A clash over the Affordable Care Act that has led to a shutdown of the federal government has ramifications for public health as agencies cease some services. The Trump administration vows mass layoffs during the impasse.

The shutdown centered largely on a disagreement over the Obama-era health law. Democrats want a further extension of enhanced subsidies that reduce ACA health insurance premiums, but GOP lawmakers insist any debate wait until after a budget deal is reached to keep the federal government afloat.

With the sides far apart, federal funding ran out at midnight Oct. 1 after Congress failed to pass even a stopgap budget. The issue now is how long the deadlock will continue.

In a KFF poll released today, more than three-quarters — 78% — of the public say they want Congress to

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