A large crowd gathered on Capitol Hill Tuesday hours before a federal government shutdown to protest rising health care costs — the crux of Democrats’ stand against approving a temporary Republican funding bill.

More than a dozen Democratic lawmakers joined activists and people who shared stories of rising health insurance premium costs at the “Healthcare Over Billionaires” rally hosted by the advocacy group Fair Share America, along with nearly three dozen labor unions, political advocacy groups and other organizations.

Senate Democrats again on Tuesday blocked Republicans’ temporary government funding bill, citing the expiration of Affordable Care Act enhanced premium tax credits that since 2021 have lowered health insurance costs tied to an enrollee’s income.

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The standoff means a federal government shutdown will begin after midnight Tuesday.

Tony Gonzales, of Indiana County, Pennsylvania, told the crowd he worries how losing the premium tax credits will affect his family’s finances as he continues treatment for thymic carcinoma, a rare cancer he was diagnosed with two years ago.

“I need these subsidies. If the rich and the Republicans can go out there and have money for tax cuts, to buy another yacht, to go out in space, why can’t I at least have health care to address my needs, my wife’s needs, and maintain a lifestyle that we deserve as an American family?” said Gonzales.

Senator Amy Klobuchar of Minnesota said her constituents are “standing on a health insurance cliff right now” and she will not support a Republican funding proposal until GOP lawmakers agree to extend the health insurance subsidies.

“When I hear them say, ‘oh, we’ll look at this in December, we’ll look at this in January.’ This is not a December thing. This is not a January thing. This is a now thing,” she said.

Open enrollment for health care plans begins Nov. 1 in most states, except Idaho, where it begins Oct. 15.

Annual insurance premiums could double on average in 2026 if the subsidies expire at year’s end, according to an analysis published Tuesday by the nonprofit health policy research organization KFF.

The enhanced premium tax credits were extended through 2025 under the Democrat-led budget reconciliation law in 2022, otherwise known as the Inflation Reduction Act.

Participation in Affordable Care Act health insurance exchanges has more than doubled to over 24 million, up from 11 million, since the introduction of the tax credits, which the majority of enrollees receive, according to KFF.