healthcare

They Should Have Left the Government Shut Down.

/ Rich Wilkins / Leave a comment

Last week the Senate failed to extend subsidies for people buying health care on the Affordable Care Act Exchanges. This week?

Friday’s proposal from House Republicans includes measures that would allow small businesses to join together to buy insurance plans for their employees and put in place new requirements for pharmacy benefit managers in an effort to lower drug costs.

Starting in 2027, federal payments, known as cost-sharing reduction payments, would aim to lower premiums for some low-income Americans. Health plans that provide abortion coverage would be excluded.

A vote on the package is expected next week, House Speaker Mike Johnson said.

“House Republicans are tackling the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation’s health care system for all Americans,” Johnson said in a statement.

Democratic House Minority Leader Hakeem Jeffries blasted the proposal Saturday.

“Mike Johnson just released a toxic Republican Healthcare plan that hurts everyday Americans,” Jeffries wrote on X. “It fails to extend the ACA tax credits that expire this month. And is a deeply unserious proposal.”

This is a joke. Sure, let employers buy together, but what does that do for people who are buying their own health insurance? The answer is nothing. For people like me, who buy their coverage at full price, this will mean not only do I get hit with higher 2026 premiums, but when millions drop their coverage in 2026, my premiums will skyrocket again in 2027. Health care costs the least when the most number of people are able to pay for their care, or are insured. House Republicans actively are plotting to harm that. Why? Some sort of stubborn insistence on free markets? I doubt it. They simply don’t want the government to provide anything, so they can cut taxes more for wealthy people. At this point, it’s clear their goal is no income taxes at all.

This did not have to happen. The decision by Chuck Schumer to send Tim Kaine, Dick Durbin, John Fetterman, Jeanne Shaheen, Maggie Hassan, Angus King, Catherine Cortez Masto, and Jackie Rosen over to vote to end the government shutdown without even this small concession from Republicans will essentially do massive damage to the American health care system. If Republicans were going to re-open the government without these subsidies, Democrats should have forced them to end the filibuster to do it. Let them have the blood on their hands. Instead Democrats gave them a way out of their own mess, and we all know it was approved by their leader, because they gave just enough votes to get it done. Senate Democrats basically own this mess as much as Trump’s GOP, which is utterly embarrassing for a party whose crowning achievement of the last 20 years was a health care system that insured over 20 million people who were previously uninsured.

We really need to get rid of John Fetterman in 2028, by the way.

Chuck and the Democrats Bad Deal is Actually a Potential Disaster for Abortion Access in America

/ Rich Wilkins / 2 Comments

They really didn’t need to do it. I guess if you think keeping the government open was crucial, maybe you think they did. If you’re a federal worker, maybe you’re happy they did. Maybe if you’re on SNAP, you’re happy to get what you can here. It wasn’t necessary though. Republicans could have re-opened the government themselves by ending the filibuster. Eventually, when the government re-opened, federal workers would get back pay and SNAP would be restored at that time. Republicans could have done it and eventually would have to turn off the pressure on them from the public. Then they would have owned all the terrible things in this bill. They would have owned pricing a large chunk of the 20 million or so people insured under ACA plans out of the health insurance market. They would have owned the closing hospitals from their Medicaid cuts AND the cuts to the ACA subsidies. This is their government. They fought hard to win it and give it to President Trump.

Instead, the Democrats got absolutely nothing. The “promise” of a Senate vote on subsidies for ACA buyers in December isn’t worth the air used to utter it. It’s not a promise to pass it through the Senate, it’s not a promise to vote on it in the House, it’s not even enforceable to get a vote in the Senate. It’s a promise that is worthless and made for the naive. There are now those saying it’s brilliant because Speaker Johnson was forced to swear in Adelita Grijalva, thereby giving the signatures to force the discharge petition on the “Epstein Files.” Number one, we got the smoking gun without the vote even happening, but also, even Epstein’s own words implicating Trump are probably not going to move Republicans, and we are a day later and absolutely zero Republicans are calling on him to step down. We got everything we needed from a leak, the actual vote in Congress will probably be turned into a circus. We didn’t need to trade health care for it.

What’s worse is now the Democrats will get beat at their own game. Namely, Republicans are going to use health care to gut reproductive health services for women to the bone. By passing the CR, Democrats have acquiesced Medicaid spending levels set in the “Big, Beautiful Bill.” Those are going to gut reproductive health care for all Medicaid recipients. Of course, it doesn’t stop there. Republicans are demanding tougher abortion rules in exchange for voting for the ACA subsidies, which will probably kill the bill, but it might even be worse if it ends up passing. Namely, they want to stop states who mandate reproductive health care in their ACA plans. Basically they’re going to make the major blue states accept their version of “pro-life” health care. If Democrats say no, they’ll torpedo the bill. There are also discussions about just handing out the subsidies as cash, which could destroy the entire ACA system.

Insurance companies set rates mostly based on whether they think there will be less or more consumers in the market for the next year. Based on already passed legislation and executive orders in 2025, insurance companies raised their rates, because they think less people will buy next year. Those 2026 rates are set in stone. With the ACA subsidies that are in question, which cover people who just missed qualifying for subsidies in the original ACA, less people will drop their coverage for 2026. That would do a lot to help keep rates in line for 2027. The Democrats best chance to force Republicans to fund those subsidies for 2026 died with the passage of this Continuing Resolution to keep the government open. Their time to pass these subsidies with little to no strings attached has now officially expired.

Chuck Schumer is apparently calling 2028 Presidential contenders (his idea of contenders, but whatever) and begging them to not attack the deal. Gentlemen, unsolicited, free advice- bury the deal. Democrats should be hanging their entire brand on expanding health insurance access, bringing down housing and food costs, and childcare costs. Essential, building block things that people absolutely need to live. Keeping the government open is not the important thing. Keeping the focus on fixing real people’s problems should be the entire focus. Chuck, Fetterstein, a couple of future retirees, a dude from Virginia, and a couple of random Senators I didn’t expect to cave all failed the test. It’s time for a change.

Happy Shut Down Day

/ Rich Wilkins / Leave a comment

The government is shut down. Good. The truth is that the Republicans are in the majority in both houses of Congress. They also hold the White House. If they want to fund this government, they should figure out a way. What is this government doing that someone who disagrees with Donald Trump should want to continue?

This fight is not about illegal immigrants getting health care from the government. That is illegal now, and does not happen on any meaningful level. Medicare and Medicaid have plenty of safe guards now against giving a policy to non-citizens. If you wanted to make sure those programs and the VA and ACA had literal zero illegal immigrants on policies, you’d give them more money, not less, so they could enforce it better. This is all just excuses from Donald Trump.

This fight is about the ACA and affordable health care in America. Cutting subsidies for premiums under the ACA simply will raise the amount of money people pay for a plan. If premiums are higher, less people will buy plans. Because less people are buying, plans will become more expensive people who buy plans. It’s a nasty cycle, and the reason most of the 20 million or so on “Obamacare” plans didn’t just buy an insurance plan before. The whole market is cheaper with more people on it. With less people insured, you get more people showing up at hospitals and clinics and receiving care they will never pay for. The hospitals and clinics then make up that money by charging insurers more for the people they are covering. Simply put, health care is cheaper on the micro (household) level with more people insured than less. Cutting subsidies to the ACA is a rate hike even for people like me, who don’t accept the subsidy.

Aside from the multitude of horrific things the current government is doing that Democrats should have no interest in paying for, there’s no point in screwing up the health care market because you don’t like the President who designed it. Keep the government shut down. If the Republicans want to fund it, let them figure it out. If they want Democrats to help, they can cave on health insurance premiums. Otherwise there is no harm in shutting it down and keeping it down. Democrats were voted out, we’re under no obligation to help them.