Greg Sargent: This is The Daily Blast from The New Republic, produced and presented by the DSR Network. I’m your host, Greg Sargent.
Monica Potts: Thanks for having me.
Potts: Right. Well, what’s happening is what’s been happening all year so far, which is the reason the Democrats wouldn’t agree to the continuing resolution that didn’t extend health care subsidies. So under some of the Covid emergency acts, the subsidies for Affordable Care Act insurance that people purchase on health care marketplaces in their states was enhanced. So it gave more money to the people who qualified for it. It increased the people who do qualify for subsidies to some degree. And so it made it easier for people to buy subsidies because health care had gotten too expensive. People were trying to buy health care and they couldn’t afford it. And so this helped them out a little bit. And it really worked, because it increased the uptake. We had the lowest uninsured rate in the history of the United States in 2023.
Potts: That’s good. Yeah.
Potts: Not to Republicans. It was good. It was the point of the Affordable Care Act was to get as many people in this country insured as possible to move us toward universal health care. And Republicans let those enhanced subsidies expire.
And so people are really struggling to think about affording health care next year. For some people, it’s an increase of $100, and that’s more than they can afford. For other people, it’s increases of thousands of dollars for their family coverage. And some people are deciding to opt out and not buy insurance. And every day that passes, more and more Americans are looking at the exchanges, deciding whether or not they can afford health care, and they’re panicking and they’re probably calling their representatives.
Potts: It varies from state to state. I think in Wyoming, they’re seeing some of the highest increases in the country. On average, it’s about 26 percent higher than next year. And like I said, some people will still qualify for subsidies. But the issue is that if some people opt out of buying insurance, the people who tend to opt out are healthier. They are younger, they’re healthier, they don’t have any health issues, and they think, ‘I can go without insurance.’ And that means that the people who do buy insurance, the people who are left who can’t make that decision, often tend to be sicker; they have some kind of chronic issue, and they cost the system more. And that’s why premiums are rising, and it could lead to what some people call a death spiral that just makes premium costs higher and higher. The higher they get, the more people decide to drop out. The more people left on insurance are sicker and sicker. And this was the problem that the Affordable Care Act was meant to solve.
This is bizarre politically, because you’ve got all these vulnerable House Republicans who are at serious risk next year, and Republicans just got blown out in elections in New Jersey and in Virginia and elsewhere that were in no small part about exactly this issue. We’ve had a test run. As you wrote in your piece, there’s just this deep ideological hostility inside the GOP caucus to doing anything that seems like, “Obamacare lite,” as one Republican put it. And you talk about this hostility, it just seems like on some basic level, they just can’t get to yes on government helping people.
Progressives want Medicaid or Medicare buy-ins. They want government insurance for all. They want Medicaid for All. And they continue to advocate for that kind of system. At the same time, the Affordable Care Act was somewhat based on a more conservative idea from the Heritage Foundation that was similar to something signed into law by Governor Mitt Romney of Massachusetts, who was a Republican.
Sargent: It’s not as if Republicans don’t know what sort of political predicament they’re in. Punchbowl News had this amazing report about how Republicans are receiving the news that Marjorie Taylor Greene is retiring. We should probably insert here that she was one of the few Republicans who was saying, ‘We’ve got to do something about health care costs for people.’ Now, you know, she’s not ideologically where you or I are, but at the same time, she recognized that it’s an actual problem to some degree, and many Republicans won’t allow that.
Potts: I can’t. Because the Democrats shut down the government to try to get the subsidies extended; that was a really popular position. Most people supported the Democrats in their efforts to do that. The Affordable Care Act is more popular than it’s ever been. It’s just gained popularity since it was passed. The idea that the subsidies should be extended is also really popular with Americans.
Trump had run on affordability issues, had promised he was going to lower prices, and the prices of almost everything are going up, and insurance is really going to hit people hard. It’s a big bill to pay.
Potts: Yeah, it really is. And of course, it conveniently leaves out that Republicans were trying to gerrymander Texas first. They’ve been seeing the writing on the wall since Trump was elected. They know they’re likely to lose seats in the midterms, and they’ve been trying to do everything that they can to prevent that from happening. And it seems like everything that they do makes it worse, like Trump’s rants, which kind of say the quiet parts out loud always.
Potts: Yeah, it really seems like that they feel like their only chance is to lock down power as when they have it now. And then that way they won’t face consequences from the voters, which I think is just another scary thing that’s happening in Trump’s second term.
Potts: That’s right. Yeah. And I think that when you look across the country, working Americans are suffering so much right now. The people in immigrant communities who are scared to go to work because of ICE raids that are picking up even people who were born in the United States because of hostility from all different corners of the Trump universe and because gas is expensive. Energy bills are expensive. The labor market is not very good right now. People feel stuck in their jobs. They feel like they’re not making enough. They feel like they can’t move forward. And so people aren’t very optimistic right now. And I think that all the things that Trump is doing are really making it worse to a huge degree.
Potts: Yeah, and consolidate power and use the wealth and the power we have to get more of it. I think, you know, that’s what we see across the board, the alliance between politics and the big tech companies and Wall Street. I mean, I think that’s what all of this boils down to.
Republicans did win a couple elections on it, right? In 2010 and 2014, the midterms, they won both those on the ACA to one degree or another. Maybe to some degree it helped Trump win in 2016, I don’t know, but let’s just grant that.
But I just want to bear down on this one point, Monica. Trump’s takeover of the GOP was supposed to be about a rejection of GOP plutocratic, anti-safety-net politics, right? Trump himself kind of talked a good game about getting people health care. He spoke a little differently than, say, Paul Ryan, at least rhetorically. And that might be why he won in 2016, but they’ve had literally a decade to sort this out—to sort their own response out on this—and they’re still lost. I just don’t get it.
Sargent: Yeah, you know you could actually look at Trump’s terrorizing of immigrant communities as a piece with this, because as you said, Trump kind of presents this idealized picture—idealized from his point of view—picture of the working classes as heavily white, heavily male, heavily concentrated in industrial work, Appalachian fossil fuel mining, that type of thing. But the working class today is really quite diverse. It’s got a heavy immigrant component to it.
Potts: I think that’s right. Somos Votantes, which is an organization that does outreach to Latino voters and also does polling, has found that Trump has steadily lost support from Latinos over the course of the past year.
And so I think that some people just thought, well, he’s a businessman, he can bring us jobs, he can straighten out the economy. Without thinking too much more about it. And so I think that there were some voters who voted for Trump for that reason, and they’re no longer fooled. They can see now what’s happening.
Potts: At this point, I think they may just have to not do anything and take the hit because they’re running out of time. Open enrollment for plans that start January 1 ends December 15, which is just a few short weeks away—it’s two or three weeks away, actually. And they really don’t have time to do anything other than just extend the subsidies that already exist. It’s too late for insurers to change their premium prices. It’s probably too late to introduce anything new next year for next year’s plans. I think their choices are either to quickly vote to extend the enhanced subsidies, or to not. I think those are the only two choices available to them. And so I think the answer might be that they’re just not going to do it. A lot of people are going to lose their insurance. A lot of people are going to face really, really high bills if they want to keep it. And that’s what we’re going to see next year.
Potts: Thanks so much for having me.
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