Democrats Bet Briefly Preventing a Health Insurance Apocalypse Is Good Politics

[Celerity]

https://prospect.org/politics/2025-09-08-democrats-bet-on-briefly-preventing-health-insurance-apocalypse/



In March, Democrats faced a decision: shut down the government over the litany of lawless actions and usurped spending powers by the Trump administration, or fall in line. They decided not to fight, reinforcing the fundamental fault lines in current-day Democratic politics between weakness and fortitude. Fast-forward six months and Democrats have the same decision. The government spending that was extended for the full fiscal year by a continuing resolution in March runs out at the end of the month. Twelve appropriations bills aren’t going to be passed in a few weeks, so some stopgap continuing resolution will probably be offered for a vote. Any spending bill, needed by September 30, will require 60 votes in the Senate (because of the Senate filibuster), meaning Democrats will have to supply some of them if it’s going to pass.

If anything, the lawless actions and usurped spending powers by the Trump administration in the intervening six months have grown worse. One rescission package to reverse already approved appropriations has passed; another “pocket rescission,” where the administration is trying to cut approved spending without even giving Congress a say in the matter, has been issued. Hundreds of billions of dollars in grants that are required by law to be sent have been withheld. And the White House is putting troops in American cities, using a paramilitary immigration force to kidnap people off the street, and engaging in untold other abuses.

Once again, Democrats can decide whether to participate in this destruction of the nation’s founding principles, or resist it. It’s a rare point of leverage in a time when national policy is being run almost exclusively out of the Oval Office. I’ve been skeptical that Democrats have any real strategy for what to do. But a strategy is actually emerging. Reporting indicates that Democrats will use the imminent expiration of Affordable Care Act subsidies as a bargaining chip in the shutdown showdown. Votes could be exchanged for an extension of those subsidies, which run out at the end of the year. Democrats are also looking to reverse some of the Medicaid cuts in the One Big Beautiful Bill Act (a law that’s so unpopular Republicans are already trying to rebrand it), but my guess would be that Republicans aren’t interested in changing a bill they just passed two months ago; the extension of the ACA subsidies is likely to be the main ask.



Some Republicans have been open to extending those subsidies. Senate Majority Leader John Thune (R-SD) called it a topic his members were “paying attention to,” for good reason. In a matter of a couple of months, the real cost of insurance is likely to spike by an average of 75 percent or more for those who will lose the enhanced subsidies. That’s on top of a projected increase in the raw cost of insurance; companies have proposed premium hikes of 18 percent this year. Unless action is taken, it will be an enormous example of Trump’s failure to rein in the runaway cost of living. And an estimated five million households will no longer be able to afford insurance and will lose their coverage, according to the Congressional Budget Office.

snip

[markodochartaigh]

1. "...an

estimated five million households will no longer be able to afford insurance and will lose their coverage..."
I assume that these five million households are just the ones on the Affordable Care Act. This loss of money will ripple through the entire "health" insurance system. Public and private hospitals, insurance companies, and businesses who provide insurance to their workers will all get hit.
How many other people will lose their insurance when it becomes unaffordable for them or their employers?

[gab13by13]

3. A lot more than Obamacare subsidies have been attacked, have been gutted.

Medicaid will be gutted, Medicare is on track to be privatized, Social Security is being gutted.

The time to fight was last March, that was the time to take a stand, but when I asked for Democrats to fight harder I was accused of bashing Democrats.

Remember, only 1 House Democrat from Maine voted for the CR, and only a handful of Senate Democrats voted for the CR, the vast number of Democrats back in March voted NO to the CR. I was bashed here for supporting the majority of Congressional Democrats and for not supporting a minority of too timid Democrats.

[markodochartaigh]

4. Another thing not being talked about

is that the pay-go provision will force substantial Medicare cuts soon.


https://hfwcny.org/could-the-one-big-beautiful-bill-mean-cuts-to-medicare/

http://democrats-budget.house.gov/resources/fact-sheet/trumps-big-ugly-law-triggers-536-billion-medicare-cuts

[Celerity]

5. House Reconciliation Bill Could Trigger $500 Billion in Mandatory Medicare Cuts

https://www.kff.org/quick-take/house-reconciliation-bill-could-trigger-500-billion-in-mandatory-medicare-cuts/

One consequence of the reconciliation bill that is making its way to the House floor is more than $500 billion in Medicare cuts between 2026 and 2034. According to the Congressional Budget Office, the reconciliation bill reported out of the House Budget Committee would increase the deficit compared to current law by at least $2.3 trillion. If enacted into law in its current form, and Congress takes no further action, that increase in the deficit would trigger mandatory cuts, also known as sequestration, under the Statutory Pay-As-You-Go Act of 2010. Unlike Social Security and programs for low-income people, Medicare is not exempt from these cuts.

Triggering Statutory PAYGO would mean an automatic 4% reduction to most Medicare spending. That includes payments to hospitals, physicians and health care providers, Medicare Advantage plans, and standalone prescription drug plans. The cuts to hospitals are on top of the effects of Medicaid changes included in the legislation. Some spending to support low-income beneficiaries is exempt, but most Medicare spending is not.

The purpose of Statutory PAYGO was to impose some budget discipline. However, the across-the-board cuts triggered by the law have never been allowed to go into effect because Congress has either excluded those effects from the “scorecard” as part of the underlying legislation or later acted to exclude or delay the effects. For example, neither the 2017 Tax Cuts and Jobs Act nor 2021 American Rescue Plan resulted in automatic cuts despite large increases in the federal deficit.

Congress could choose to take action before the end of the year to block implementation of the cuts as it has done in the past. Unlike the reconciliation bill, excluding the effects of legislation from the PAYGO scorecard requires 60 votes, rather than a simple majority in the Senate, which is a higher hurdle.

[Silent Type]

6. +1. In 2017, trump's chitty tax cuts would have prompted a similar cut, and Congress approved a waiver. They can do same

this time if they want to. Hope we are working on that.

[gab13by13]

2. Imagine that Chuck,

This is a paragraph from the OP.

In March, Democrats faced a decision: shut down the government over the litany of lawless actions and usurped spending powers by the Trump administration, or fall in line. They decided not to fight, reinforcing the fundamental fault lines in current-day Democratic politics between weakness and fortitude. Fast-forward six months and Democrats have the same decision. The government spending that was extended for the full fiscal year by a continuing resolution in March runs out at the end of the month. Twelve appropriations bills aren’t going to be passed in a few weeks, so some stopgap continuing resolution will probably be offered for a vote. Any spending bill, needed by September 30, will require 60 votes in the Senate (because of the Senate filibuster), meaning Democrats will have to supply some of them if it’s going to pass.

The time to fight was last March, Chuck, before they passed bills gutting our social safety net.

The article is misleading when it said that Democrats capitulated back in March. Only a handful of Senate Democrats capitulated, the vast majority of Democrats were in favor of voting NO to the CR back then.

The Medicaid, Medicare, Social Security, Obamacare subsidy horses are all out of the barn and now you want Democrats to try to convince Magats to rein them all in and put them back in the barn. Good fucking luck with that.

When I told people that voting for the CR back in March was a huge mistake because it would give Krasnov the means to gut our social safety net, people told me that Democrats would be blamed for a shutdown, people told me that Social Security would be protected.

Hey Chuck, I heard what you told Chris Hayes after you led a small group of Senators to pass the CR. You told Chris that your plan was that Krasnov would burn it all down and then Democrats would win the next election. Well Chuck, Krasnov burned down Medicare, Medicaid, Social Security, Obamacare subsidies, that was the plan, remember? I wish you luck with the shutdown now, not fighting back in March was one of the worst decisions a handful of Senate Democrats made in the history of our country.

The deal to protect our social safety net should have been done last March, and the vast majority of the country would have been behind Democrats, worrying about who would be blamed for a shutdown was a political, wrong-headed mistaken reason for giving Krasnov everything he wanted and getting absolutely nothing in return.