Why is the government shut down? How health care became the sticking point

ORLANDO, Fla. – The federal government shutdown is close to being one for the record books.

Now in its fourth week, the shutdown is the second longest in U.S. history at 28 days, with the longest occurring during President Donald Trump’s first term in office.

Federal workers remain furloughed, while those deemed essential are working without pay. SNAP benefits for food will not be distributed on Nov. 1.

[WATCH: Florida families face SNAP crunch as shutdown persists]

Republicans say Democrats are the ones keeping the government shut down, because they refuse to support a continuing resolution that would keep the government funded through Nov. 21.

Democrats blame the Republicans, saying they need to reverse cuts to health programs that will otherwise lead to higher premiums next year and more people uninsured.

The heightened rhetoric between the two sides hit Central Florida on Monday, when Rep. Randy Fine, R-District 6, blamed Democrats for the shutdown and said it would hurt recovery efforts after storms caused damage in Lake County.

Let’s take a look at what Fine said and what the facts are.

Rep. Randy Fine’s remarks

[WATCH the news conference featuring Fine in the YouTube player below]

“Well, thank you, and thanks for having me today. Because the government is shut down, I’m not in Washington. I’m home. So when I heard about the issues here in my district, I wanted to come over and see them. And I wanted to tell everyone here that we will be committed to do what we can at the federal level to make, to help with the infrastructure issues. And I’m grateful not only to my staff that is here, but to the FEMA staff that we have coordinated with, all of whom are working unpaid, thanks to the Democrats’ decision to shut down the government. And I do want people to understand something because they should be very angry about this. If your home was flooded and you had federal flood insurance, FEMA is closed because Democrats have voted 12 times to keep the federal government closed in order to give free health care to illegal immigrants. So when we talk about the damage that they are doing to regular Americans, we can see it today. So what I would tell people to do is if you’re having a problem with your federal flood insurance because the lines are not open, they are not operating today, the federal flood insurance program is not working. They can call my office and we will try to help them as best we can. Again, with my staff that is working, as all federal government employees are working without being paid. But I want people to know that we are committed to working with Lake County, with the city of Mount Dora, the City of Eustis, to make sure that once the government reopens, if the Democrats ever choose to reopen it, to make sure that they have the resources that they need to respond to this disaster.”

“Thanks to the Democrats’ decision to shut down the government, and I do want people to understand something because they should be very angry about this..."

Whether Republicans or Democrats are to blame for the shutdown is a matter of perspective.

House Republicans passed HR 5371 in September, which would have kept the government running through Nov. 21 while Congress negotiates a long-term spending bill.

Democrats in the Senate are pushing S. 2882 instead, which would have kept the government running through Oct. 31.

The bill was identical in many respects. However, it also featured an extension of Affordable Care Act premium tax credit subsidies that are set to expire at the end of the year. These tax credits were expanded in 2021 to allow more people to take advantage of them.

According to health policy nonprofit KFF, more people signed up for health care through the ACA marketplace, growing to over 24 million people.

These two points have been the biggest for Democrats. Republicans have said the health care issue could be dealt with once the government has reopened, but Democrats want this dealt with now.

According to KFF, the tax credits help lower the share of income that people who get health insurance on the ACA marketplace pay for health insurance.

[WATCH: Dollars & Sense: Navigating 2026 Open Enrollment]

If the tax credits expire, KFF says premium payments next year would more than double. The latest analysis from KFF shows premiums would go from an average of $888 a year in 2025 to $1,904 a year in 2026.

S. 2882 also would reverse $1 trillion in cuts to Medicaid over the next decade that were made earlier this year under HR 1, also known as the One Big Beautiful Bill, which is now law.

The nonpartisan Congressional Budget Office says 1.3 million Americans would become uninsured next year because of the cuts. That number is projected to grow over the next decade to 10 million more uninsured by 2034.

Republicans want Democrats to support HR 5371 and once the government is back open, then health care negotiations can take place.

Democrats, however, say health care can’t wait, because people will get notices about next year’s premium increases this fall with open enrollment.

When News 6 asked, KFF communications director Craig Palosky pointed us to the group’s preview report on open enrollment.

“While these tax credits do not expire until the end of 2025, if Congress does not extend the subsidies at least a few days before the enrollment window opens, Marketplace enrollees will log on and see these higher premiums as soon as open enrollment starts on Nov. 1. The Congressional Budget Office projects significant coverage losses, and insurers expect younger, healthier enrollees to be more likely to drop their Marketplace plans, which will in turn push premium increases even higher than they otherwise would be."

Republicans say they will only consider extending the subsidies if Democrats vote to reopen the government.

However, not every Republican lawmaker supports expanding the subsidies or rolling back the Medicaid cuts, which has stymied GOP leaders trying to offer a compromise to the Democrats.

U.S. Sen. Rick Scott wrote in a Wall Street Journal op-ed that the subsidies amounted to “taxpayer-funded checks to insurance companies.” He said the Affordable Care Act has failed and Democrats are going to great lengths to “mask the true costs.”

Democrats also don’t trust the Republicans. Congressional staffers say Democrats got burned when they negotiated a budget in good faith, and then Republicans passed a rescission package that stripped funding after the fact, including funding for foreign aid and the Corporation for Public Broadcasting.

During an interview on South Florida radio station WLRN last week, Rep. Darren Soto, D-District 9, said, “We don’t trust them as far as we can throw them.”

Since the government shutdown began, there have been 10 cloture votes in the U.S. Senate to allow the chamber to proceed to a vote on HR 5371. Sixty senators are needed. Which means some Democrats need to break ranks and vote for cloture. The measure has failed every time.

“If your home was flooded and you had federal flood insurance, FEMA is closed”

Because of the shutdown, it’s estimated that some 670,000 federal employees are furloughed, according to the Bipartisan Policy Center.

The rest are considered essential and are working without pay. That includes many FEMA employees.

According to the U.S. Department of Homeland Security, roughly 20,000 of FEMA’s nearly 25,000 workers will continue to work without pay. Others are deemed non-essential.

[WATCH: Concerns grow as government enters partial shutdown]

Also, FEMA’s Disaster Relief Fund, which funds disaster operations, is operational and has about $10 billion.

In order for FEMA to provide help to any of the affected areas, Gov. Ron DeSantis would have to ask for help, which means Trump would have to declare them federal disaster areas. That would unlock FEMA resources and funding.

News 6 has contacted the governor’s office to ask if DeSantis is planning to do that. We are waiting to hear back.

The Florida Department of Emergency Management has deployed water pumps to remove floodwater in Lake County, and the Florida Department of Transportation is working to help deal with damaged roads, according to DeSantis.

Because of the shutdown, the National Flood Insurance Program is not issuing new policies or renewing policies that were not paid for before the shutdown. That is a problem for people trying to get a home with a mortgage that requires flood insurance.

Homeowners with active policies are still covered if they need to file a claim. However, processing and paying out claims could be delayed, according to Insurance Business Magazine.

“Democrats have voted 12 times to keep the federal government closed in order to give free health care to illegal immigrants.”

This is the number one talking point Republicans have used against Democrats. The answer is complex.

Undocumented immigrants cannot get federally funded Medicaid. They also cannot get insurance through the Affordable Care Act. It’s against federal law.

Democrats want to reverse some health care cuts for “lawfully present” immigrants. These are people with specific status, such as refugees, immigrants under Temporary Protected Status, green card holders, victims of human trafficking and more. The full list is on Health Care.gov.

Lawfully present immigrants are subject to a five-year waiting period for Medicaid.

Meanwhile, DACA recipients are no longer able to sign up for coverage through the ACA marketplace.

Democrats also want to reduce the reduction in reimbursements hospitals receive through Medicaid for emergency care. Under the Emergency Medical Treatment and Active Labor Act of 1986, hospitals are required to ensure people can get emergency care, regardless of whether they can pay. That includes a medical screening and stabilizing treatment.

That is care for everyone – even undocumented immigrants.

According to KFF, total emergency Medicaid spending in fiscal year 2023 cost $3.8 billion. That represents 0.4% of total Medicaid spending.

Some states may use their own money to provide health care to undocumented immigrants, but they are not supposed to use federal money.

The cuts in Medicaid reimbursement will affect hospitals in other ways as well. According to KFF, hospital care accounted for about one-third of Medicaid spending in 2023: $283 billion out of $872 billion.

In a presentation to the Florida House Health Care Facilities and System Subcommittee earlier this month, Brian Meyer, Florida’s Medicaid director, said Florida’s health care system would lose $3.8 billion because of the cuts in the One Big Beautiful Bill, with the cuts primarily affecting hospitals.

Other states will see far worse impacts because more people are on Medicaid, with an outsized impact on rural populations, according to KFF.