There were a variety of factors that led to the government shutdown, but at the heart of the matter was health care costs — or, more specifically, Democratic efforts to save tens of millions of American consumers from vastly more expensive premiums under the Affordable Care Act, also known as Obamacare.

The shutdown is over, but the underlying issue on coverage costs remains entirely unresolved, and millions of families will soon have to choose between paying far more or going without.

Republican Rep. Jeff Van Drew of New Jersey said during a Fox Business interview last week that if the matter remains unresolved in the coming weeks, the GOP is likely to “get killed” in the 2026 midterms. He’s not alone: Punchbowl News reported that other House Republicans from competitive districts are also pushing party leaders to extend existing Obamacare subsidies.

It’s against this backdrop that House Speaker Mike Johnson and other members of the GOP leadership have seemed quite eager in recent days to deliver public assurances about the party and its serious intentions. On Wednesday night, for example, Johnson told reporters that Republicans have “volumes of ideas” about health care policy, though the Louisiana congressman didn’t share any of the ideas.

Earlier in the week, the House speaker similarly told Fox Business, “We’ve got notebooks full of ideas” — though, again, he didn’t elaborate or offer any specifics.

On Wednesday afternoon, House Majority Whip Tom Emmer appeared on Fox News and was asked to name “one thing” he wants to do on health care policy. The Minnesota Republican responded, “More choice. More transparency. More competition. There’s all kinds of ideas.”

And while his buzzwords sounded nice — few argue against choice, transparency or competition — Emmer’s rhetoric was vague to the point of comedy.

Earlier in the day, however, the GOP leader was willing to get a little more specific. “You’re going to have to create high-risk pools again,” Emmer said on a talk radio show.

For those who might benefit from a refresher, the idea behind high-risk pools might sound appealing at first glance. Emmer was describing an insurance model in which older consumers and those with preexisting conditions, and younger consumers who are healthy, are kept in separate risk pools. As a result, the latter group can spend far less on coverage, since insurers expect they’ll need less (and less expensive) care.

But whether Emmer realizes this or not, while this model allows insurers to charge the young and healthy far less, it also allows insurance companies to charge those who are neither young nor healthy vastly more.

Recommended

MS NOW Opinion

The White House and Republicans want to intimidate Democrats like me. They’ll fail.

Rep. Robert Garcia

MS NOW Opinion

Republicans are holding Americans’ health care hostage — and lying about it

Natasha Murphy

Indeed, Americans have some experience with this model: It’s the one that existed before the Affordable Care Act became law.

States created high-risk pools to cover people with expensive health care needs — those with preexisting conditions, for example — keeping them out of the patient pools with younger and healthier people. The high-risk pools, however, created dramatic problems for those who needed the most help: Americans with preexisting conditions were stuck with plans they couldn’t afford and benefits that didn’t meet their needs.

Obamacare fixed this problem to the benefit of millions, with shared risk and guaranteed protections for those with preexisting conditions. The one idea a congressional Republican leader has been willing to publicly endorse is an idea that would roll back the clock.

Politico reported this week, “House committee chairs will begin having listening sessions next week with groups of Republican members on health care policy and the fate of expiring Obamacare subsidies.” Or put another way, more than 16 years after GOP officials vowed to unveil a health care plan, the party is organizing “listening sessions” to kick around some thoughts, no doubt reviewing Johnson’s “notebooks full of ideas.”

For those facing soaring coverage costs, it’s tough to be optimistic.

This post updates our related earlier coverage.