The latest government shutdown was all about health care — and money. During the COVID-19 pandemic, temporary enhanced premium tax credits for the Affordable Care Act were put into effect, but those enhanced tax credits are scheduled to expire on Dec. 31, 2025. Republicans wanted to keep the government open and allow the enhanced tax credits to expire. Democrats would only vote to keep the government open if the enhanced tax credits were continued indefinitely.

Neither side appeared willing to budge until, after 43 days of a government shutdown, eight Democratic senators crossed the aisle and voted in favor of the Republican bill.

Lost in this debacle was a reckoning with why the Affordable Care Act needed the enhanced tax credits — enacted under emergency circumstances — simply to function. How did we arrive at the point where the Affordable Care Act, originally sold in part as a panacea for expensive insurance, is now said by its main proponents to be on life support unless the emergency subsidies are continued indefinitely?

And what is a palatable compromise that both Democrats and Republicans might accept that would also address the Affordable Care Act’s problems?

The core problem is simple: Health insurance is expensive because health care is expensive. Unfortunately, the enhanced tax credits that triggered the shutdown do not make health insurance or health care less expensive.

Instead, they shift and hide the costs associated with having health insurance — which in the long run will make health insurance more expensive. Unless steps are taken to make health insurance and health care less expensive, the “affordability” agenda that both Democrats and Republicans are now pursuing will not go anywhere.

The divide between Democrats and Republicans on health care is rooted in the history of the Affordable Care Act. It was supposed to reduce health care costs by providing access to comprehensive coverage, coupled with tax subsidies tied to income. President Barack Obama promised that the Affordable Care Act would reduce premiums by $2,500. That promise was quickly discarded, as it became clear that the Affordable Care Act actually resulted in ever-increasing premiums, large deductibles and high out-of-pocket costs.

The politics of the Affordable Care Act are also important. Democrats passed it without a single Republican vote. Fifteen years later, Republicans have little incentive to help Democrats with taxpayer-funded premium subsidies to keep ObamaCare afloat.

Sens. Rick Scott (R‑Fla.) and Bill Cassidy (R‑La.) have recently promoted a proposal whereby the subsides would be sent directly to Affordable Care Act enrollees. President Trump followed with support. While sending money directly back to the people will be appealing to most Republicans, it is unlikely to appeal to Democrats, whose votes will be needed to defeat a filibuster when the debate returns to the Senate next month.

What kind of compromise will attract the necessary votes and help make health insurance and care less expensive? One obvious place to start is with the excessive list of mandated benefits that all policies sold on the ObamaCare exchanges must satisfy. ObamaCare proponents decided to call their laundry list of mandates “Essential Health Benefits,” but they are better described as overly expensive and inflexible “Cadillac coverage.” People who would happily accept less comprehensive (and cheaper) coverage are prohibited from buying it — even if it fits their needs better than the overly expensive coverage offered on the ObamaCare exchanges, which require enhanced subsidies to be remotely affordable.

One obvious compromise would be for Republicans to offer a phased reduction of the enhanced premium subsidies in exchange for Democrats agreeing to eliminate the Essential Health Benefits provisions. A phased reduction in enhanced premium subsidies will help avoid sudden premium increases, and eliminating the essential benefit requirements will provide a pathway for reducing the cost of coverage. This would also provide states the flexibility to design more affordable plans better suited to local conditions. This compromise would be a positive step toward building bipartisan support for fixing the many problems that have made the Affordable Care Act unaffordable.

If we want to make health care and health insurance more affordable, we should stop regulating and subsidizing them in ways that make them more expensive. Eliminating the EHBs and phasing out the enhanced subsidies is a great way to start.