Tag: government shutdown
Fearing Midterm Ruin, Trump Blinks On Obamacare --Yet Still Aims To Gut Program

Fearing Midterm Ruin, Trump Blinks On Obamacare --Yet Still Aims To Gut Program

Plus ça change, plus c’est la même chose.

President Trump’s health plan, promised by Thanksgiving, was leaked to the press over the weekend. With the frosty reception immediately given this trial balloon by Republicans on Capitol Hill, I doubt it will see the light of day before people gather for their holiday dinners with family and friends.

The leaked plan’s outline went something like this:

  • It offered a two-year extension for the expanded premium subsidies, which Democrats demanded be restored in full during the six-week government shutdown
  • It establishes a minimum monthly payment of $5 for any plan, no matter how poor you are.
  • It would raise premiums for millions of low-income plan purchasers by turning the current cost-sharing formula, which currently lowers premiums, into a reimbursable expense, which will raise premiums.
  • It will establish a new subsidy cliff (when all subsidies stop) at 700 percent of poverty income (about $110,000 for a single adult in 2025).
  • It will allow beneficiaries to shift their tax credits into a health savings account, but only if they buy a bronze or high-deductible plan.

Other press accounts suggested the Trump proposal would also make short-term, limited benefit plans a permanent option on the Obamacare exchanges, and turn their allowable duration (just three months under a Biden administration rule) into years. Trump also wants to ban any government-subsidized plan from providing gender-affirming care or providing care for undocumented immigrants.

If you want more insight into this plan, you can turn to Charles Gaba’s substack or Andrew Sprung’s XPostFactoid. No one knows more about how the exchanges work (or don’t) than those two.

The politics

The only thing new in this plan is its direct relevance to the next two spins of the political cycle. Limiting the subsidy extension to two years gets the Republicans beyond the mid-terms, where they are staring at the possibility of a major shellacking.

Also, if passed, it would guarantee another fight over “failing Obamacare” during the next presidential election. That slogan will ring true to millions of people if the other elements of the plan are enacted, since they will go a long way toward turning a relatively successful program into a failing one.

There’s no need for me to go on at great length about why these rehashed GOP talking points should be non-starters for anyone who cares about health care, or has empathy for the least well-off among us. In short:

  • Any co-premium paid out-of-pocket for the very poor — even $5 — will dissuade hundreds of thousands of not millions from purchasing plans.
  • Turning cost-sharing into a reimbursable expense for the sick will also raise premiums.
  • The new subsidy cliff for the better-off people will incentivized hundreds of thousands if not millions of younger, healthier workers to drop coverage. This raises the average cost of the sicker, poorer patients still in the risk pool, which in turn raises premiums, which in turn discourages even more people from purchasing plans.
  • And, if those younger, healthier workers still want insurance, they will be offered the opportunity to buy those longer-duration, limited benefit plans, which will leave them with huge bills should they actually need to use their insurance. Again, more healthier people out of the risk pool; higher premiums for everyone in the risk pool.

Can you see a pattern? Raise premiums (for 2026), raise premiums (for 2027), and raise premiums (for 2028). Give young, healthy people an out (who cares about those who get sick and can’t afford their high deductibles). Then, let’s have an election where the GOP can point to the “obvious” failures of Obamacare.

As for preventing transgender people and undocumented immigrants from receiving care (whoops, the undocumented are already ineligible), that’s just cruel. It’s especially cruel to the more than half million people brought here as children by undocumented parents, most of whom are now hard-working, taxpaying adults.

Trump has already denied them coverage, reversing an earlier rule. This would make it permanent.

Merrill Goozner, the former editor of Modern Healthcare, writes about health care and politics at GoozNews.substack.com, where this column first appeared. Please consider subscribing to support his work.

Reprinted with permission from Gooz News

I Was Wrong: Democrats Won A Dunkirk Victory In Shutdown Defeat

I Was Wrong: Democrats Won A Dunkirk Victory In Shutdown Defeat

In 1940, Winston Churchill ordered the evacuation of 338,000 troops facing annihilation on the beaches of Dunkirk. Churchill called the successful operation "a miracle of deliverance." Historians portray it as a perfect example of victory in defeat.

Democrats raging at eight members of their caucus for ending the government shutdown might take a few lessons from the master of morale and strategy. What some hotheads framed as "capitulation" is, in the long run, the wisest plan.

Right after Dunkirk, Churchill famously said, "Wars are not won by evacuations." That is so, but stopping a potential disaster lets your side fight another day. Ending the shutdown prevented negative outcomes that had begun chugging the Democrats' way.

Shutdowns almost always bite the party that starts them. The record for this is so strong that I thought Democrats had erred from Day One.

I was wrong. Democrats effectively used the headlines to highlight the issue sure to haunt Republicans come the midterms: the soaring cost of health care.

Democrats prevailed in the recent elections, partly on threats to their health coverage, partly on rising food prices, tariff chaos and in-your-face corruption. But at a certain point, the news started turning from the fight to extend the Obamacare subsidies to flights being canceled and the poor losing food assistance.

With Thanksgiving approaching, the sight of family members sitting on suitcases in airports is not optimal. As many more Americans feel shutdown pain at the personal level, Democrats are harder pressed to avoid blame, even if the public liked certain items they were fighting for.

Now some firebrands just want a fight. But their contention that reopening the government caused a loss of leverage is based on illusion. Democrats never held meaningful leverage because they don't have the votes. Republicans control the White House, the House, and the Senate.

To quote Barack Obama, "Elections have consequences."

The election of Trump and a mostly pliant Republican Congress created such consequences as attacks on Obamacare and, more ominously, our democratic institutions. Democrats can offer a prettier set of consequences, but they can only deliver them if they retake control.

The Democrats' winning message should be, elect us and we will restore health care security. Even the temporary loss of it will hit home. As another great American, Joni Mitchell, sang, "Don't it always seem to go that you don't know what you've got till it's gone?"

Now, if the shutdown worked in avoiding even some pain, that would be an argument in favor. But it wasn't.

Speaking for Democrats who voted to reopen the government, Maine Sen. Angus King, an independent, posed the right question: "Does the shutdown further the goal of achieving some needed support for the extension of the tax credits?" (He's referring to credits that were temporarily increased during the pandemic, making coverage cheaper for millions.)

These senators come from the swing states of Nevada, Virginia, Pennsylvania, New Hampshire and Maine. They are key to Democrats obtaining and keeping a majority in Congress. Without them, Democrats have no hope of obtaining real power. And without real power, their politics are just performance.

As noted, the shutdown did succeed in putting the specter of lost health coverage front and center. That mission has been accomplished. Trump's now railing that Obamacare is a "scam" to get the insurance companies filthy rich. Democrats should thank him for calling this revered benefit a "scam."

Assessing the dire situation at Dunkirk, Churchill chose not to make a heroic yet suicidal stand. But he followed closely with his immortal "We shall fight on the beaches" speech — a rally to the nation for continued resistance.

The midterms are the beaches that Democrats should be storming.

With Unity And Grace, Democrats Can Build Powerful Midterm Message On Shutdown

With Unity And Grace, Democrats Can Build Powerful Midterm Message On Shutdown

The shutdown is winding down as eight Senate Democrats (7 Democrats and one Independent who caucuses with Democrats) voted with Republicans to get to the 60 votes needed to reopen the government. The ensuing spending plan will not include the health coverage subsidies for which the Democrats were holding out.

There is a lot of legitimate anger at the “defectors.” If you were going to cave, why wait until day 40? With public opinion leaning your way, why let up? Especially when this is the only leverage you’ve got? And how can you shake hands with these thoroughly untrustworthy Reppublicans, who have blatantly and illegally ignored previous spending allocations? All for the promise of a show vote on the health-coverage tax credits next month, a vote that will almost surely fail?!

Also, some of what the moderate Democrats are claiming they “got” in the deal are not at all Republican concessions, specifically rehiring government workers illegally laid off during the shutdown and “fully funding SNAP.” Simply getting the other side to obey the law may look like a win these days, but it is not.

Still, there are a number of arguments that point the other way, ones I’d argue are more compelling, though if and only if the fight we saw in the shutdown regarding who’s fighting for whom continues to rage. If these moderates don’t work with the rest of the Democratic caucus to build on the political and messaging gains made during the shutdown, then they really are part of the problem, not part of the solution.

The main argument for ending the shutdown was that the Ds were not going to get the tax credits and too many people were feeling the brunt of the shutdown. The former is probably true; the latter is definitely true.

The group of people affected by the shutdown grew with each week, beyond the hundreds of thousands of federal workers who have not been paid for weeks. The Trump administration’s legal fight to avoid paying SNAP food assistance benefits put tens of millions of Americans at risk of going hungry. And its decision to ratchet back air traffic capacity ensnared millions of others in air travel disruptions and flight cancellations that began over the weekend.

Given that these two facts—probable loss on tax credits and spreading pain—were highly predictable from the start, why shutdown at all? For one, minority leader Schumer understood that the party was itching for a fight with what is, hands down, the worst, most spineless GOP Senate caucus of any of our lifetimes. On a daily basis, they bow before their corrupt leader and violate their vows to protect the Constitution.

Granted the leverage that shutdown gave them, Senate Democrats had to pitch a fight. And they pitched a uniquely strong one. They made the Republicanss own the highly potent health-care (un)affordability issue, and they’ll get another chance to elevate that issue next month when Republicans continue to stand by while 20-plus million people see their premiums spike.

My sense, backed by some polling evidence, with the most important polls being last Tuesday’s mini-blue-wave, is that a very important sentiment is clarifying among voters: the Trump administration doesn’t care a whit about their economic concerns but the Democrats do.

I grant you, that last bit—”the Democrats do”—is an uphill battle and is just now maybe coming into focus. The shutdown underscored that for Republicans, unaffordability and cruelty are spectator sports. This leaves Democrats as the only party in the game. No question, the party is suffering from years, if not decades, of being perceived as abandoning working-class economics, in many cases, justly so. But during the shutdown, they were clearly the party fighting for affordable health care, for SNAP, for government workers, while the Republicans were weaponizing the moment to push hard in the wrong direction on each of these issues.

This is the fight that Democrats won in the shutdown, even if they lost on tax credits. But if they stop here, they’re toast, and deservedly so. I could be wrong—maybe this time is different—but in a few months, most regular folks won’t remember the shutdown. These events have historically had a very short half-life.

But if they start here, if they learn from this shutdown that they can unify around the message of affordability, of competent governance that follows the rule of law, of elevating the hurt that this administration, backed by a do-nothing, wholly-compliant Congressional majority, is doing to large swaths of Americans on a daily basis, then the shutdown will have been worth it.

Jared Bernstein is a former chair of the White House Council of Economic Advisers under President Joe Biden. He is a senior fellow at the Council on Budget and Policy Priorities. Please consider subscribing to his Substack.

Reprinted with permission from Econjared.

Surrender Caucus: Enough Senate Democrats Cave To End Shutdown

Surrender Caucus: Enough Senate Democrats Cave To End Shutdown

Senate Democrats are caving on the shutdown.

The broad framework for agreement, which was negotiated in part by Sens. Angus King, Jeanne Shaheen, and Maggie Hassan, as well as GOP senators, has “more than enough” members of the Senate Democratic Caucus to advance, according to two people granted anonymity to disclose the terms,” Politico reported.

In exchange for their votes, these handful of “moderate” Democrats—which notably does not include Senate Minority Leader Chuck Schumer—are getting nothing.

Well, that’s not true.

They’re getting a promise of a vote on ACA subsidies in the Senate, which will easily go down in defeat. Not to mention, Speaker Mike Johnson has said he’ll never even bring the matter up for a vote in the House.The deal also fully funds the Veterans Administration and Department of Agriculture, and the operations of Congress, of course, because they have to take care of themselves.

Nothing in that is a victory for Democrats.The surrender is perplexing given how clearly the shutdown was hurting Republicans, so much so that President Donald Trump specifically cited it as one reason for why Republicans got their asses kicked in last Tuesday’s off-year elections.

But instead of letting Trump figure out a way out of his own mess, Democrats inexplicably threw him a life vest on Sunday night.There is one silver lining—this deal will eventually haunt Republicans. Had Democrats succeeded in saving ACA healthcare subsidies, clueless voters would never have known of the Democrats’ role in safeguarding their insurance.

When Republicans vote down Democratic efforts to save health care for millions of Americans, the blame will be crystal clear.

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