The Americans they are not ready for a discussion about its kind welfare state which they desire, so the elected officials their they closed it government to avoid it.

Since the 1960sthe American welfare state has expanded to cover not only the poor but increasingly the middle class. When a temporary economic hardship arises, it tends to be used as a justification for a permanent expansion of social security programs. By and large, this phenomenon explains today’s government shutdown.

In 2021, during the pandemic, the American Rescue Plan increased the subsidies available to those who bought health insurance through the exchanges created with Affordable Care Act. The original subsidies were designed so that premiums would not exceed a certain percentage of the insured’s income and were available only to those earning less than 400% of the federal poverty line. The 2021 law removed this 400% limit and significantly reduced income rates. The most generous package was introduced as an emergency measure to ensure everyone would have insurance during a health crisis and is set to expire at the end of the year.

Democrats want to make the subsidies permanent, while Republicans don’t. In a sense, the parties have switched roles: Last spring, Republicans were the ones who wanted to extend a program that was set to expire at the end of the year, the tax cuts enacted in 2017. Democrats see welfare the same way Republicans see tax cuts: once enacted, they become so popular that they cannot be abolished.

And subsidies are indeed popular, even though most Americans don’t receive them, as they have them Medicaid, Medicare or health insurance through employerh. However, subsidies made exchanges more popular. As of 2021, the number of Americans enrolled in the marketplace has grown from 11 million to 24 million, and 92% of them receive some subsidy. If the increased subsidies end, everyone who participates will face higher premiums, and not just because they’ll be paying more out of pocket. Healthier people who don’t use their insurance often will drop out of the market, and the Congressional Budget Office (CBO) estimates that this least favored group will increase premiums by 7.6%.

Subsidies have proven to be a more popular way to encourage people to buy insurance than the individual mandate, which was repealed in 2019, because people prefer tax credits to being forced to buy something they don’t want. But the subsidies don’t come cheap: CBO estimates they will add $350 billion to the public debt over the next ten years. In an ideal world, where the federal debt wasn’t huge, interest rates weren’t high, and the population wasn’t aging, maybe the cost would be worth it. Who doesn’t want cheaper health insurance?

However, the United States they cannot afford the continued expansion of their welfare state. It is true that some European countries offer very generous benefits to the middle class, including state health insurance. Many European governments, reflecting the preferences of their citizens, have chosen security and stability, in the form of a larger welfare state and higher taxes, at the expense of economic growth. Europeans, and not just the rich, also pay much higher taxes.

Even so, this option may not be viable for much longer. Faced with high debt and low growth, many European countries have proposed modest cuts in social spending and are struggling to implement them.

Wherever they are, governments face dilemmas. Gone are the days when they could respond to every crisis with a permanent expansion of social benefits. Instead, they must use the crisis as an opportunity to reform the welfare state.

When it comes to health insurance in the US, that means fewer piecemeal benefits for the relatively affluent and better-designed, more comprehensive benefits for the truly vulnerable and unfortunate. There is no doubt that health care is becoming increasingly expensive for many Americans and a financial burden for many families. There is also widespread support for the idea that every American deserves affordable health insurance, public, private, or some combination. But that will require higher premiums, higher taxes or cuts to other programs. Adding more, unfunded subsidies is not a sustainable solution.

Better and more accessible health insurance for all is a worthy goal. But it’s not free.