The gap between the two parties is primarily due to a Democratic demand to extend Affordable Care Act subsidies for low- and middle-income Americans, which are set to expire at the end of the year.

But Republicans are eager to spread a different narrative.

Here are the facts.

False Claims

The battle for the narrative during a shutdown is crucial to both parties, and who the public blames can determine how long it lasts.

President Donald Trump’s leadership has maintained a standard message—that Democrats are looking to reinstate emergency healthcare to migrants in the U.S. without citizenship or green cards.

Trump pushed this message last week on Truth Social when he claimed that Democrats wanted to give “free healthcare” to immigrants, demonizing many of them as “VIOLENT CRIMINALS.”

After the shutdown began, Vice President JD Vance stepped into gear.

“Democrats spent years giving taxpayer-funded healthcare to illegal aliens and, as promised, President Trump put a stop to it,” Vance said on X on Wednesday. “Now, Senate Democrats are shutting down the government and holding the economy hostage because they want to reinstate those benefits for illegal aliens.”

Democratic leadership is seeking Republican compromise on healthcare policy in their spending bill, asking for increased spending to continue Obamacare subsidies and to reverse the deep Medicaid cuts implemented in the domestic tax cut bill.

Undocumented immigrants are ineligible for Obamacare benefits and Medicaid. Only those with “qualified” immigration status have access to Medicaid, which includes those with legal permanent residence status, refugees, asylees, and several other groups. This means that not only are undocumented immigrants ineligible for these programs, but many of those with legal status are also ineligible because they are not on the “qualified” list.

The Democrats are asking to reverse a cut in funding for federal reimbursement hospitals can get for treating undocumented immigrants with an emergency medical condition, which they are required to do by law. Hospitals can be reimbursed by Medicaid for this emergency care, but comprehensive Medicaid coverage is not available to undocumented immigrants. Furthermore, according to the health policy research nonprofit KFF, less than 1% of total Medicaid spending was allocated to emergency Medicaid for undocumented immigrants in fiscal year 2023.

Beyond this, Democrats are seemingly even more concerned about extending subsidies under The Affordable Care Act (ACA), as the government is receiving warnings that allowing ACA subsidies to expire at the end of the year could have immense ramifications, kicking millions of people off of their healthcare, skyrocketing out-of-pocket insurance premiums, and premiums across the health insurance market are to increase drastically. 

In 2025, 24 million individuals obtained their insurance through the ACA marketplace, and nearly all (93%) of these individuals utilized subsidies to help cover costs, according to the Center for Budget and Policy Priorities. They estimate that if Congress does not extend these subsidies, approximately 4 million people will lose their marketplace coverage and become uninsured.

Democrat Response

Democratic leadership has been clear in calling out the false narrative being pushed about healthcare for immigrants without legal status. Earlier this month, two Democratic leaders, Rep. Rosa DeLauro and Sen. Patty Murray, put forth a budget proposal to extend ACA subsidies, a proposal that did not include free healthcare for undocumented immigrants.