The Real Cost of the Shutdown: How Defunding the ACA Hurts Us All

We’re now entering the 18 days of a government shutdown (source), and while the headlines may focus on furloughed federal workers, paused military pay, and closed national parks, I want to talk about something else — something much more personal:

The Affordable Care Act (ACA) is under attack, and millions of Americans, including myself, are being put at risk.

Let’s be clear: This shutdown isn’t just a political game. It’s the result of a fight over whether or not our government will continue to fund the ACA, which currently provides health coverage to over 44 million Americans through subsidies, Medicaid expansion, and protections for people with preexisting conditions (Source). If funding isn’t extended, more than 4.8 million people could lose their health insurance as early as next year. (read more stories here)

As someone who works in mental health, I’ve already felt the ripple effects of this uncertainty.

My Story: From Full-Time Therapist to Struggling Small Business Owner

I’m a licensed mental health therapist. Recently, I was demoted from a full-time position to a contractor role — meaning I only get paid when I see a client. No benefits. No 401k. No health insurance. I decided to open a private practice, driven by a core belief: that quality mental health care should be affordable and accessible.

That belief is directly tied to the ACA.

Because of the ACA, I’m able to offer therapy through insurance panels. This makes therapy affordable for clients who can't pay out of pocket. But if the ACA is defunded, insurance premiums are expected to rise dramatically — some experts predict a 114% to 300% increase for certain plans if the individual marketplace collapses due to lack of funding and healthy enrollees leaving.

This doesn’t just affect my clients — it affects me and my family. Right now, my husband and I rely on ACA subsidies to pay for our insurance. Without them, our monthly premium could jump to over $1,800, with deductibles in the $8,000–$10,000 range — and that’s just for two people, with no kids.

Who can afford that?

Certainly not the self-employed therapist trying to keep her doors open. Certainly not the single mom working two jobs. And certainly not the chronically ill person managing medications, doctor visits, and a full-time job.

Why This Matters for Everyone

Let’s break this down:

• If ACA subsidies disappear, healthy people will be priced out and leave the insurance market.

• This causes premiums to rise further.

• Sicker people will also eventually be priced out or go without care.

• More people will use emergency rooms for preventable care, raising healthcare costs for everyone.

• Hospitals and providers will eat those costs — or pass them on to the insured.

• Insurance companies, in response, hike premiums again.

It’s a vicious cycle.

And I am caught in the middle — both as a provider and as a patient.

If premiums go up, I may have to drop coverage for myself just to continue coverage for my chronically ill spouse. I may have to stop accepting insurance in my practice and switch to self-pay only, limiting access for those who can’t afford it. That means fewer clients. Less income. No healthcare. And no path to a stable future — no homeownership, no student loan repayment, no savings.

And I’m one of the lucky ones. I don’t have kids. I have family support. I still have income — for now. But what about those who don’t?

This is Bigger Than Me

This isn’t just about me or even just about therapists. This is about millions of Americans who rely on the ACA every day to survive. It's about small business owners, parents, gig workers, disabled folks, retirees, and students.

If the ACA is dismantled through defunding, we all suffer — economically, medically, emotionally.

What's Really Happening With the Shutdown?

While the details of the shutdown are complex, a core point of contention is funding — including the future of

ACA subsidies and Medicaid expansion.

Republican lawmakers in the House have pushed for major cuts to health care programs as part of broader budget negotiations and the Big Atrocious Bill. Democrats, on the other hand, are fighting to protect the ACA and ensure continued access to affordable coverage.

There is also the topic of the Epstein files. Some suggest that another reason the government shut down continues is to avoid swearing in Adelita Grivalja, a newly elected congresswoman from Arizona who won the special election against republican opponent. She is the last signature needed:  “for a petition to trigger a vote on legislation that would force the release of federal files on Epstein, angering Trump and the leadership of his own party in the process. Grijalva has said she’ll sign the discharge petition once she takes office, likely providing Massie the 218 signatures needed to trigger a vote.” (Source)

What You Can Do Right Now

If this makes you angry — good. It should.

We can't afford to be silent when our health, livelihoods, and futures are on the line. Here’s what you can do:

1. Call your representatives — Tell them to support full funding for the Affordable Care Act.

2. Use https://www.congress.gov/members to find your senator or House rep.

   • Scripts and contact info are also available at 5calls.org.

3. Share your story — Post on social media, write letters to local papers, talk to your community. Lawmakers need to hear from us.

4. Support organizations that fight for health equity.

5. Register to vote — and vote for candidates who prioritize healthcare for all.

Final Thoughts

The Affordable Care Act isn’t perfect, but it’s a lifeline. For me, for my clients, for my family — and for millions of others.

If we allow it to be defunded, the human cost will be devastating. We’ll see more bankruptcies, more untreated illness, more unnecessary deaths — and more people like me, fighting to provide care while struggling to access it ourselves.

We don’t have to accept that future.

Raise your voice. Call your representatives. And demand they protect the ACA — before it’s too late.