{"id":210578,"date":"2025-09-08T16:03:12","date_gmt":"2025-09-08T16:03:12","guid":{"rendered":"https:\/\/www.europesays.com\/us\/210578\/"},"modified":"2025-09-08T16:03:12","modified_gmt":"2025-09-08T16:03:12","slug":"democrats-bet-briefly-preventing-a-health-insurance-apocalypse-is-good-politics","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/210578\/","title":{"rendered":"Democrats Bet Briefly Preventing a Health Insurance Apocalypse Is Good Politics"},"content":{"rendered":"

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<\/a> between weakness and fortitude.<\/p>\n

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\u2019t 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\u2019s going to pass.<\/p>\n

More from David Dayen<\/strong><\/a><\/p>\n

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 \u201cpocket rescission,\u201d 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.<\/p>\n

Once again, Democrats can decide whether to participate in this destruction of the nation\u2019s founding principles, or resist it. It\u2019s a rare point of leverage in a time when national policy is being run almost exclusively out of the Oval Office. I\u2019ve been skeptical<\/a> that Democrats have any real strategy for what to do. But a strategy is actually emerging.<\/p>\n

Reporting indicates<\/a> 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\u2019s so unpopular Republicans are already trying to rebrand it), but my guess would be that Republicans aren\u2019t interested in changing a bill they just passed two months ago; the extension of the ACA subsidies is likely to be the main ask.<\/p>\n

\n

Passing a stopgap spending bill would give Trump the ability to once again subvert the federal budget process, without guarantees that he\u2019ll follow through on whatever gets passed.<\/p>\n

\n<\/p><\/blockquote>\n

Some Republicans have been open to extending those subsidies. Senate Majority Leader John Thune (R-SD) called it<\/a> a topic his members were \u201cpaying attention to,\u201d 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<\/a> for those who will lose the enhanced subsidies. That\u2019s on top of a projected increase in the raw cost of insurance; companies have proposed premium hikes of 18 percent<\/a> this year. Unless action is taken, it will be an enormous example of Trump\u2019s 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<\/a>.<\/p>\n

But there is tension within the Republican ranks over expanding a program they have tried to repeal dozens of times, to say nothing of the massive cuts they made just months ago in exchange for giant tax cuts for the wealthy.<\/p>\n

There is a bill called the Premium Tax Credit Extension Act<\/a>, issued by frontline Democrats and Republicans who want to deliver a victory to their voters in swing seats. The PTCEA would extend the subsidies for one year. Democrats have proposed their own bill<\/a> to make the subsidies permanent.<\/p>\n

Senate Democrats are backing some form of extension<\/a> as the only way to get their votes on a spending package. Senate Minority Leader Chuck Schumer (D-NY) is trying to add some pressure by encouraging insurance companies<\/a> to explain the consequences of the subsidies expiring. Hospitals are also on the side of keeping the subsidies in place, and are in fact optimistic that it will happen<\/a>.<\/p>\n

Participating in government funding in exchange for a short-term extension would, in a word, be madness. Republicans want both to pass a budget and to avoid the heat for the crumbling of American health care; in this trade they would get both!\u00a0<\/p>\n

Even if the extension were permanent, it brings up a strategic question that can be answered in multiple different ways. On the one hand, Democrats fighting for health care benefits speaks to an issue where they have the highest level of support from the public. They would credibly be able to tell voters that they fought for lower costs during an affordability crisis and won, and that more of that will happen if they are given power in the midterms.<\/p>\n

On the other hand, Republicans willingly drove the health care system toward the point of oblivion, and some may question why Democrats would offer a lifeline to bail them out. In this reading, relieving Republicans of the consequences of their health care plans would be harmful to Democratic midterm chances; Trump would take credit for keeping health care costs low. This is writer and TAP alum Josh Marshall\u2019s position<\/a>.<\/p>\n

Plus, by passing a stopgap spending bill, Democrats would be giving Trump the ability to once again subvert the federal budget process, without guarantees that he\u2019ll follow through on whatever gets passed. Democrats are asking for assurances, but they may fall short of being ironclad. Some would argue that even participating in the budget process implicitly justifies Trump\u2019s lawlessness, and that only after the president ended those actions could negotiations possibly begin. As Bill Scher writes<\/a>, Democrats \u201ccannot exercise joint responsibility if Republicans not only won\u2019t keep bipartisan agreements but are openly dismissive of them.\u201d<\/p>\n

This question is mainly an extension of the \u201ccollaborate or fight\u201d decision Democrats weighed in March. Fighting does mean fighting for something, and Democrats appear to have landed on that something being short-term relief on health care.<\/p>\n

But, as noted above, it is quite likely that there won\u2019t be sufficient Republican votes in Congress, or support from Trump, to preserve ACA subsidies. The real issue, therefore, is whether Democrats are willing to see a shutdown battle through to its conclusion. I think at some level Democrats know that Trump isn\u2019t very likely to come to the table around a bipartisan negotiation; it has not been his posture whatsoever in the second term.<\/p>\n

So this really comes down to whether Democrats actually believe they can win a shutdown fight politically\u2014or have the stomach for it. That\u2019s a little curious, since Democrats have won every shutdown fight of the past 30 years, whether they were the party in power or out of power. Under Clinton, Republicans were blamed; under Obama, Republicans were blamed; under Trump, in his first term, Trump was blamed. And Democrats got favorable outcomes in the aftermath.<\/p>\n

But Democrats have this burning desire to be the responsible party, and in their minds, shutdowns are irresponsible. There are also a lot of theories of how Trump could run roughshod over the bureaucracy if funding is cut off, though I don\u2019t know how you could even entertain such a threat given his trampling of federal agencies since January 20. What would be any more punitive toward the civil service after a shutdown, relative to before?<\/p>\n

The thing about a strategy is you should probably know your next moves before you have to play them. It\u2019s natural to not have a lot of faith in the Democratic leadership at this point. Demanding to prevent a health care disaster is a fine ask. But what happens when Republicans say no?<\/p>\n","protected":false},"excerpt":{"rendered":"In March, Democrats faced a decision: shut down the government over the litany of lawless actions and usurped…\n","protected":false},"author":3,"featured_media":210579,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[7023,18007,3232,327,92188,7033,69,2142,210,1227,1141,3168,1142,3170,80,5620,67,132,68],"class_list":{"0":"post-210578","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-affordable-care-act","9":"tag-big-beautiful-bill","10":"tag-budget","11":"tag-congress","12":"tag-david-dayen","13":"tag-democrats","14":"tag-donald-trump","15":"tag-federal-government","16":"tag-health","17":"tag-health-social-policy","18":"tag-health-care","19":"tag-health-insurance","20":"tag-healthcare","21":"tag-medicaid","22":"tag-politics","23":"tag-republicans","24":"tag-united-states","25":"tag-unitedstates","26":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115169525928482836","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/210578","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=210578"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/210578\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/210579"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=210578"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=210578"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=210578"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}