By C. D. Casscells, M.D.
Director, Center for Health Policy
Caesar Rodney Institute
October 23, 2025
As the federal shutdown continues, Delaware residents may wonder whether their health-insurance premiums will rise. The short answer is no for most policyholders. The current debate in Washington concerns temporary Affordable Care Act (ACA aka “Obamacare”) marketplace subsidies that affect only a small share of Delaware’s insured population.
Under the Antideficiency Act, federal agencies must pause most operations when Congress fails to pass a budget, according to the U.S. Government Accountability Office (GAO). The GAO notes this is a legal requirement—not chaos.
In Congress, a simple majority in the House and 60 votes in the Senate are generally needed to pass funding measures.
The current dispute involves ACA marketplace subsidies, not Medicaid. These tax credits, broadened during COVID-19 to include some households above 400% of the Federal Poverty Level (FPL) when premium exceed 8.5% of income, are scheduled to expire at the end of 2025 unless extended. According to the Kaiser Family Foundation, these subsidies are key to keeping premiums affordable for many enrollees.
Meanwhile, hospitals remain open. The Emergency Medical Treatment and Labor Act requires emergency departments to treat and stabilize patients regardless of insurance status or a shutdown.
Supporters of extending the subsidies argue that they are necessary to prevent higher costs for ACA enrollees. Others contend that the subsidies were always meant to be temporary and should end as scheduled.
For the majority of Americans:
These programs represent the overwhelming majority of insured Americans.
Health insurance is a financial product—a way to share the cost of medical care through premiums and deductibles. Health care is the delivery of those services: doctors, hospitals and pharmacies providing actual treatment.
You can have insurance yet still face barriers to care, such as high out-of-pocket costs or limited provider networks. Hospitals must still provide emergency treatment under federal law, regardless of funding delays.
The ACA reshaped the insurance market, but did not directly change how medical care is delivered or priced.
Since its creation, the ACA marketplace has struggled to remain stable without federal subsidies. When subsidies have been reduced or eligibility narrowed, enrollment has consistently declined—evidence that many consumers find full-price premiums unaffordable.
For most Americans—particularly those covered by Medicare, Medicaid, or employer-based insurance—premiums will not change as a result of the shutdown or the expiration of temporary subsidies.
According to the Delaware Department of Insurance, which announced in August, Delaware’s ACA marketplace plans could see rate increases averaging 25% to 35% for 2026 if the enhanced subsidies expire. That would primarily affect higher-income households that benefited from the temporary expansion.
If the subsidies continue, they will require additional taxpayer funding—costs ultimately absorbed through higher federal and state spending.
For most Delawareans, including working families, retirees, and low-income individuals, insurance costs will remain stable.
The government shutdown is a legal budget procedure, not a crisis that will rewrite anyone’s health plan. For most Delawareans—and most Americans—health-insurance rates will remain steady.
While a small portion of ACA enrollees may see higher premiums if temporary subsidies expire, the majority will experience no change. If temporary subsidies expire as scheduled, the marketplace may gradually rebalance as insurers adjust to sustainable pricing and competition.
About the Caesar Rodney Institute
The Caesar Rodney Institute (CRI) is a Delaware-based, nonprofit 501(c)(3) research organization. As a nonpartisan public policy think tank, CRI provides fact-based analysis in four key areas: education, energy and environmental policy, the economy and government spending, and health policy.
Our mission is to educate and inform Delawareans—including citizens, legislators, and community leaders—on issues that affect quality of life and opportunity.
Learn more at CaesarRodney.org.
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