By JOEY CAPPELLETTI and ALI SWENSON, Associated Press

WASHINGTON (AP) — The first caller on a telephone town hall with Maryland Rep. Andy Harris, leader of the House’s conservative Freedom Caucus, came ready with a question about the Affordable Care Act. Her cousin’s disabled son is at risk of losing the insurance he gained under that law, the caller said.

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“Now she’s looking at two or three times the premium that she’s been paying for the insurance,” said the woman, identified as Lisa from Harford County, Maryland. “I’d love for you to elucidate what the Republicans’ plan is for health insurance?”

Harris, a seven-term Republican, didn’t have a clear answer. “We think the solution is to try to do something to make sure all the premiums go down,” he said, predicting Congress would “probably negotiate some off-ramp” later.

His uncertainty reflected a familiar Republican dilemma: Fifteen years after the Affordable Care Act was enacted, the party remains united in criticizing the law but divided on how to move forward. That tension has come into sharp focus during the government shutdown as Democrats seize on rising premiums to pressure Republicans into extending expiring subsidies for the law, often referred to as Obamacare.

President Donald Trump and GOP leaders say they’ll consider extending the enhanced tax credits that otherwise expire at year’s end — but only after Democrats vote to reopen the government. In the meantime, people enrolled in the plans are already being notified of hefty premium increases for 2026.

As town halls fill with frustrated voters and no clear Republican plan emerges, the issue appears to be gaining political strength heading into next year’s midterm elections.

“Premiums are going up whether it gets extended or not,” said GOP Sen. Rick Scott. “Premiums are going up because health care costs are going up. Because Obamacare is a disaster.”

‘Concepts of a plan’

At the center of the shutdown — now in its fourth week with no end in sight — is a Democratic demand that Affordable Care Act subsidies passed in 2021 be extended.

Trump has long promised an alternative. “The cost of Obamacare is out of control, plus, it’s not good Healthcare,” he wrote on Truth Social in November 2023. “I’m seriously looking at alternatives.”

Pressed on health care during a September 2024 presidential debate, Trump said he had “concepts of a plan.”

But nearly 10 months into his presidency, that plan has yet to come. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, told NBC on Wednesday, “I fully believe the president has a plan,” but didn’t go into details.

Centers for Medicare & Medicaid Services administrator Dr. Mehmet Oz listens as President Donald Trump speaks in the Oval Office of the White House, Thursday, Oct. 16, 2025, in Washington. (AP Photo/Alex Brandon)

Republicans say they want a broader overhaul of the health care system, though such a plan would be difficult to advance before next year. Party leaders have not outlined how they’ll handle the expiring tax credits, insisting they won’t negotiate on the issue until Democrats agree to end the shutdown.

A September analysis from the nonpartisan Congressional Budget Office estimated that permanently extending the tax credits would increase the deficit by $350 billion from 2026 to 2035. The number of people with health insurance would rise by 3.8 million in 2035 if the credits are kept, CBO projected.

Asked Wednesday on CNN whether Republicans have a plan to address the subsidies if the government reopened, House Speaker Mike Johnson said they had “proposals” that can be “ready immediately.”

“It’s a very complicated, very complex issue, that requires a long time to build consensus around,” he said.

A growing political issue

With notices of premium spikes landing in mailboxes now and the open enrollment period for Affordable Care Act health plans beginning Nov. 1, the political pressure has been evident in Republican town halls.

In Idaho, Rep. Russ Fulcher told concerned callers that “government provided health care is the wrong path” and that “private health care is the right path.” In Texas, freshman Rep. Brandon Gill responded to a caller facing a sharp premium increase by saying Republicans are focused on cutting waste, fraud and abuse.

Harris echoed a message shared by many in his party during his Maryland town hall, saying costs are “just going back to what it was like before COVID.”

But the number of people who rely on Affordable Care Act health insurance has increased markedly since before the pandemic. More than 24 million people were enrolled in the marketplace plans in 2025, up from about 11 million in 2020, according to an analysis from the health care research nonprofit KFF.

Sara from Middleville, Michigan, told Rep. John Moolenaar during his town hall that if health insurance premiums go up by as much as 75%, most people will probably go without heath care. “So how do you address that?” she asked.

Moolenaar, who represents a district he handily won last year, responded: “We have time to negotiate, figure out a plan going forward and I think that’s something that could occur.”

Some Republicans have shown urgent concern. In a letter sent to Johnson, a group of 13 battleground House Republicans wrote that the party must “immediately turn our focus to the growing crisis of health care affordability” once the shutdown ends.

“While we did not create this crisis, we now have both the responsibility and the opportunity to address it,” the lawmakers wrote.

Some Republicans dismiss projections that ACA premiums will more than double without the subsidies, calling them exaggerated and arguing the law has fueled fraud and abuse that must be curbed.

Many Democrats credited their ability to flip the House in 2018 during Trump’s first term to the GOP’s attempt at repealing Obamacare, and they’re forecasting a similar outcome this time.

About 4 in 10 U.S. adults say they trust the Democrats to do a better job handling health care, compared with about one-quarter who trust the Republicans more, a recent AP-NORC poll found. About one-quarter trust neither party, and about 1 in 10 trust both equally, according to the poll.

A looming internal GOP fight

Even as GOP leaders pledge to discuss ending the subsidies when the government opens, it’s clear that many Republican lawmakers are adamantly opposed to an extension.

“At least among Republicans, there’s a growing sense that just maintaining the status quo is very destructive,” said Brian Blase, the president of Paragon Health Institute and a former health policy adviser to Trump during his first term.

Michael Cannon, director of health policy studies at the libertarian Cato Institute, said he’s working with multiple congressional offices on alternatives that would let the subsidies end. For example, he wants to expand the Affordable Care Act exemption given to U.S. territories to all 50 states and reintroduce a first-term Trump policy that gave Americans access to short-term health insurance plans outside the Affordable Care Act marketplace.

Cannon declined to name the lawmakers he’s working with, but said he hopes they act on his ideas “sooner than later.”

David McIntosh, president of the influential conservative group Club For Growth, told reporters Thursday that the group has “urged the Republicans not to extend those COVID-era subsidies.”

“We have a big spending problem,” McIntosh said.

“I think most people are going to say, OK, I had a great deal during COVID,” he said. “But now it’s back to business as usual, and I should be paying for health care.”

Swenson reported from New York.

By ADRIANA GOMEZ LICON, Associated Press

Former President Joe Biden called these “dark days” as he urged Americans to stay optimistic and not to check out in response to what he says are attacks on free speech and tests on the limits of executive power by President Donald Trump.

“Since its founding, America served as a beacon for the most powerful idea ever in government in the history of the world,” Biden said. “The idea is stronger than any army. We’re more powerful than any dictator.”

Former President Joe Biden listens to a speaker before receiving the Lifetime Achievement Award at the Edward M. Kennedy Institute’s 10th Anniversary Celebration, Sunday, Oct. 26, 2025, in Boston.(AP Photo/Robert F. Bukaty)

Biden, 82, speaking publicly for the first time since completing a round of radiation therapy for an aggressive form of prostate cancer, addressed an audience in Boston on Sunday night after receiving the Lifetime Achievement Award from the Edward M. Kennedy Institute.

He said America depends on a presidency with limited power, a functioning Congress and an autonomous judiciary. With the federal government facing its second-longest shutdown on record, Trump has used the funding laps as way to exercise new command over the government.

“Friends, I can’t sugar coat any of this. These are dark days” Biden said before predicting the country would “find our true compass again” and “emerge as we always have — stronger, wiser and more resilient, more just, so long as we keep the faith.”

Biden listed examples of people who are standing their ground against threats from the current administration, citing the example of federal employees who resign in protest, and universities and comedians that have been targeted by Trump.

“The late night hosts continue to shine a light on free speech knowing their careers are on the line,” he said.

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Biden also shouted out elected Republican officials who vote or openly go against the Trump administration.

“America is not a fairy tale,” he said. “For 250 years, it’s been a constant push and pull, an existential struggle between peril and possibility.”

He finished the speech by telling people to “get back up.”

The Democrat left office in January after serving one term in the White House. Biden dropped his bid for reelection after facing pressure following a disastrous debate against Trump and concerns about his age, health and mental fitness. Vice President Kamala Harris launched her bid right after, but lost to Trump last November.

In May, Biden’s post presidential office announced that he had been diagnosed with prostate cancer and that it had spread to his bones.

Prostate cancers are graded for aggressiveness using what is known as a Gleason score. The scores range from 6 to 10, with 8, 9 and 10 prostate cancers behaving more aggressively. Biden’s office said his score was 9.

By KONSTANTIN TOROPIN, Associated Press

WASHINGTON (AP) — A fighter jet and a helicopter based off the aircraft carrier USS Nimitz both crashed into the South China Sea within 30 minutes of each other, the Navy’s Pacific Fleet said.

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The three crew members of the MH-60R Sea Hawk helicopter were rescued on Sunday afternoon, and the two aviators in the F/A-18F Super Hornet fighter jet ejected and were recovered safely, and all five “are safe and in stable condition,” the fleet said in a statement.

The causes of the two crashes were under investigation, the statement said.

President Donald Trump, speaking to reporters aboard Air Force One en route to Tokyo on Monday, said the incidents could have been caused by “bad fuel.” He ruled out foul play and said there was “nothing to hide.”

The USS Nimitz is returning to its home port in Naval Base Kitsap in Washington state after having been deployed to the Middle East for most of the summer as part of the U.S. response to attacks by Yemen’s Houthi rebels on commercial shipping. The carrier is on its final deployment before decommissioning.

Another aircraft carrier, the USS Harry S. Truman, suffered a series of mishaps in recent months while deployed to the Middle East.

In December, the guided-missile cruiser USS Gettysburg mistakenly shot down an F/A-18 jet from the Truman.

Then, in April, another F/A-18 fighter jet slipped off the Truman’s hangar deck and fell into the Red Sea.

And in May, an F/A fighter jet landing on the carrier in the Red Sea went overboard after apparently failing to catch the steel cables used to stop landing planes and forcing its two pilots to eject.

No sailors were killed in any of those mishaps. The results of investigations into those incidents have yet to be released.

By LUIS ANDRES HENAO and TIFFANY STANLEY, Associated Press

WASHINGTON (AP) — The imposing Shrine of the Sacred Heart, a Catholic church a short drive from the White House, was intended to be a sanctuary for worshippers. Now, its mostly immigrant congregation is steeped in fear.

Parishioners pray during a Sunday Mass at the Shrine of the Sacred Heart Catholic church in Washington, Oct. 12, 2025. (AP Photo/Luis Andres Henao)

Church leaders say more than 40 members of their parish have been detained, deported or both since federal law enforcement stepped up their deployment in August.

Many parishioners are too scared to leave home to attend Mass, buy food or seek medical care, as the Trump administration’s immigration crackdown targets their communities.

Cardinal Robert McElroy, who leads the Archdiocese of Washington, said the government was using fear to rob immigrants “of any sense of real peace or security.”

“It really is an instrument of terror,” he told The Associated Press.

Trump’s federal law enforcement surge technically ended on Sept. 10. But National Guard troops and federal agents remain in the nation’s capital. That includes immigration authorities, who continue to prowl near Sacred Heart, which sits in a vibrant Latino community flanked by two neighborhoods — Columbia Heights and Mt. Pleasant — that have been home to successive waves of immigrants.

The parish was established more than 100 years ago by Irish, Italian and German immigrants. Today, most of its 5,600 members came from El Salvador, but also from Haiti, Brazil and Vietnam.

The immigration raids have upended lives and worship at Sacred Heart. Families grieve for missing loved ones. Attendance at Masses, which are held in several languages, has dropped dramatically, visible in the many empty pews under the domed church’s colorful mosaics.

“About half the people are afraid to come,” said the Rev. Emilio Biosca, the church’s pastor.

The Rev. Carlos Reyes greets parishioners after celebrating Mass at the Shrine of the Sacred Heart, a Catholic church in Washington, Sunday, Oct. 12, 2025. (AP Photo/Luis Andres Henao)

But the church community rejects being reduced to powerless victims. During the crisis, pastors and church volunteers have attended immigration court hearings, covered rent and legal fees, and donated and delivered food to those fearful of leaving home.

“Our role here at the church has changed, also dramatically,” Biosca said. “Because we have so many people who are adversely affected by that situation, we cannot possibly go on as business as usual.”

Active church volunteers face deportation

On a recent day, parishioners dedicated a rosary to the detained and deported church members. They pray daily on Zoom because so many are fearful of stepping outside their homes.

Reverend Carlos Reyes works in the office of the Shrine of the Sacred Heart as the parish cat, Maseo, named after Friar Masseo, a close companion of St. Francis, in Washington, Oct. 12, 2025. (AP Photo/Luis Andres Henao)

Among them was a woman who hasn’t returned to the church since last month, when U.S. Immigration and Customs Enforcement officers detained her husband while the couple sold fruits and vegetables from a stand that was their main source of income.

They entered the U.S. illegally nearly two decades ago to escape gang violence in El Salvador. They met at Sacred Heart, where they both have been active volunteers, often leading retreats and programs. For years, her husband helped coordinate popular Holy Week processions.

When her husband was detained, the first person the woman called was her pastor. Since then, the church has helped to pay her rent. She is now preparing to move to Boston with family members as her husband faces deportation from a Louisiana detention center.  Barring some unforeseen change that would allow him to stay in the U.S., she plans to move back to El Salvador to be with him.

“It’s been a very difficult, bitter month of crying and suffering,” she said, speaking on condition of anonymity out of fear she could be deported. “Our lives changed from one day to the next. We had so many dreams.”

In her apartment, she clutched rosary beads, surrounded by the cardboard boxes she had been packing with their belongings. On her desk near a makeshift altar of the Virgin Mary, she keeps a prayer card of Pope Leo XIV, who has vowed to “stand with” migrants.

When someone on the Zoom worship read a name from a long list of the detained, she flinched and whispered sadly: “That’s my husband.” Above her hung a framed photo of the couple, smiling joyfully on their wedding day at Sacred Heart.

The Catholic Church supports migrants

A top archdiocesan leader, Auxiliary Bishop Evelio Menjivar, crossed into the U.S. illegally in 1990 after fleeing El Salvador. His journey to the church hierarchy — after working odd jobs and obtaining asylum and then U.S. citizenship — has made him an important symbol for the area’s Catholic immigrants.

Of the recent ICE detainments, Menjivar said, “That could have been me, you know.”

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He recently helped lead a procession in support of migrants and refugees that began at Sacred Heart.

He said the parish feels like home to him. “It holds a very special place not just for me, but for many, many immigrants.”

The Catholic Church staunchly defends the rights of migrants, even as it acknowledges the rights of nations to control their borders. U.S. Catholics depend on foreign-born priests to serve parishes. In the Washington Archdiocese, which includes D.C. and parts of Maryland, more than 40% of parishioners are Latino.

Tricia McLaughlin, Department of Homeland Security assistant secretary, said via email that “DHS law enforcement in Washington, D.C. is targeting the worst of the worst violent criminal aliens.”

Biosca, Sacred Heart’s pastor, had thought the Trump administration’s immigration enforcement would target violent criminals. But then, he said, they began to go after his congregation.

“It became very unbearable,” he said, adding that the targets seemed like anyone who “just looked Hispanic.”

At the Sacred Heart School, principal Elias Blanco said at least two families withdrew their children because they didn’t want to risk being detained while dropping them off.

“There’s certainly a lot of fear with our parents,” he said.

Many of the children at the school are U.S. citizens who have parents in the country illegally. In case they are detained, some parents have signed caregiver affidavits, which designate a legal guardian, in hopes their children stay out of foster care.

“It’s like a ripple effect,” Blanco said of the immigration detentions. “It might be one person, but that individual is the father of someone, the husband of someone, the brother, and then it impacts the whole family.”

Clergy join immigrants at court

Church leaders have accompanied congregants to immigration court, where, in cities nationwide, masked ICE officers have arrested immigrants as they leave hearings.

The Rev. Carlos Reyes, a Sacred Heart priest originally from El Salvador, attended a hearing with a 20-year-old congregant who recently arrived in the U.S. illegally from Bolivia.

Thanks to support from Reyes and Sacred Heart, she said her hope and her Catholic faith have deepened.

“It’s a refuge for me because it’s all I have here, because I don’t have anyone,” she said, sobbing after a Sunday Mass. She spoke on condition of anonymity because she has another court hearing soon and fears deportation.

Parishioners make deliveries to those in hiding

On a recent Saturday, volunteers gathered in the church basement. They formed a circle to pray before they packed bags of donated food.

Then they made deliveries to immigrant congregants who hadn’t left their homes in weeks, not even to buy groceries. Some recipients stepped out to thank the volunteers, cautiously looking around for ICE personnel.

“These people are losing their dignity,” said a congregant who helped deliver the food and is a legal U.S. resident. She spoke on condition of anonymity, fearing her U.S. citizenship process could still be disrupted.

“As people of God, we can’t just sit and watch,” she said. “We have to do what we can.”

Associated Press video journalist Jessie Wardarski contributed to this report.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.