healthcare

WASHINGTON – In the moments after the Supreme Court’s landmark healthcare ruling, Capitol Hill was unnervingly quiet as legislators took time to absorb the ruling. The silence did not last long.

Senate Majority Leader Harry Reid (D-Nev.) headed to the Senate floor to mark the milestone.

“Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every person in America, regardless of where they live, how much money they make,” Reid said. “I’m happy and I’m pleased the Supreme Court put the rule of law ahead of partisanship.”

House Speaker John A. Boehner(R-Ohio) – and tea party groups — vowed to press forward on efforts to repeal the law.

“Today’s ruling underscores the urgency of repealing this harmful law in its entirety,” Boehner said. “Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country Obamacare.”

Republicans and their allies in this battle said the court ruling underscores the urgency of electing more conservatives to Congress to repeal the law.

“We are focused on taking control of the Senate, reinforcing our 2010 gains in the House, and defeating President Obama,” said Amy Kremer, chairman of Tea Party Express. “These key objectives will open the door for a wave of new conservatives in Washington who are committed to repealing Obamacare.”

Rep. Michelle Bachmann (R-Minn.), the chairwoman of the Tea Party Caucus in the House, said: “Today’s Supreme Court decision raises the stakes for the coming months.”

House lawmakers from both parties had been meeting – separately – on Thursday morning behind closed doors before the decision became public. Boehner was expected to be reiterating to members not to “spike the ball” in the event of a favorable ruling. Both parties said they expect the fight to continue both in Congress and on the campaign trail.

“Our struggle isn’t over,’’ said Rep. Lynn Woolsey (D-Petaluma), expecting congressional Republicans to continue to try to dismantle the law “piece by piece.’’

As the court’s decision became known – and initial television reports gave confusing accounts of the outcome — one congressman, Rep. Brian Bilbray (R-San Diego), was the among the first out with a statement: “In the wake of the Supreme Court declaring the ‘individual mandate’ portion of the Affordable Care Act unconstitutional, it is questionable as to whether the rest of the bill can stand,” he said.

Fifteen minutes later his office sent out an “updated” release: “Simply put, we cannot afford the president’s health care plan.”

Some Democrats, though, just savored the moment.

“We’re just ecstatic,’’ Rep. Linda Sanchez (D-Lakewood) said. She was in a committee meeting, checking her iPad for word on the court ruling.

Rep. Nancy Pelosi (D-San Francisco), the minority leader – who had long predicted a 6-3 decision from the court – took her moment.

“This decision is a victory for the American people,” Pelosi said. “In passing health reform, we made history for our nation and progress for the American people.” Rep. Adam Schiff (D-Burbank) was also in a committee meeting when he got conflicting messages about the ruling.

“I rushed back to the office to watch the coverage with staff,’’ he said. “Along the way, I could hear hoots and hollers from various congressional offices as the staff of different members reacted with elation or upset. Needless-to-say, we were on the elated side.”

He said was pleased by the ruling but said he also was pleased for another reason: “The court was at risk of becoming yet another partisan institution if it threw out decades of precedent. The chief justice chose a different legacy, and this was not only the correct legal decision, it was also enormously important to maintaining the independence and reputation of the court.”

Rep. Paul Broun (R-Ga.) called it a “sad day for liberty.’’

“The court’s misguided decision is an attack on freedom, an insult to our Constitution, and it will ultimately destroy the best healthcare system in the world,’’ he said. “Chief Justice Roberts once said that the Supreme Court’s job is to apply the law – ‘to call balls and strikes, not to pitch or bat.’ He couldn’t have been more right in saying so, and he couldn’t have been more wrong by choosing to circumvent the Constitution this morning. Even worse, I fear that the high court has opened Pandora’s box by blatantly disregarding the law, and there will no longer be any real limits to what the federal government will be able to force the American people to do.’’

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When Mariam* first started thinking of deserting Boko Haram’s settlement at Sambisa Forest, where she had been living for a decade, she was not entirely sure that it was the best idea. She still believed in the cause, for starters. But there was the matter of her body starting to fail her. 

Her husband had just died of HIV/AIDS, and she had unfortunately contracted the disease from him before he passed. Although the doctor in the forest tried to provide her with medication, it was not consistent. In addition, she had kids she feared infecting. Then, she started to hear that access to antiretroviral drugs was free in Maiduguri, the Borno State capital in northeastern Nigeria. So, she began to tinker with the idea, for the first time, of leaving the group behind. 

The group was all she had known for the past decade. She had even been prepared, at some point, to give her life for the cause by volunteering for a suicide bombing. She had been approved for it and had begun to undergo training and preparations when she realised she was pregnant. Her husband, previously supportive of what they collectively thought of as her noble martyrdom, then decided she could not blow herself up while carrying their child. She was heavily disappointed. That’s how far she was willing to go for the Boko Haram cause.

And so to leave it all behind seemed impossible. 

She had joined when the group first declared war on the Nigerian state over a decade ago, leaving state-controlled territories for the Sambisa Forest. They sought to establish what they believed to be an Islamic state, declaring formal education, democracy, and elections forbidden. Their campaign has killed over 35,000 people violently, displaced over two million others, and caused over 25,000 others to go missing. Mariam had been attending their sermons right from the early, non-violent days. 

Eventually, after nearly a decade, she left with her children in 2017. Since coming back to Maiduguri, she has had uninterrupted access to free medications for her condition, reducing her viral load and making her no longer infectious. And so, even though she considered the economic prospects and living conditions in Maiduguri to be worse than in Sambisa, she stayed because she could remain alive.

She keeps the truth of her condition from her children and everyone she knows. 

Earlier this year, however, the United States President Donald Trump announced the suspension of USAID, which was primarily responsible for the accessibility of antiretroviral drugs for people like Mariam. Without the USAID subsidy, the drugs are estimated to be unaffordably expensive for low-income earners like Mariam.

Word started to go around that the availability of the drugs would falter. When Mariam ran out of her six-month stash of medications, she returned to the Borno State Specialist Hospital to get a refill, as she has done for years now. There, she met a surprise that scared her. 

“They only gave me one small can of pills, not the usual two. They seemed to have changed the ratio. They didn’t say why, only that they had changed the ratio. The bottle will only last me three months,” she recounted.

It worried her. When she got home from the hospital, she poured the pills into a thin white plastic bag and hid it, as usual. That way, it is inconspicuous, and anyone who knew the kind of bottles the drugs came in would not be able to recognise hers. This is so that she would avoid stigma.

“Nobody knows I have HIV to date. Even my children. And they are HIV-free. I had them tested at the hospital. Even the eldest among them doesn’t know.”

Around the same time, NGO-run health facilities were also starting to shut down in many rural communities in Borno. For example, in Konduga, a primary healthcare centre run by Family Health International (FHI360) was shut down. The facility had been receiving hundreds of patients daily until its abrupt suspension, leaving many in need and others unemployed. 

For Mariam, this has made her begin to consider going back to the terror group, especially after she lost everything during the tragic Maiduguri floods last year. She and her children barely escaped with their lives. The flood had swept through Maiduguri and neighbouring areas, affecting over one million people in total. Her daughter had initially been swept away until a neighbour dove into the waves and rescued her.

“It was a young man who came to help. I was at the verge of diving into the water myself when he came and said not to worry, that he would get her back, and he did. We could not salvage anything else from the flood. We were displaced to the Bakassi IDP camp.” 

When Mariam ran out of the three-month stash and went back to the hospital for a refill, she was only handed a one-month stash this time. The two times she has gone back for more refills after she had exhausted each, she only received one month’s stash, further scaring her.

Though she is no longer as committed to the Boko Haram ideology as she used to be, the realisation that she and her children’s lives are not safe has made her seriously reconsider the prospect of returning

A medical doctor working in Borno State, who pleaded anonymity, confirmed that the drugs had become difficult to access after the USAID suspension. “Patients who showed up at the hospitals were being told that the drugs were not available,” the doctor told HumAngle. “But if you knew your way around and gave some pharmacists some money, they would then give you the drugs, but keep in mind that the drugs are meant to be free. The situation has mildly improved.”

The availability of healthcare among terror groups is traceable to many sources. They are notorious for abducting healthcare workers and forcing them to work for them. But they also took medical training very seriously during the early days when the group first started to tactically come together over a decade ago, according to a former member of the group. 

Now, as many people are coming back to state-controlled territories, the rewards for recidivism have reportedly become higher, as the groups struggle to maintain their followers. Mariam hears these whispers from many of her associates.

“In addition to the drugs they were giving me in Sambisa, they would also give me a litre of honey and some black seed,” she said, adding that the honey and black seed were to help build her immune system.

In northwestern Nigeria, children who escaped or were rescued from terror groups have reported similar experiences. Some boys told HumAngle in an investigation that they joined the groups for things like food and healthcare. They said these were some of the incentives that made staying easy, and why they were not so keen on returning to state-controlled territories.

“I collected the last batch exactly a week ago today,” Mariam said of her access to the drugs. “The flow has never stopped. They always give me on schedule; it is just that I now only get one-month refills.” 

“The life over there is way better,” she said of Sambisa. “If I were there, I would have received a lot of support, especially with my husband dead. Here, who will help me? Everyone is focused on themselves. There is peace of mind there.”

When asked how there could be peace of mind there, with the threat of military bombardment ever present, she said the military would not harm women and children, and so she still would have been safe. “They will only ‘rescue’ us and bring us back to Borno… Even recently, I said to myself that life over there would be better for me. There were so many things weighing down on me at that time. It was even before the flood.”

On whether her children’s lives would be better in Maiduguri, she said it would only be so if her children had access to formal education here, which they don’t. Now, they spend all their time either at home with her or roaming the streets.

When we first spoke in June 2023, she had told me that her children were opposed to the Nigerian army and would throw rocks at them on the road, chanting war songs. When I asked her if things had improved now, she said yes.

“They don’t do that anymore,” she laughed. “They have forgotten. They don’t even want to hear anything related to Boko Haram anymore.”

If she could make an appeal for help to the government, it would be for three things. “Healthcare, school for my children, and a means of livelihood.”

This work was produced as a result of a grant provided by the Wits Centre for Journalism’s African Investigative Journalism Conference.

*Mariam is a pseudonym used to protect her anonymity. 

WASHINGTON — Republicans won a significant political victory this month when moderate Senate Democrats joined them to end the longest government shutdown in U.S. history, relenting from a showdown over the rising costs of healthcare.

But the fight is already back on, with mere weeks to spare before the Trump administration faces a potential uproar from the public over the expiration of Affordable Care Act tax credits on New Year’s Day, when premium costs will skyrocket.

The fast-approaching deadline, coupled with stinging defeats in elections earlier this month driven by voter concerns over affordability, has prompted a series of crisis meetings in the West Wing over a path forward on Capitol Hill.

The White House response that emerged this week is a political Hail Mary for an increasingly divided party entering an election year: a second megabill, deploying the parliamentary tool of reconciliation, addressing not just healthcare costs but Trump’s tariff policies under intense scrutiny at the Supreme Court.

“We’re going to have the healthcare conversation. We’re going to put some legislation forward,” White House Deputy Chief of Staff James Blair said Tuesday, addressing a breakfast event hosted by Bloomberg Government, as House Republican leaders pitched the plan to their members in a closed-door meeting.

“The president probably would like to go bigger than the Hill has the appetite for,” Blair added, “so we’ll have to see how that, you know, works out.”

New plan, last minute

House Majority Leader Steve Scalise presented the plan to skeptical Republican lawmakers on Tuesday, arguing an extension of tax credits for what he called the “Unaffordable Care Act” — even if they are renegotiated on Republican terms — would only mask the problem of rising premium costs, ultimately burdening the taxpayer.

Trump sent a message to the caucus ahead of their meeting on Tuesday morning with a post on Truth Social, emphatic in all caps.

“THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH,” Trump wrote. “THE PEOPLE WILL BE ALLOWED TO NEGOTIATE AND BUY THEIR OWN, MUCH BETTER, INSURANCE. POWER TO THE PEOPLE!”

“Congress, do not waste your time and energy on anything else,” Trump added. “This is the only way to have great Healthcare in America!!! GET IT DONE, NOW.”

Yet the plan is causing anxiety across a wide ideological range of Republican lawmakers, including moderates in vulnerable races entering next year’s midterm elections as well as those from deep red districts whose constituents rely on the Affordable Care Act, more widely known as Obamacare.

Nearly six in 10 Americans who use the ACA marketplace live in Republican districts, according to the Kaiser Family Foundation. Enrollment is highest across the South, where districts across Texas, Mississippi, Georgia, South Carolina and Florida consistently see more than 10% of their residents relying on the program.

Going for broke with reconciliation

Trump’s proposal would do away with the tax credits, potentially overhauling health savings accounts that would encourage Americans to save on their own and choose their healthcare plan.

But it’s unclear whether such a dramatic, last-minute change in the healthcare system, still in draft form, would garner enough Republican support to pass the House, where Speaker Mike Johnson (R-La.) can only afford to lose two Republicans on party-line votes.

The bill would come in a perilous political environment for Republican lawmakers, who one year ago faced a tie with Democrats on a generic ballot, according to an NPR/PBS News/Marist poll. In the group’s latest poll, Democrats are up by 14 points.

Even if Trump’s proposal were to secure House support, the Trump administration’s plan to pursue a bill through reconciliation in the Senate — which allows the upper chamber to pass legislation with a simple majority, instead of 60 votes — could face significant hurdles.

Senate parliamentary rules only allow reconciliation to be used for legislation that directly changes federal spending, revenues, or the debt limit. That could encompass an overhaul to health savings accounts, and potentially to codify Trump’s tariff policies, which have been approved through reconciliation in years past. But the fine print would be up to the discretion of the parliamentarian, whose cuts to tangential policy provisions could upend delicate negotiations.

Reconciliation was used in Trump’s last major push to repeal Obamacare, in 2017, when the late Sen. John McCain (R-Az.) surprised the nation with a thumbs-down vote on the measure.

That bill, McCain argued, would have repealed the healthcare of millions without a plan to replace it.

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More to come,
Michael Wilner
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WASHINGTON — Now that the government shutdown is over, House and Senate Republicans say they will negotiate with Democrats on whether to extend COVID-era tax credits that help tens of millions of Americans afford their healthcare premiums. But finding bipartisan agreement could be difficult, if not impossible, before the subsidies expire at the end of the year.

The shutdown ended this week after a small group of Democrats made a deal with Republicans senators who promised a vote by mid-December on extending the Affordable Care Act subsidies. But there is no guaranteed outcome, and many Republicans have made clear they want the credits to expire.

House Speaker Mike Johnson (R-La.) called the subsidies a “boondoggle” immediately after the House voted Wednesday to end the shutdown, and President Trump said the Obama-era healthcare overhaul was “disaster” as he signed the reopening bill into law.

It is far from the outcome that Democrats had hoped for as they kept the government closed for 43 days, demanding that Republicans negotiate with them on an extension before premiums sharply increase. But they say they will try again as the expiration date approaches.

“It remains to be seen if they are serious,” said House Democratic leader Hakeem Jeffries of New York. But he said Democrats “are just getting started.”

Republicans have been meeting privately to discuss the issue. Some want to extend the subsidies, with changes, to avoid the widespread increases in premiums. Others, like Johnson and Trump, want to start a new conversation about overhauling “Obamacare” entirely — a redo after a similar effort in 2017 failed.

Democrats push for extension

Healthcare has long been one of the most difficult issues on Capitol Hill, marked by deep ideological and political divides. Partisan disagreement over the 2010 law has persisted for more than a decade, and relationships are already strained from weeks of partisan tensions over the shutdown.

Connecticut Rep. Rosa DeLauro, the top Democrat on the House Appropriations Committee, said that while Republicans have promised negotiations and a Senate vote, Democrats are wary. She noted that Johnson has not committed to anything in the House.

“Do I trust any of them? Hell no,” DeLauro said.

If the two sides cannot agree, as many as 24 million people who get their healthcare from the exchanges created by the law could see their premiums go up Jan. 1. New Hampshire Sen. Jeanne Shaheen, one of the Democrats who struck a deal with Senate Majority Leader John Thune (R-S.D.) to reopen the government, said she thinks an agreement on the tax credits is possible.

During the talks that led to the shutdown’s end, Shaheen said she and other moderate Democrats sat across from Thune and “looked him eye to eye” as he committed to a serious effort.

“We’re going to have a chance to vote on a bill that we will write by mid-December, in a way that gives us a chance to build — hopefully build — bipartisan support to get that through,” Shaheen said.

While Democrats would like to see a permanent extension of the tax credits, most realize that is unlikely. Just before the shutdown ended, Senate Democratic leader Chuck Schumer of New York proposed a one-year extension and a bipartisan committee to address Republican demands for changes to the Affordable Care Act. But Thune said that was a “nonstarter” as the government remained shut down.

In the House, Democrats have proposed a three-year extension.

What Republicans want

While Republicans have long sought to scrap Obamacare, they have had challenges over the years in figuring out what would replace it. That problem plagued the 2017 effort, when then-Sen. John McCain (R-Ariz.) cast the deciding vote to kill a bill on the Senate floor that was short on detail.

Republican Sen. Bill Cassidy of Louisiana, chairman of the Senate Health Education Labor and Pensions Committee, and Sen. Rick Scott (R-Fla.) have proposed overhauling the law to create accounts that would direct the money to individuals instead of insurance companies. Those are ideas that Trump echoed as he signed the funding bill Wednesday evening.

“I want the money to go directly to you, the people,” Trump said.

It is unclear exactly how that would work, and scrapping the law in its current form would take months, if not years, to negotiate, even if Republicans could find the votes to do it.

Slow start to negotiations

Some moderate Republicans in the House have said they want to work with Democrats to extend the subsidies before the deadline, which is only weeks away. In a letter to Thune and Schumer on Wednesday, Pennsylvania Rep. Brian Fitzpatrick, the Republican co-chair of the Bipartisan Problem Solvers Caucus, encouraged negotiations.

“Our sense of urgency cannot be greater,” Fitzpatrick wrote. “Our willingness to cooperate has no limits.”

So far, though, Senate Republicans have been meeting on their own to figure out their own differences.

“Right now, it’s just getting consensus among ourselves,” Sen. Thom Tillis (R-N.C.) said Monday after GOP members of the Senate Finance Committee met to discuss possible ways forward.

Tillis is supportive of extending the tax credits, but said lawmakers also need to find a way to reduce costs. If the two sides cannot eventually agree, Tillis said, Republicans may have to try to figure out a way to do it on their own, potentially using budget maneuvers that enabled them to pass Trump’s “Big Beautiful Bill” this summer without any Democratic votes.

“We should have that in our back pocket too,” Tillis said.

Another shutdown?

Some House Democrats have raised the possibility that there could be another shutdown if they are unable to win concessions on healthcare. The bill signed by Trump will fully fund some parts of the government, but others run out of money again at the end of January if Congress does not act.

“I think it depends on the vulnerable House Republicans who are not going to be able to go back to their constituents without telling them that they’ve done something on healthcare,” said Rep. Pramila Jayapal (D-Wash.).

“We’ll just have to see” if there could be another shutdown, said Rep. Mark Takano (D-Riverside).

Rep. Jim McGovern (D-Mass.) said he is “not going to vote to endorse their cruelty” if Republicans do not extend the subsidies.

DeLauro said that Republicans have wanted to repeal the ACA since it was first enacted. “That’s where they’re trying to go,” she said.

“When it comes to Jan. 30 we’ll see what progress has been made,” she said.

Jalonick writes for the Associated Press.

Nov. 11 (UPI) — Senate Republicans have signaled that they are willing to negotiate with Democrats on healthcare subsidies, but are demanding tighter abortion rules on insurance plans.

Senate Republican Leader John Thune described his party’s negotiating position to reporters before the chamber passed a bill on Monday to reopen the government, according to NBC News. Thune’s remarks set the stage for the next partisan fight over expiring health care subsidies that were at the center of the longest government shutdown on record.

Sen. Ron Wyden, D-Ore., sharply criticized the Republican proposal in a floor speech Saturday, calling it “a backdoor national abortion ban.”

“Democrats must dismiss this radical Trojan horse against women’s essential healthcare out of hand,” he said.

Senate Democrats earlier demanded that an extension of pandemic-era enhanced subsidies be included in any government-funding bill. That demand was left out of a funding bill that passed the Senate on Monday and is expected to pass the House.

With no extension of the subsidies in place, individuals who purchase health insurance through Affordable Care Act marketplaces will see steep premium rises — some by thousands of dollars a month — beginning next year.

Republicans have expressed a willingness to negotiate on the enhanced subsidies, but Thune said that in exchange for an extension of the subsidies, Republicans will ask for more stringent enforcement of longstanding restrictions on federal funding being used for abortion, known as the Hyde Amendment.

“A one-year extension along the lines of what [Democrats] are suggesting, and without Hyde protections — doesn’t even get close,” Thune said, according to NBC News.

Wyden said in his floor speech that the Affordable Care Act, also known as Obamacare, already bars the use of taxpayer money for abortions.

However, Republicans want to block states from allowing people to access abortions through the Affordable Care Act marketplaces using state or other funding, NBC News reported.

Sen. Mike Rounds, R-S.D., has indicated he’s open to extending the subsidies, but said Republicans won’t support it without the abortion restrictions.

WASHINGTON — A deal that could end the longest government shutdown in U.S. history is poised to head to the House, where Democrats are launching a last-ditch effort to block a spending agreement reached in the Senate that does not address healthcare costs.

The push comes as Speaker Mike Johnson (R-La.) urged House members on Monday to start making their way back to Washington in anticipation of the chamber voting on a spending package later in the week. The Senate began taking a series of votes Monday night, a day after Senate Republicans reached a deal with eight senators who caucus with Democrats.

The spending plan, which does not include an extension of the Affordable Care Act subsidies that are set to expire at the end of the year, has frustrated many Democrats who spent seven weeks pressuring Republicans to extend the tax credits. It would, however, fund the government through January, reinstate federal workers who were laid off during the shutdown and ensure that federal employees who were furloughed receive back pay.

Senate Majority Leader John Thune (R-S.D.) also promised senators a vote in December that would put lawmakers on record on the healthcare subsidies. Thune said in a speech Monday that he was “grateful that the end is in sight” with the compromise.

“The American people have suffered long enough,” he said. “Let’s not pointlessly drag this bill out. Let’s get it done, get it over to the House so we can get this government open.”

Senate Democrats who defected have argued that a vote is the best deal they could get as the minority party, and that forcing vulnerable Republicans in the chamber to vote on the issue will help them win ahead of next year’s midterm elections.

As the Senate prepared to vote on the deal Monday, Sen. Chuck Schumer of New York, the Democratic leader of the chamber, continued to reiterate his opposition to what he called a “Republican bill.” Schumer, who has faced backlash from Democrats for losing members of his caucus, said the bill “fails to do anything of substance to fix America’s healthcare crisis.”

House Minority Leader Hakeem Jeffries (D-N.Y.) speaks to reporters about the government shutdown.

(Mariam Zuhaib / Associated Press)

Thune’s promise to allow a vote in the Senate does not guarantee a favorable outcome for Democrats, who would need to secure Republican votes for passage through the chamber. And the chance to address healthcare costs will be made even harder by Johnson, who has not committed to holding a vote on his chamber in the future.

“I’m not promising anybody anything,” he said. “I’m going to let the process play out.”

House Minority Leader Hakeem Jeffries (D-N.Y.), meanwhile, told reporters that House Democrats will continue to make the case that extending the subsidies is what Americans are demanding from elected officials, and that there is still a fight to be waged in the chamber — even if it is a long shot.

“What we are going to continue to do as House Democrats is to partner with our allies throughout America is to wage the fight, to stay in the Colosseum,” Jeffries said at a news conference.

Some Republicans have agreed with Democrats during the shutdown that healthcare costs need to be addressed, but it is unlikely that House Democrats will be able to build enough bipartisan support to block the deal in the chamber.

Still, Jeffries said the “loudmouths” in the Republican Party who want to do something about healthcare costs have an opportunity to act now that the House is expected to be back in session.

“They can no longer hide. They can no longer hide,” Jeffries said. “They are not going to be able to hide this week when they return from their vacation.”

Democrats believed that fighting for an extension of healthcare tax credits, even at the expense of shutting down the government, would highlight their messaging on affordability, a political platform that helped lead their party to victory in elections across the country last week.

If the tax credits are allowed to lapse at the end of the year, millions of Americans are expected to see their monthly premiums double.

In California, premiums for federally subsidized plans available through Covered California will soar by 97% on average next year.

Senate Majority Leader John Thune answers questions Monday about a possible end to the government shutdown after eight members of the Democratic caucus broke ranks and voted with Republicans.

(J. Scott Applewhite / Associated Press)

California’s U.S. senators, Adam Schiff and Alex Padilla, were among the Democrats who voted against the deal to reopen the government because it did not address healthcare costs.

“We owe our constituents better than this. We owe a resolution that makes it possible for them to afford healthcare,” Schiff said in a video Sunday night.

Some Republicans too have warned that their party faces backlash in the midterm elections next year if it doesn’t come up with a more comprehensive health plan.

“We have always been open to finding solutions to reduce the oppressive cost of healthcare under the unaffordable care act,” Johnson said Monday.

A final vote could still take several days. Republican Sen. Rand Paul of Kentucky, for one, has said he supports an expeditious vote to reopen the government, but is insisting on a prior vote on an amendment that would eliminate language from the spending deal he says would “unfairly target Kentucky’s hemp industry.”

Without unanimous consent to proceed, the final Senate vote could end up bogged down by procedural delays.

Johnson, meanwhile, has asked members to return by Wednesday in anticipation of a vote in the latter part of the week. Republicans expect to have the votes to pass it, Johnson said.

Any piece of legislation needs to be approved by both the Senate and House and be signed by the president.

Speaking to reporters in the Oval Office on Monday, President Trump said he would support the legislative deal to reopen the government.

“We’re going to be opening up our country,” Trump said. “Too bad it was closed, but we’ll be opening up our country very quickly.”

Trump added that he would abide by a provision that would require his administration to reinstate federal workers who were laid off during the shutdown.

“The deal is very good,” he said.

Johnson said he spoke to the president on Sunday night and described Trump as “very anxious” to reopen the government.

“It’s after 40 days of wandering in the wilderness, and making the American people suffer needlessly, that some Senate Democrats finally have stepped forward to end the pain,” Johnson said. “Our long national nightmare is finally coming to an end, and we’re grateful for that.”

SACRAMENTO — Antonio Villaraigosa, former Los Angeles mayor and current candidate for California governor, on Friday said he opposed the creation of a state-level single payer healthcare system.

Villaraigosa’s stance separated him from three rival Democrats who appeared on stage with him at a candidate forum at UC Riverside.

Candidates, who were asked about a single-payer healthcare system during a question-and-answer session that only involved raising their hands, did not provide explanations for their stances. But during earlier remarks, Villaraigosa had said he had no interest in selling “snake oil” solutions to voters on complex matters like healthcare.

The divide stood out because the four Democrats were otherwise closely aligned on prioritizing healthcare if elected in the 2026 race.

Aside from Villaraigosa, the candidates included: former state Controller Betty Yee, former U.S. Secretary of Health and Human Services Xavier Becerra and California Supt. of Public Instruction Tony Thurmond.

During the event, candidates were asked how they would approach a range of issues that impact an individual’s health, including aging, nutrition and mental illness.

The four contenders were largely on the same page, with all promising to work on removing barriers to care by expanding healthcare coverage and supporting programs that increase access to fresh food and mental health services. They all voiced support for creating pathways and incentives for students to study healthcare to help with industry staffing shortages.

Each also offered slightly different insights when asked a question about how to best support the “sandwich generation,” or those who are caring for both children and aging parents.

Becerra recalled how he and his siblings took turns caring for their aging father, which allowed him to spend his final years at home.

“There is nothing better because they are being cared for by those who love them,” Becerra said. “If I am governor, home care will be compensated.”

Yee said income tax credits could help and explained she would work with employers to improve employee leave options.

Thurmond said California should create a long-term care system for seniors similar to the system the state developed to help homeowners unable to access homeowners insurance.

The event was organized by Health Matters, a nonpartisan forum on health and equity that is organized by 11 health-focused foundations in California.