Our healthcare storm that’s been brewing on the horizon is getting a lot closer these days. And if Congress doesn’t get their act together soon, it could be a category 5 hurricane.

As I write this, we’re about two weeks into the government shutdown. It’s shut down because Democrats want to ensure that millions of Americans don’t see their monthly healthcare premiums double – or worse – by the end of the year. I don’t always agree with Democrats or how they go about governing, but in this case I couldn’t agree more.

The “Big, Ugly Bill” that Republicans passed earlier this summer not only cut $1 trillion from our Medicaid program, it also terminated the Affordable Care Act (ACA) subsidies put in place in 2021. In the past four years, the number of folks enrolled in ACA marketplace plans went from 11 million to almost 24 million.

These 24 million people are small business owners in our communities. They’re independent contractors and gig workers just trying to get by in our turbulent economy. A sizable chunk of the increase in enrollees are from our nation’s farmers. Now they’re about to be left out to dry.

And it’s not like this was a problem that just presented itself. Our Representatives, Mariannette Miller-Meeks, Zach Nunn, Ashley Hinson, and Randy Feenstra knew this would happen when they all voted for the Big Ugly Bill. And they still knew this when they all voted for the continuing resolution to keep the government open that did not include an extension of the ACA subsidies.

Even more telling, State Insurance Commissioners across the board have been sounding this particular alarm for months now. These are Republicans and Democrats who have been united in telling Congress they needed to take action on ACA subsidies so their states don’t see a tidal wave of rising premiums, constituents losing coverage, or disastrous health outcomes.

This impending storm isn’t just limited to those who could face astronomical health insurance premiums. More of our rural hospitals will close, and quicker. The cuts to Medicaid were bad enough, but if folks choose to forgo health insurance that means they forgo hospital visits. Around 800 rural hospitals across the country are at risk of closure due to dire financial straits, with 314 at immediate risk of closing in the next 2-3 years.

If nothing is done, this will end up impacting all of us one way or the other. That’s because if Congress doesn’t act, millions of younger, healthier people will simply drop their coverage because the premiums are too high. Without this population, the risk pool becomes older and sicker, driving insurers to raise premiums even further. Then the ACA marketplace will inevitably crash and cease to exist.

Fixing this problem now is a no-brainer. The American people want access to affordable healthcare, not more tax breaks for millionaires and billionaires. A recent poll by the Kaiser Family Foundation found that 78% of the public wants Congress to extend the ACA subsidies.

Iowa’s Representatives know this, but they went along with policies that gutted our healthcare anyway. The chickens are coming home to roost and time for action is now, not later. Otherwise, we’ll be waking up to a wolf at the henhouse door.

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Barb Kalbach of Adair County

is a 4th generation family farmer,

retired registered nurse, and board member of Iowa CCI Action. She can be reached at barbnealkalbach@gmail.com.