QL. “They’re attacking me and AOC — but it’s the Republicans who are trying to make the healthcare system worse”: Sanders fires back amid shutdown battle

In the early hours of the US government shutdown, a “political punch” was thrown by Senator Bernie Sanders and Representative Alexandria Ocasio-Cortez (AOC). They alleged that, while being attacked for not supporting a temporary “clean continuing resolution,” it was actually the Republicans who were trying to make the healthcare system worse.

Background: Shutdown and the danger to the people

On October 1, 2025, the US government officially entered a state of shutdown when the Senate Majority failed to approve a temporary funding bill. One of the major points of contention is the extension of the Affordable Care Act (ACA) health tax subsidies — which are in danger of expiring — as well as changes to the Medicaid program.

Democrats, led by lawmakers like Chuck Schumer, Hakeem Jeffries, and progressive voices like Sanders and AOC, are trying to include a health care provision in the spending package, to ensure health care subsidies are not cut, and to prevent insurance premium increases for low-income people.

Sanders and AOC’s response

In a video posted to social media, Sanders noted that there have been attacks on both him and AOC for refusing to vote for a “clean” version of the temporary spending bill. But he said it was Republicans who were trying to “roll back” the health care system.

“We are the only major country on Earth that doesn’t guarantee health care to everyone,” Sanders said, accusing the GOP of trying to make an already “broken” health care system worse.

AOC insisted there was nothing “clean” about the Republican version of the bill — she warned that millions would see their premiums double:

“This is one of the dirtiest tricks they’re pulling on the American people.”

Along with Sanders, AOC urged people to be wary that high premiums, or people being kicked out of Medicaid or the ACA, would leave many people without access to treatment, and even lead to death — especially among low-income people.

Republican pushback and health policy debate

Meanwhile, Republican leaders and supporters of a “clean CR” version of the temporary spending bill have criticized Democrats for conditioning policy — specifically, health care benefits — on keeping the government open. They say this amounts to “putting policy into a spending deal,” complicating negotiations.

A common point of emphasis from the GOP is the allegation that Democrats want to expand health care to undocumented immigrants — a point critics say is “misleading or overblown” because under current law, undocumented immigrants are often excluded from many federal health programs.

Health policy analysts also warn that if ACA subsidies expire or are withdrawn, premiums could rise, many people would lose coverage, and an already stressed health system would be further strained.

Assessment: Who “caused” the health care crisis?

The key question is: who is right — Sanders and AOC in accusing the GOP, or Republicans in denying responsibility?

Laws & Budget Power: Republicans currently control both the House and Senate (with majorities) and the White House — which gives them a strong position in spending negotiations. When they refuse to expand Medicare or improve Medicaid, they are largely responsible for any deterioration in the health care system.

Political Pressure & Negotiation: Democrats have an advantage in attaching health care provisions to spending packages — because of their large reach, affecting millions of people — but this also makes negotiations difficult, especially when their opponents (Republicans) refuse to “attach” policies to spending.

Real-world Impact: If premiums rise sharply or many people lose insurance, the consequences for health care and personal finances could be severe. People like Sanders and AOC highlight research numbers and models that show increased mortality risks if low-income people lose health care.

International comparison: Sanders’s argument—that the United States is the only major country that does not guarantee health care to everyone—highlights the difference between the American health care system and many other developed countries, where health care is considered a basic right, guaranteed or heavily subsidized by the government.

Sanders and AOC’s statements reflect an “ideological” battle and a “policy turning point” in the federal spending package: whether health care will be maintained as