Looming health insurance spikes for millions are at the heart of the government shutdown

WASHINGTON — The U.S. government shut down Wednesday, with Democratic lawmakers insisting that any deal address their health care demands and Republicans saying those negotiations can happen after the government is funded .

At issue are tax credits that have made health insurance more affordable for millions of people since the COVID-19 pandemic. The subsidies, which go to low- and middle-income people who purchase health insurance through the Affordable Care Act, are slated to expire at the end of the year if Congress doesn't extend them . Their expiration would more than double what subsidized enrollees currently pay for premiums next year, according to an analysis by KFF , a nonprofit that researches health care issues.