Human Rights Watch (HRW) and Oxfam America released a statement on Wednesday calling attention to the millions of Americans who may lose affordable health insurance if Congress refuses to extend public subsidies for the insurance marketplace created by the Affordable Care Act (ACA).

In response to the ongoing federal shutdown—now the longest in US history—the groups warned that if healthcare subsidies are not extended, millions of Americans will need to choose between living uninsured or paying increased private health insurance prices resulting from provisions of the One Big Beautiful Bill Act (OBBBA).

Rebecca Riddell, senior policy lead for economic justice at Oxfam America, alerted to likely financial impacts on lower- and middle-class individuals in comparison to higher-income people:

Instead of ensuring ordinary people can access adequate health care, the administration and Congress have chosen to prioritize large tax handouts for the wealthy and well-connected… Not extending subsidies risks further inflaming economic inequality, which is already sky high and likely to increase following massively regressive cuts to social protection passed in July.

The ACA was passed in 2010 with the aim of lowering health care premiums for millions of Americans. In 2021, Congress passed the American Rescue Plan Act, which helped maintain lower private health insurance costs for low- and middle-income households through public subsidies for the ACA insurance marketplace. These subsidies were initially scheduled to expire at the end of 2025, and with the passage of the OBBBA, they have not been extended.

As thousands of Americans continue to be affected financially by the government shutdown, the issue continues to break down along partisan lines in Congress.