The Shutdown: Talking Points
“I have been thinking that I would make a proposition to my Republican friends... that if they will stop telling lies about the Democrats, we will stop telling the truth about them.” - Adlai E. Stevenson
First, a talking point: The Affordable Care Act polls well, people support it, regardless of party affiliation (or lack thereof). When it’s referred to as “Obamacare”? Support drops on the red side of the spectrum. Yes, it’s the same thing. Regardless, I will call it The Affordable Care Act (or ACA), not Obamacare. The difference in wording matters.
Next, the Republican (MAGA) lies:
The president and his MAGA allies keep repeating that Chuck Schumer and the Democrats shut down the government in attempt to provide health insurance through the ACA to “illegal aliens”. This is patently and totally false. Federal law specifically forbids selling insurance, and/or providing subsidies through the ACA to people in the United States without documentation. The MAGA crowd is distorting a different point: hospitals are required to provide emergency care to everyone without asking for documentation of residency status. If the person is uninsured there are provisions in Federal law to bill to Medicare for the services provided. This is existing law and is outside of Democratic demands.
Democrats are “cutting” $50 billion in aid to rural hospitals. This is true and false all at the same time. The $50 billion in question was added to that disgusting piece of legislation called “The Big Beautiful Bill” specifically to placate Josh Hawley (R-MO). He had indicated that he would vote against an early version of the BBB. His concern? The proposed cuts to Medicare would severely hurt rural hospitals in his state, causing many to close. The reality is that if the Democrats restore the cuts to Medicare and continue the ACA subsidies then the $50 billion WILL NOT BE REQUIRED.
Mike Johnson, and others, like to repeat that “this is a clean spending bill, just like Chuck Schumer voted for in April”. Another lie. It’s not. The bill in April included funding for Planned Parenthood, for PBS and NPR, and USAID. All of these were eliminated in a rescission package submitted by Trump and passed after the April CR. Funding for these programs is not part of the current GOP legislation. The long and short is twofold: first, this new “Continuing Resolution” (CR) is NOT the same as the one in April. Second, and more importantly, the April CR was passed with bipartisan support. In a significant betrayal, key provisions in the April CR were then later de-funded in a package that did not require Democratic support. So why would Chuck Schumer, or any Democrat for that matter, trust that they won’t be betrayed again?
A common Republican/MAGA refrain is “what’s the hurry? We have until the end of the year to deal with healthcare funding.” Nope!!! Open enrollment for 2026 ACA health plans starts on November 1. This issue needs to be addressed before then. The reasons why will be outlined in the next section: The Democratic Truths.
“Never underestimate the difficulty of changing false beliefs by facts”. – Henry Rosovsky
Finally, The Democratic Truths. First, a note on sources. Everything below can be independently verified. My primary source is Dan Rather and his “Steady” newsletter. Most of what he reported comes from independent analysis done by KFF (formerly known as “The Kaiser Family Foundation”). I will also be citing reporting from Bloomberg. The facts:
The ACA provides subsidies to enable people to purchase health insurance. The original ACA subsidy provisions where expanded in 2021 under Joe Biden, in part to extend access to healthcare during the COVID pandemic. Because of the expanded subsidies ACA enrollment increased from 11 million people to 24 million (Steady). The expanded subsidies expire at the end of this year.
If the subsidies are not extended health insurance premiums will increase by an estimated 114% and four million enrollees will lose health insurance because they will no longer be able to afford the premiums (Steady / KFF).
“The New York Times calculated that a 55-year-old couple making $85,000 a year would see their premiums triple to $24,535 annually.” (Steady)
People living in red states will be disproportionately be impacted with Texas being the hardest hit. Projections show that over a million Texans will lose access to health insurance (Steady / KFF). Note: “Red” states will be more heavily impacted if the subsidies are not extended than will be “Blue” states. This ties to provisions in the original ACA that provided federal funding to states to expand access to Medicaid. Most blue states accepted the funding and expanded Medicaid. Most red states did not expand nor accept the funding leaving more people needing the expiring subsidies to be able to afford health insurance (Bloomberg).
The “Big Beautiful Bill” is expected to remove 7.8 million Americans from Medicaid (yet Mike Johnson continues to say that the bill didn’t cut the program). If the cuts stand many of these people would have turned to the ACA, but without continued subsidies these millions of our fellow citizens will be faced with health insurance that they cannot afford.
Twelve million people in GOP help House districts are covered through the ACA. This compares to nine million in Democratic district (Bloomberg)
The long and short is that starting on November 1 people will be enrolling in health insurance programs through the ACA. It’s true that the funding isn’t required until 2026. Yet the simple fact based reality is that if the subsidies are not approved prior to November 1 then anyone going to an ACA site to enroll in a health insurance program will see the full cost to them, not the subsidized cost. How many people will decline health insurance when presented with a an unsubsidized cost that they cannot afford? It’s a lie to say that we can wait. This is a problem that has to be addressed now.
This final section is a bit opinion, a bit factual, and partially speculative:
As much as 20% of every dollar spent on healthcare through private insurance goes to administration and profits to companies like UnitedHealthcare (the administrative cost of Medicare is roughly 2%). There are anecdotal stories of senior execs in the for-profit sector of our healthcare industry who are having a bit of a freak-out. Why? Lower enrollees mean lower revenues resulting in lower profits. Lower profits mean smaller bonuses. I support a government sponsored, single payer system, whether it be Medicare for all or something similar. I prefer that our tax dollars go to providing healthcare rather than increasing corporate profits and CEO bonuses. And to be direct, that’s exactly where part of the subsidies go.
As fewer people can afford health insurance it’s the sickest who will maintain polices while those in generally good health will “take a chance” and go uninsured. This will result in an overall increase to the cost of health insurance polices. Why? It’s best to consider health insurance as a “pooled risk”. If there are more people who require treatments whose costs exceed their annual premiums than there are whose needs cost less? The overall rates will increase.
The long and short of it is that this fight is about ensuring that a basic human right is met in this country: the right to access to quality healthcare. It’s a fight about human dignity. I’ve been saying for a while that we can’t just oppose, we need to propose. The fight to maintain ACA subsidies is exactly that: we are the opposition with a proposition.
The Ugliness is the Hope.
Resist. Persist. Oppose. Propose. Be the opposition with a proposition.
This was originally posted at davidvalade.blog.