ACA to be extended versus the Republi- The Senate Republicans introduced a second bill thataimed to replace the enhanced credits with health savingsaccount contributions. This motion also failed by a 51-48vote. Lawmakers agreed to hold another vote in the com- Encouragingly, punters using Polymarkets are optimisticabout a solution and currently put the odds of anothershutdown at just 23%, down from a peak of 38% in mid- Back in 2021, in the midst of the pandemic, the Biden ad-ministration sought to use the crisis as an opportunity tohelp low- and middle-income households who were facedwith dramatically rising healthcare costs and to increase Enhanced premium tax credits were introduced as partof the March 2021 American Rescue Plan as a temporarymeasure. These credits were extended in August 2022as part of the Inflation Reduction Act, with an expiration The original subsidies were included as part of PresidentObama’s 2010 ACA healthcare reform (but only actuallyenacted in 2014) and remain in place. As discussed below, with around 22 million Americansnow likely to see their health insurance premiums morethan double, this has understandably become a major In November, members of Congress agreed to reopen thegovernment (and only until January 31, 2026) followingthe longest government shutdown in history, after bothsides agreed to exclude the question of the enhanced pre-mium tax credit extension in exchange for a guarantee of Since the start of this year, the millions of Americanswho purchased health insurance through the ACA mar-ketplaces are no longer receiving the enhanced premium Since 2014, the ACA has limited the share of income thatenrollees pay for private health insurance if their house-hold income is at least 100% but not more than 400% ofthe federal poverty level (FPL) for their family size that William Blair by a sliding scale (shown in exhibit 2), and the federalgovernment subsidizes the remainder through a tax cred-it. Consumers can choose to either apply the credit as anadvance premium tax credit (APTC) paid directly to their Since the introduction of enhanced premium tax credits,enrollment in ACA health insurance plans has more thandoubled—from 10.7 million in 2020 to 23.4 million in2025. About 93% of enrollees, or 21.8 million people, re- The 2021 enhanced premium tax credits expanded eligi-bility to include those above 400% of FPL and increasedsubsidy amounts, such that households below 150% of If enhanced tax credits are not extended, many ACAmarketplace consumers will still qualify for a reduced taxcredit. However, those with incomes between 100% and For example, with the enhanced tax credits in place for2025, a family of four making $75,000 paid no more than3.62% ($2,712) of their annual income toward a bench-mark plan. Once enhanced tax credits expire, that samefamily will pay 7.82% ($5,869) toward a benchmark planin 2026. In other words, the family will experience an These examples assume the family purchases the bench-mark plan through the ACA marketplace. If they choose amore expensive plan, the credit will remain the same, and During the 2025 open enrollment period, roughly10.9million enrollees fell into this category, and 10.3mil-lion of them would have paid monthly premiums lessthan $10 after APTC for the plans they selected. Theroughly 1.6 million people with incomes above 400% of William Blair their low-income counterparts, some of whom may forgohealth insurance altogether for lack of affordable options. In September 2025, the Congressional Budget Officeprojected that a permanent extension of the enhancedpremium tax credit (PTC) would increase the federaldeficit by $349.8 billion from 2026 to 2035 and increasethe number of insured by 2 million in 2026 and 3.8 mil-lion by 2035. Put another way and holding all else equal,loss of the subsidy would act as a major tax inc