A variety of factors led to the recent 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.
The good news is, the shutdown is over. The bad news is, 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.
Though there is no official Republican position on a possible solution, many GOP officials agree that doing nothing isn’t a tenable approach.
It therefore falls on the Trump White House to do something it doesn’t want to do: Take the lead on health care policy.
At a public event last week, JD Vance offered a curious boast on the issue. “I think that we have a great health care plan coming together,” the vice president said while failing to elaborate or offer any details.
Three days later, MS NOW reported that Donald Trump was poised to announce “a general framework to address health care costs,” which would include calling on Congress to send a bill to his desk that would halt ACA premium spikes. The rollout, described as imminent, would include a White House event featuring public remarks from the president and Mehmet Oz, who currently leads the Centers for Medicare and Medicaid Services.
But as Monday progressed, the plans were suddenly scrapped, and it’s worth appreciating why. MS NOW reported that the White House agreed to “delay” a planned announcement on a proposal to extend ACA subsidies “after congressional Republicans pushed back against the president’s sudden embrace of the expiring subsidies.” The report quoted one unnamed GOP lawmaker:
‘I wasn’t expecting the proposal to be Obamacare-lite,’ said a conservative House Republican, who requested anonymity to discuss the yet-to-be-released plan. ‘Absolutely not supportive of extending ACA subsidies. … I’ve talked to enough [Republicans] to know that people weren’t expecting this and aren’t happy about it,’ the lawmaker added. ‘I don’t see how a proposal like this has any chance of getting majority Republican support. We need to be focused on health care, but extending Obamacare isn’t even serious.’ It’s important to define some of the relevant terms here. There’s been ample chatter in recent weeks about the White House unveiling a health care “plan,” but there’s nothing to suggest that Trump and his team were crafting a comprehensive proposal to replace the Affordable Care Act. That kind of sweeping blueprint, which the president has been promising — and failing — to deliver for many years, will almost certainly never materialize. Rather, in this instance, we’re talking about a far narrower and more focused “plan” only to address dramatic price hikes that American consumers are poised to face over the coming weeks. Trump, already struggling with woeful approval ratings, doesn’t want to be on the hook for this affordability disaster, so he was prepared to pitch extending existing ACA subsidies — right up until his congressional allies, many of whom have voted to repeal Obamacare several dozen times, told him they’re unwilling to take such a step. The broader circumstances are certainly familiar. Indeed, Republicans have been trying to come together on health care policy for many years, only to repeatedly come apart. But in 2025, their divisions and lack of direction are poised to lead to real adverse consequences for millions of families across the country. Watch this space.
Steve Benen is a producer for "The Rachel Maddow Show," the editor of MaddowBlog and an MS NOW political contributor. He's also the bestselling author of "Ministry of Truth: Democracy, Reality, and the Republicans' War on the Recent Past."
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