Greg Sargent: This is The Daily Blast from The New Republic, produced and presented by the DSR Network. I’m your host, Greg Sargent.
Grace Segers: Thanks so much for having me.
Segers: So today we saw four House Republicans sign onto a discharge petition, which is basically a way for them to get around the House process and force a vote on legislation that would allow the extension of these subsidies. Like you said, this is a really big deal for millions of Americans who rely on the Affordable Care Act marketplace to enroll in health care.
So in a sense, this is more of a way for those House Republicans to make it look as if they are doing something on the issue. But it’s hard to see whether this would have an actual policy impact.
Mike Lawler (voiceover): I am pissed for the American people. This is absolute bullshit. And it’s absurd that we are in a body with 435 members. Everybody has a responsibility to serve their district, to serve their constituents.
Kevin Kiley (voiceover): That’s a failure of leadership. I mean, we have, you know, members on both sides who believe this is an urgent issue, and it is for all of our members in terms of what their constituents are going to have to deal with at the start of the new year. So what’s wrong with having a vote?
As you say, they’re going to spike anyway. But I think also the entire Republican Party is likely to get most of the blame for what’s happening. And that just is going to fuel a desire to throw out Republicans.
Segers: It’s of course tricky to say. I think that we should note that all of those four, with the exception of Brian Fitzpatrick, did vote for the One Big Beautiful Bill Act over the summer—the law that cut Medicaid and made a lot of changes to social policy. And we know that Republicans generally fall in line, as they did over the summer with that legislation.
But I was just looking at a Quinnipiac poll out today that showed that Democrats in Congress do have the lowest approval rating that they’ve had since 2009 right now, with only 18 percent of Americans—registered voters—supporting how they’re doing right now.
Sargent: Yeah. The Democrats have a lot of work to do in convincing voters that they’re going to be better. I just think that the way midterms function generally is [that] it’s a referendum on the party in power. So I guess we’ll see if the miserable numbers for Democrats undo that structural fact. Let’s listen to how Mike Johnson responded to this. He was asked by a reporter if the fact that the discharge petition now has enough signatures means he’s lost control of the House. Listen to this.
Sargent: So, Grace, here Johnson says, “I have not lost control,” and yet it appears that he’s going to be unable to prevent a vote on extending the ACA subsidies. Can you walk us through why he wanted to block this vote in the first place? There was a pretty large bloc of House Republicans that absolutely didn’t want to extend the subsidies, right?
So I actually do think that is probably his biggest motivation in preventing—or attempting to prevent—this from coming to a vote: simply because he fundamentally disagrees with the ACA and doesn’t believe that any more federal money should be spent on it.
And you kind of saw that in the fall during the government shutdown, when the House was out for several weeks because it is easier to keep the House out of session than to have them in session and not be in control of what they do.
I mean, this is the thing. What’s been revealed here is that the Republican position is very unpopular—so unpopular that, finally, a bloc of moderates had to break with Mike Johnson and the Republican conference to join the Democrats, right?
So that includes lower-middle- and middle-income Americans, and in particular, older Americans are going to be affected and see their premiums hike by a dramatic amount as well. And so I think that Republicans recognize, as Democrats recognize, that this is an issue that is not going to go away. And particularly when we see those premiums go up next year, the policy consequences for Americans will be very real.
One thing that’s striking to me about this whole situation is that health care is now even more of an economic issue than it sometimes is. It’s sometimes—I think wrongly—put in a separate bucket from the economy in a funny way in the minds of pundits and in our discourse.
Segers: Well, when you think about all of the folks who aren’t going to be able to afford their health care next year, that could have really significant consequences where they may choose to look for a different plan that has a lower premium, but that has higher deductibles or copays.
So not only are we seeing a cost increase in the immediate term, it’s probably only going to compound as more people choose to drop health care. And of course, when people choose to drop health insurance, that means people are sicker.
Segers: So the ACA marketplace enrollees are the ones who are going to be the most immediately affected. But when one aspect of the American health care system is undermined or put at risk, then the rest of the health care system is as well. So everyone is seeing health care costs go up next year.
So even though directly it’s primarily going to affect enrollees, there are ripple effects throughout the rest of the American health care system that will impact everybody.
So, you know, acknowledging your point about the dismal numbers for Democrats, it still doesn’t prevent them from being trusted on this issue by double digits over Republicans.
Segers: Well, when you look at polling, just generally speaking, Democrats do tend to do better on issues such as health care. We know that. And then Republicans tend to do better on issues such as immigration, and it seems in recent polling as if those gaps for Republicans are narrowing.
And in terms of structural trends, I do think that Democrats have the advantage when it comes to next year. But it is also just [that] things are bad with the economy. People are hurting. And sometimes you just don’t know how they are going to interpret that when they go to the ballot box, particularly not [a] year in advance.
It seems to me that we’re looking at a bit of a perfect storm of factors here that are really bad. And we were kind of on a track to something good with the Affordable Care Act—at least, you know, at certain times over the last few years. The big story was kind of that it was lowering the uninsured rate, which was a real progressive achievement.
Segers: Yeah, none of this exists within a vacuum. So with regard to the ACA specifically, since these enhanced subsidies were introduced in 2021, participation in the ACA marketplace has spiked dramatically.
And then when you look on top of that with the cuts to Medicaid, that also is going to have a dramatic effect on the insured rate, particularly as people may not be able to meet new work requirements.
Sargent: Yeah, looks to me like it’s going to be really, really terrible. Grace Segers, thanks so much for coming on with us. That’s some pretty brutal stuff, though.
Segers: Thanks for having me.
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