The end of the federal government shutdown brings relief for many whose lives and livelihoods were disrupted. Yet, urgent challenges remain. Many Ascension patients in Maryland rely on the enhanced premium tax credits to purchase affordable health coverage through the Individual Insurance Marketplace. These credits make coverage possible for millions of lower-income and middle-class families. Without them, many of them will experience unaffordable spikes to their monthly premiums, and millions could lose their coverage entirely.