What Does a Federal Government Shutdown Mean for Women’s Healthcare? A Stealthy Rollback of Coverage

Trump and Republicans’ budget priorities quietly strip women of critical healthcare protections.

Congress faces a shutdown, as lawmakers debate whether or not to extend the subsidies that millions rely on for affordable health coverage. This debate comes on the heels of massive cuts to Medicaid that Republicans passed as part of President Trump’s budget bill this summer. If cuts to premium tax credits and Medicaid stick, this won’t just be another budget fight. It will be a quiet repeal of the Affordable Care Act (ACA)—and women will bear the brunt of it.

Women gained tremendously from the ACA, which expanded coverage for everyone. Prior to the ACA, women faced sex discrimination in higher premium rates, pregnancy was deemed a “pre-exisiting condition,” and maternal care was not covered. Expanded coverage is especially important to women of color and women experiencing poverty, who are less likely to have access to employer-sponsored health insurance than white women or women with higher incomes. 

Premium tax credits were enacted as part of the ACA to make private health insurance plans purchased on the ACA Marketplace more affordable. The American Rescue Plan Act of 2021 made enhancements to the credits that significantly increased the number of households that benefit. Those subsidies are scheduled to expire at the end of 2025, which the Congressional Budget Office estimates would increase the number of uninsured people in the United States by more than 30 million people over the next decade and increase the cost of health insurance premiums by nearly 8 percent each year from 2026 to 2034. Without them, a mother of two in Mississippi earning $50,000 could see her premiums increase by almost 300 percent overnight. 

Women’s Health Coverage Is Family Health Coverage

Medicaid has been one of the most important pillars of women’s health coverage over the last 15 years, covering nearly half of all U.S. births and insuring 15 million women ages 19 to 64 in 2023. The Georgetown Center on Poverty and Inequality (GCPI) estimates that 6 million women will be subject to the new work requirements imposed by the Republican budget bill, putting their health coverage at the mercy of glitchy and cumbersome government paperwork reporting systems. 

Without [government subsidies], a mother of two in Mississippi earning $50,000 could see her premiums increase by almost 300 percent overnight. 

Women experience health conditions differently than men and face unique ones, such as pregnancy, childbirth and menopause. Medicaid expansion under the ACA led to a 17 percent drop in postpartum hospitalizations, helping new mothers recover safely. But when women lose access to healthcare, it doesn’t just hurt them. It hurts their children, their families, their workplaces and their communities. It hurts all of us. Women make 80 percent of healthcare decisions for families and when healthcare is disrupted, it has ripple effects. Children miss check-ups, women delay care and families face greater financial strain and poorer health. 

In 2013, congressional Republicans shut down the government in a failed bid to “defund Obamacare.” They were blamed and forced to back down. Today, they aren’t calling for repeal outright—but they are quietly gutting Medicaid and undermining the ACA marketplace.

With Republicans in control of all three branches of government, the responsibility for protecting women and families rests squarely with them.

Sen. Chuck Schumer and Rep. Hakeem Jeffries have put forward a reasonable path: Roll back the Medicaid cuts and make premium tax credits permanent. States are bracing for the Medicaid cuts, warning Washington that slashing the program would destabilize families and hospitals in their states. Extending these tax credits has bipartisan support. By any definition of negotiation, the offer has something for both sides.

Yet President Trump has dug in, canceling meetings, while the House has left town. With Republicans in control of all three branches of government, the responsibility for protecting women and families rests squarely with them.

This isn’t about “other people.” It’s about all of us.