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Our Lives on Hold - Day 40 - The Shutdown’s Hidden Tax

  • Writer: Mark Fukae
    Mark Fukae
  • Nov 9
  • 3 min read
Graphic design with teal background featuring abstract security elements and a digital collage of gears and padlocks; headline reads “Shutdown Day 40: The Shutdown’s Hidden Tax” with a quote about health and financial security; logo for Professionals Who Care in bottom corner.
“Shutdown Day 40: The Shutdown’s Hidden Tax” - a visual callout from Professionals Who Care highlighting the economic and health consequences of subsidy lapses during government shutdowns.

By Mark Fukae - Director of Advocacy - Professionals Who Care


Day 40 is not an abstract statistic. It is a string of household decisions: which bill to pay, which dose to skip, who misses work to drive an elder to an appointment. Amidst this crisis, a political push surfaced to eliminate subsidies and substitute them with Health Savings Accounts (HSAs)-a move that turns a technical market redesign into a crisis-era political maneuver.


The core of the problem: This maneuver risks redistributing public supports upward and institutionalizing harm against the caregivers who need stability most.

Read the full, in-depth dispatch AND listen to the podcast from Mark Fukae on Substack: 🔗 Our Lives on Hold: Day 40 — The Shutdown’s Hidden Tax


The Core Problem: Why HSAs Fail Caregivers


HSAs assume liquidity, steady pay, and disposable income. Those assumptions collapse against the reality of American caregiving:

  • Juggling Act: 32–42 million Americans balance employment while providing unpaid care, leading to reduced hours and unpredictable income.

  • No Savings Net: You cannot ask a gig worker, a youth caregiver, or a 72-year-old on a fixed income to build meaningful HSA balances.

  • The Risk of Loss: If enhanced ACA subsidies lapse while this political shift is forced through, analysts expect steep premium increases and widespread coverage losses, deepening financial insecurity for millions.

As President Donald Trump stated: “I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies … BE SENT DIRECTLY TO THE PEOPLE.” 

But procedural shortcuts risk that money benefiting only those who can already self-insure.


The Human Impact: Who Pays the Price?


The evidence is clear: pushing major coverage redesigns during a shutdown, coupled with demands to remove the filibuster, is trading deliberation for speed and stability for political gain.

  • Families are waiting at community distribution points for food, prescription assistance, or paperwork help as SNAP payments sit in legal limbo.

  • Caregivers are forced to choose between the medication and the milk because policy decisions made in a vacuum do not reflect their reality.


PWC’s Solution: Portable Insurance


We must turn political theater into durable care policy. Professionals Who Care centers a single, pragmatic first step: portable, subsidized health insurance that follows people across jobs, unemployment, and caregiving transitions.

Key Design Priorities:

  • Portability: Coverage survives job changes and caregiving transitions.

  • Targeted Affordability: Means-tested, predictable subsidies that reduce eligibility cliffs.

  • Lifecycle Calibration: Rules that reflect the reality of youth caregivers, gig workers, and older adults on fixed incomes.


Concrete Actions You Can Take Today


Join Professionals Who Care to push for policy guardrails that prevent future political extortion.

  1. Read the full Day 40 dispatch AND listen to the Our Lives on Hold podcast on Substack to access testimony and deeper analysis.

  2. Share your caregiving story with Professionals Who Care so we can document harms and inform testimony.

  3. Call or email your Representative and Senators: Demand they preserve ACA subsidies and back portability mechanisms.

  4. Amplify Day 40 using #FamiliesFirst so PWC can track reach and mobilize volunteers.


Your voice is the shield against political maneuvering. Join us to demand policy that actually travels with people.


References


  1. Human Rights Watch public statement on health and subsidies Nov 2025

  2. Reporting of Trump’s HSA proposal and Senate reaction early Nov 2025 including The Hill CNBC USA Today Politico

  3. Coverage of filibuster pressure and procedural debate Nov 2025 including New York Times Washington Post Associated Press

  4. AARP and National Alliance for Caregiving Caregiving in the U.S. 2025 report

  5. Kaiser Family Foundation analysis on effects of subsidy expirations on premiums and uninsured rates

  6. Federal reporting on SNAP contingency funding and court orders Oct Nov 2025 including NBC News ABC News Detroit Free Press

 
 
 
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