The Irony of the Government Shutdown

The current government shutdown carries a certain irony. It was caused by the refusal of President Donald Trump and congressional Republicans’ refusal to extend the Enhanced Premium Tax Credits. These credits helped make insurance purchased through the Affordable Care Act (ACA) marketplace affordable, resulting in a surge in the number of people with health insurance.

Yet these credits had the largest impact on people living in states Trump won in the 2024 presidential election. This phenomenon can be seen in the graph below, based on data from KFF (formerly the Kaiser Family Foundation). Building on last week’s column, this column further examines evidence that getting rid of the tax credits would most seriously hurt states that voted to elect Trump in 2024.

On the graph below, each state is represented by a dot. The vertical axis shows the percentage increase in ACA marketplace enrollment between 2020 and 2025. Enhanced premium tax credits enacted in 2021 made more people eligible for subsidies.

The horizontal axis shows the outcome of the 2024 presidential election, with states Trump won on the left of the dashed line and those Harris won on the right. Led by Texas, where enrollment rose 255%, the states with the highest increases all supported Trump.

The next graph shows growth in states where Kamala Harris received at least 45% of the vote. With two exceptions (New York and Oregon, which established their own programs), every state saw increased enrollment in marketplace enrollment.

Although Wisconsin narrowly supported Trump, its enrollment grew a more modest 60%, similar to that of other competitive states, including Michigan, Pennsylvania, Nevada and North Carolina.

The next graph summarizes the results. Blue columns show total marketplace enrollment in Democratic-leaning states in 2020 and 2024. Overall, enrollment increased by 37%. Wisconsin’s enrollment rose by about 60%.

By comparison, enrollment in Republican-leaning states, shown in red, more than doubled—up 157%.

One might wonder whether the high growth rate found in the previous analysis results from low enrollment in 2020 rather than high enrollment in 2025. To examine this issue, marketplace enrollment was divided by each state’s population under age 65.

In the next graph, the results for 2020 are shown on the horizontal line. States voting for Trump are shown in red; those voting for Harris in blue. For example, marketplace enrollment in Texas grew from about 3.6% of the population under 65 in 2020 to 12.7% in 2025.

The chart below shows results for all states but Florida, which was 8.2% of the state’s under-65 population in 2020 and grew to 20.3% in 2025. It seems likely that these high percentages reflect the state’s retirees younger than 65.

Ironically, the number of people benefiting from enhanced premium tax credits is greatest in states that voted for Trump and Republican members of Congress. Yet Trump and other Republican politicians remain intent on eliminating those credits.

This case is a puzzler. The states whose residents are most dependent on the tax credits are also the states most opposed to continuing these tax credits.