Open enrollment is here. Can it break the shutdown standoff?

Modern Healthcare – Monday, November 3, 2025
By Michael McAuliff

Open enrollment on the health insurance exchanges is here, and that marks a consequential moment in the political deadlock that triggered a federal shutdown a month ago. Massive premium increases have stopped being theoretical, which could escalate pressure on Republicans and Democrats to make a deal.

The Republican congressional majority has always opposed the Affordable Care Act of 2010, which created the exchanges, and the law President Joe Biden enacted in 2021 to make the ACA’s premium tax credits more generous and more widely available. But these lawmakers represent constituents disproportionately impacted by the expiration of the enhanced subsidies at the end of the year. The enrollees who elected them are seeing now just how much their rates have gone up.

The Democratic minority used the threat of a shutdown, and the shutdown itself, to force a debate on extending the enhanced subsidies. But their chances to protect exchange customers from big price increases started slipping away once the 2026 open enrollment period began on Saturday. Sign-ups will continue until Jan. 15 in most states.

So far, neither side has blinked.

Still, the start of open enrollment is an “inflection point,” said Jonathan Burks, executive vice president of economic and health policy at the Bipartisan Policy Center. “I don’t know that it’s a hard deadline, but it is a useful point for members to start thinking seriously.”

Republican leaders have been banking on rising pain from the shutdown across the board to compel Democrats to relent.

Senate Majority Leader John Thune (R-S.D.) dismissed the notions of giving in to Democrats or passing piecemeal measures to fix the worst immediate impacts of the standoff. Thune said last week that he’s committed to insisting on a funding vote that would reopen the government before anything else.

“There’s just a simple way to do it. It’s to pick up the bill on the desk of the Senate and give us five more Democrat votes to pass it so the president can sign in the law and end the shutdown,” Thune said.

Democrats acknowledge the landscape shifts with the start of open enrollment, but maintain not only is there still time to cut a deal, but that it’s the GOP who will feel the pain when voters experience sticker shock.

“People in more than 30 states are going to be aghast — aghast — when they see their bills, and they’re going to cry out, and I believe there will be increased pressure on Republicans to negotiate,” said Senate Minority Leader Chuck Schumer (D-N.Y.).

Thune and some other Republicans have expressed openness to negotiating if Democrats go along with their funding plan. But they have indicated that a significant ACA overhaul would have to be part of the equation.

“We are more than happy to sit down with the Democrats and talk about other issues, whether it’s the unaffordability and unsustainability of ‘Obamacare.’ We’re happy to have that conversation,” Thune said. “But we can’t do it with, as Chuck Schumer has said in the past, a gun to our heads.”

Sen. Mike Rounds (S.D.), who is among the Republicans who have said they are open to extending enhanced ACA subsidies, suggested the start of open enrollment means the Democrats’ goal is all but lost.

“Our Democrat colleagues have basically run out of time, and that’s hurting a lot of people,” Rounds said, adding he reached out to Democrats in July to discuss changes to the ACA.

“We’re going to continue to look at it, but getting something done in the timeframe necessary for open enrollment is becoming more difficult every day this shutdown continues on,” Rounds said.

Sen. Elizabeth Warren (D-Mass.) scoffed at Republican claims that they are developing their own healthcare plan — 15 years after the ACA became law — despite House Speaker Mike Johnson (R-La.) keeping the lower chamber in recess throughout the shutdown.

“Are they doing it from poolside, or their vacation hostels?” Warren said. “The Republicans do a little hand-waving around healthcare, but there’s nothing on the table.” Democrats also emphasize that President Donald Trump and the GOP Congress cut the exchanges and Medicaid by a combined $1.1 trillion in their recent tax law.

Health insurance exchange enrollees and insurance companies are getting squeezed while Congress idles.

According to the health policy research institution KFF, the average cost of a 2026 exchange plan, including subsidies, is $1,904, or 114% than this year. The nonpartisan Congressional Budget Office predicts 4.2 million people will forego coverage as a result and become uninsured. Insurers are girding for a smaller, sicker and costlier customer base.

“We really need Congress to act now. That’s the most important thing,” said Cheryl Fish-Parcham, director of private coverage at the left-leaning consumer advocacy group Families USA. “It becomes harder and harder to protect people as time goes on.”

If lawmakers can come to terms quickly, it’s not too late for health insurance companies to adjust, David Merritt, senior vice president of external affairs at the Blue Cross Blue Shield Association, said during a news conference.

But the sorts of policies most Republicans demand shouldn’t be put in place before 2027, Merritt said. “It is far too late in the year to have massive changes,” he said.

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