Reality: The debt ceiling is a limitation set by Congress (originally in World War I) on the executive branch’s ability to borrow money to pay for expenses Congress has already authorized. Failure to raise the debt limit does not prevent these authorized expenditures happening because the executive branch is constitutionally required to spend the money Congress has ordered to be spent. Instead the executive branch is forced to attempt to borrow more money while halting re-payments on existing debt. This wouldn’t work very well and the world financial markets would go into a panic, since it’s tantamount to the government of the largest economy filing for bankruptcy, i.e. inability to pay creditors (while still trying to buy things!). Again, no new money is being spent when the ceiling is raised so this doesn’t somehow rein in the spending. It’s merely a cap on the ability to borrow to pay for expenditures Congress already directed the executive branch to make. It’s an idiotic device to have in place outside of the wartime blank-check appropriation context for which it was created. But as long as it exists, Congress needs to vote to raise it. It shouldn’t be subject to negotiation, because there’s nothing to negotiate.
Reality: The Affordable Care Act has 10 years worth of self-contained funding and existing appropriations in it. It has no direct impact on the government shutdown, nor does the government shutdown affect it. Republicans have only linked the two by holding the shutdown as a hostage to try to force renegotiation on the ACA. It’s frustrating reading uninformed comments of people insisting that the problem here is the President and Senate Dems being unwilling to compromise on an unrelated program that is already paid for. The actual problem centers on agreeing on new spending for other things, so there’s no functional need to bring up the ACA at all. It’s purely a political connection, not a fiscal one.