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Folks, who was supposed to be watching grandpa last night? Because he got out, got on TV and … It. Was. Not. Good.
For 18 long minutes Wednesday evening, we were subjected to a rant by President Trump that predictably careened from immigrants (bad) to jobs (good), rarely slowing down for reality. But jumbled between the vitriol and venom was a vision of American healthcare that would have horror villainess M3GAN shaking in her Mary Janes — a vision that we all should be afraid of because it would take us back to a dark era when insurance couldn’t be counted on.
Trump’s remarks offered only a sketchy outline, per usual, in which the costs of health insurance premiums may be lower — but it will be because the coverage is terrible. Yes, you’ll save money. But so what? A cheap car without wheels is not a deal.
“The money should go to the people,” Trump said of his sort-of plan.
The money he vaguely was alluding to is the government subsidies that make insurance under the Affordable Care Act affordable. After antics and a mini-rebellion by four Republicans also on Wednesday, Congress basically failed to do anything meaningful on healthcare — pretty much ensuring those subsidies will disappear with the New Year.
Starting in January, premiums for too many people are going to leap skyward without the subsidies, jumping by an average of $1,016 according to the health policy research group KFF.
That’s bad enough. But Trump would like to make it worse.
The Affordable Care Act is about much more than those subsidies. Before it took effect in 2014, insurance companies in many states could deny coverage for preexisting conditions. This didn’t have to be big-ticket stuff like cancer. A kid with asthma? A mom with colitis? Those were the kind of routine but chronic problems that prevented millions from obtaining insurance — and therefore care.
Obamacare required that policies sold on its exchange did not discriminate. In addition, the ACA required plans to limit out-of-pocket costs and end lifetime dollar caps, and provide a baseline of coverage that included essentials such as maternity care. Those standards put pressure on all plans to include more, even those offered through large employers.
Trump would like to undo much of that. He instead wants to fall back on the stunt he loves the most — send a check!
What he is suggesting by sending subsidy money directly to consumers also most likely would open the market to plans without the regulation of the ACA. So yes, small businesses or even groups of individuals might be able to band together to buy insurance, but there likely would be fewer rules about what — or whom — it has to cover.
Most people aren’t savvy or careful enough to understand the limitations of their insurance before it matters. So it has a $2-million lifetime cap? That sounds like a lot until your kid needs a treatment that eats through that in a couple of months. Then what?
Trump suggested people pay for it themselves, out of health savings accounts funded by that subsidy check sent directly to taxpayers. Because that definitely will work, and people won’t spend the money on groceries or rent, and what they do save certainly will cover any medical expenses.
“You’ll get much better healthcare at a much lower price,” Trump claimed Wednesday. “The only losers will be insurance companies that have gotten rich, and the Democrat Party, which is totally controlled by those same insurance companies. They will not be happy, but that’s OK with me because you, the people, are finally going to be getting great healthcare at a lower cost.”
He then bizarrely tried to blame the expiring subsidies on Democrats.
Democrats “are demanding those increases and it’s their fault,” he said. “It is not the Republicans’ fault. It’s the Democrats’ fault. It’s the Unaffordable Care Act, and everybody knew it.”
It seems like Trump just wants to lower costs at the expense of quality. Here’s where I take issue with the Democrats. I am not here to defend insurance companies or our healthcare system. Both clearly need reform.
But why are the Democrats failing to explain what “The money should go to the people” will mean?
I get that affordability is the message, and as someone who bought both a steak and a carton of milk this week, I understand just how powerful that issue is.
Still, everyone, Democrat or Republican, wants decent healthcare they can afford, and the peace of mind of knowing if something terrible happens, they will have access to help. There is no American who gladly would pay for insurance each month, no matter how low the premium, that is going to leave them without care when they or their loved ones need it most.
Grandpa Trump doesn’t have this worry, since he has the best healthcare our tax dollars can buy.
But when he promises to send a check instead of providing governance and regulation of one of the most critical purchases in our lives, the message is sickening: My victory in exchange for your well-being.
NEW YORK — For one Wisconsin couple, the loss of government-sponsored health subsidies next year means choosing a lower-quality insurance plan with a higher deductible. For a Michigan family, it means going without insurance altogether.
For a single mom in Nevada, the spiking costs mean fewer Christmas gifts this year. She is stretching her budget already while she waits to see if the Republican-led Congress will act.
Less than three weeks remain until the expiration of COVID-era enhanced tax credits that have helped millions of Americans pay their monthly fees for Affordable Care Act coverage for the last four years.
The Senate on Thursday rejected two proposals to address the problem, and an emerging healthcare package from House Republicans does not include an extension, all but guaranteeing that many Americans will see much higher insurance costs in 2026.
Here are a few of their stories.
Chad Bruns comes from a family of savers. That came in handy when the 58-year-old military veteran had to leave his firefighting career early because of arm and back injuries incurred on the job.
He and his wife, Kelley, 60, both retirees, cut their own firewood to reduce their electricity costs in their home in Sawyer County, Wis. They rarely eat out and say they buy groceries only when they are on sale.
But to the extent that they have always been frugal, they will be forced to be even more so now, Bruns said. That is because their coverage under the health law enacted under former President Obama is, because of congressional inaction, getting more expensive — and for worse coverage.
This year, the Brunses were paying $2 per month for a top-tier gold-level plan with less than a $4,000 deductible. Their income was low enough to help them qualify for a lot of financial assistance.
But in 2026, that same plan is rising to an unattainable $1,600 per month, forcing them to downgrade to a bronze plan with a $15,000 deductible.
Kelley Bruns said she is concerned that if something happens to their health in the next year, they could go bankrupt. While their monthly fees are low at about $25, their new out-of-pocket maximum at $21,000 amounts to nearly half their joint income.
“We have to pray that we don’t have to have surgery or don’t have to have some medical procedure done that we’re not aware of,” she said. “It would be very devastating.”
Dave Roof’s family of four has been on ACA insurance since the program started in 2014. Back then, the accessibility of insurance on the marketplace helped him feel comfortable taking the leap to start a small music production and performance company in his hometown of Grand Blanc, Mich. His wife, Kristin, is also self-employed as a top seller on Etsy.
Their coverage has worked for them so far, even when emergencies come up, such as an ATV accident their 21-year-old daughter had last year.
But now, with the expiration of Obamacare subsidies that kept their premiums down, the 53-year-old Roof said their $500-per-month insurance plan is jumping to at least $700 a month, along with spiking deductibles and out-of-pocket costs.
With their joint income of about $75,000 a year, that increase is not manageable, he said. So, they are planning to go without health insurance next year, paying cash for prescriptions, checkups and anything else that arises.
Roof said his family is already living cheaply and has not taken a vacation together since 2021. As it is, they do not save money or add it to their retirement accounts. So even though forgoing insurance is stressful, it is what they must do.
“The fear and anxiety that it’s going to put on my wife and I is really hard to measure,” Roof said. “But we can’t pay for what we can’t pay for.”
If you ask Katelin Provost, the American middle class has gone from experiencing a squeeze to a “full suffocation.”
The 37-year-old social worker in Henderson, Nev., counts herself in that category. As a single mom, she already keeps a tight budget to cover housing, groceries and daycare for her 4-year-old daughter.
Next year, that is going to be even tougher.
The monthly fee on her plan is going up from $85 to nearly $750. She decided she is going to pay that higher cost for January and reevaluate afterward, depending on whether lawmakers extend the subsidies, which as of now appears unlikely. She hopes they will.
If Congress does not act, she will drop herself off the health insurance and keep it only for her daughter because she cannot afford the higher fee for the two of them over the long term.
The strain of one month alone is enough to have an impact.
“I’m going to have to reprioritize the next couple of months to rebalance that budget,” Provost said. “Christmas will be much smaller.”
Swenson writes for the Associated Press.