Democrats Prepare to Draw Line on Health Care Spending as Shutdown Looms
WASHINGTON – As the October 1st deadline for a government shutdown rapidly approaches, Democrats are signaling a willingness to fiercely defend health care spending, setting up a potentially high-stakes confrontation wiht Republicans who control Congress. The looming budget battle centers on federal outlays, with health care already consuming a significant portion – 27% of all federal funds in fiscal year 2024, according to the Kaiser Family Foundation (KFF).
The Democratic stance comes amid growing scrutiny of the efficiency of U.S. health spending, which some experts argue doesn’t translate to improved health outcomes. Michael Cannon, a health policy expert, highlighted this point, stating, “We have the most expensive health sector in the world… Maybe the most inefficient one. Some people say. There’s more disagreement about that. but there’s a lot of evidence that when you reduce spending in the United States,it doesn’t affect health outcomes much.” Cannon detailed his research, citing multiple randomized, controlled trials examining subsidized medical care that have failed to demonstrate corresponding health improvements, in both a Wall Street Journal op-ed and a Substack entry.
However, Cannon also contends that the high cost is driven by industry influence. ”The industry has captured the policymaking process,” he said. “The industry has captured the debate over health care and health spending.”
While a government shutdown is a serious prospect, Cannon downplayed its potential impact, suggesting, “They just close the Washington monument for a few days, and then somebody caves, and they reinstate all the spending that was going to be there… So, there’s really… not much downside to a shutdown. but there’s a huge downside to increasing government spending on health care.”
The political calculus for Democrats is complex. Casey Burgat,Legislative Affairs Programme Director at George Washington University,described the situation as a “literal trillion-dollar question,” noting that shutdowns harm everyone,but the key is “politically,who do they hurt more?”
Burgat explained that Democratic voters are motivated to see their representatives resist the agenda of President donald Trump. with over two weeks remaining before the deadline, public posturing carries limited risk for Democrats. Though, the dynamic shifts as the deadline nears.
“Maybe they’re making the calculation that it forces Republicans to the table on at least some of their priorities,” Burgat said. He also suggested Democrats could potentially deflect blame for a shutdown, given Republican control of both Congress and the White House. “I think the easier case to make for the public… is they know who’s in the White house. And then if they’re paying even a little bit more attention,they know who has congressional majority.” Despite this potential advantage, Burgat acknowledged a shutdown would be damaging for both parties, calling it “a pox on both our houses.”
