The following is a lightly edited transcript of the November 26 episode of the Daily Blast podcast. Listen to it here.
Greg Sargent: This is The Daily Blast from The New Republic, produced and presented by the DSR Network. I’m your host, Greg Sargent.
Earlier this week, the White House leaked word that President Trump would soon announce a plan to extend Affordable Care Act subsidies for some of the millions of people who stand to lose them when they expire. But that plan is now on ice after House Speaker Mike Johnson and Republicans let it be known that it’s a non-starter. All this comes as new reporting indicates that House Republicans are seriously panicking about the midterm elections. And Trump is really ramping up his efforts to rig the midterms, exploding at Republicans who won’t gerrymander their state’s House seats, obviously aware that his party is in trouble. Yet if there’s one thing that might help the GOP midterm hopes, it’s preventing those ACA subsidies from expiring. But they won’t do this. New Republic staff writer Monica Potts has a good new piece digging into the really bizarre disconnect here. So we’re talking to her about what all of it means. Monica, nice to have you on.
Monica Potts: Thanks for having me.
Sargent: So the White House had let word be known that Trump wants to extend the ACA subsidies for two years with some income caps limiting how many people would qualify to win over conservatives. Over 20 million people get these subsidies, and many are set to see huge premium increases or get knocked off health coverage entirely. So you’d think Republicans would want to find a way out of this, but that’s not what’s happening. Monica, can you tell us what is happening?
Potts: Right. Well, what’s happening is what’s been happening all year so far, which is the reason the Democrats wouldn’t agree to the continuing resolution that didn’t extend health care subsidies. So under some of the Covid emergency acts, the subsidies for Affordable Care Act insurance that people purchase on health care marketplaces in their states was enhanced. So it gave more money to the people who qualified for it. It increased the people who do qualify for subsidies to some degree. And so it made it easier for people to buy subsidies because health care had gotten too expensive. People were trying to buy health care and they couldn’t afford it. And so this helped them out a little bit. And it really worked, because it increased the uptake. We had the lowest uninsured rate in the history of the United States in 2023.
Sargent: That’s good, right?
Potts: That’s good. Yeah.
Sargent: Not to Republicans.
Potts: Not to Republicans. It was good. It was the point of the Affordable Care Act was to get as many people in this country insured as possible to move us toward universal health care. And Republicans let those enhanced subsidies expire.
And what’s happened as a result of that is that insurers have increased their premium rates. So right now, as we speak, people who buy health care on the insurance marketplaces are looking at the costs for next year, and they’re seeing premiums for the same plans go up. Some people are seeing really dramatic increases. There are still subsidies, but they’re just slightly less generous. They cover slightly fewer people.
And so people are really struggling to think about affording health care next year. For some people, it’s an increase of $100, and that’s more than they can afford. For other people, it’s increases of thousands of dollars for their family coverage. And some people are deciding to opt out and not buy insurance. And every day that passes, more and more Americans are looking at the exchanges, deciding whether or not they can afford health care, and they’re panicking and they’re probably calling their representatives.
Sargent: Yeah. And this comes as people are getting really badly squeezed by prices on other fronts. It’s like a real terrible situation that a lot of households across the country, including many in Trump country, including a whole lot of Trump voters, are getting kind of clobbered by. A big part of the Trump base gets hit by this as well, don’t they? What kind of numbers are we talking about?
Potts: It varies from state to state. I think in Wyoming, they’re seeing some of the highest increases in the country. On average, it’s about 26 percent higher than next year. And like I said, some people will still qualify for subsidies. But the issue is that if some people opt out of buying insurance, the people who tend to opt out are healthier. They are younger, they’re healthier, they don’t have any health issues, and they think, ‘I can go without insurance.’ And that means that the people who do buy insurance, the people who are left who can’t make that decision, often tend to be sicker; they have some kind of chronic issue, and they cost the system more. And that’s why premiums are rising, and it could lead to what some people call a death spiral that just makes premium costs higher and higher. The higher they get, the more people decide to drop out. The more people left on insurance are sicker and sicker. And this was the problem that the Affordable Care Act was meant to solve.
Sargent: And it was making great strides toward solving it. And this was a real serious policy advance. It was a major progressive improvement over what was there before. We have Mike Johnson reportedly informing the White House that Republicans don’t support extending the enhanced subsidies at all.
This is bizarre politically, because you’ve got all these vulnerable House Republicans who are at serious risk next year, and Republicans just got blown out in elections in New Jersey and in Virginia and elsewhere that were in no small part about exactly this issue. We’ve had a test run. As you wrote in your piece, there’s just this deep ideological hostility inside the GOP caucus to doing anything that seems like, “Obamacare lite,” as one Republican put it. And you talk about this hostility, it just seems like on some basic level, they just can’t get to yes on government helping people.
Potts: I think that’s right. And it’s confusing to me and it’s confusing to a lot of the experts I spoke to because I’m old enough to remember when the health care debate happened in Obama’s first term. The Affordable Care Act itself is a compromise bill. It was not what progressives wanted. It uses the marketplace. It relies on for-profit insurance. The government is paying private insurers to cover more Americans through these subsidies.
Progressives want Medicaid or Medicare buy-ins. They want government insurance for all. They want Medicaid for All. And they continue to advocate for that kind of system. At the same time, the Affordable Care Act was somewhat based on a more conservative idea from the Heritage Foundation that was similar to something signed into law by Governor Mitt Romney of Massachusetts, who was a Republican.
And so it’s confusing as to why it is that Republicans no longer like this market-based approach. And what they’ve been trying to do is repeal it since the law was passed. And now they’re very clearly trying to undermine it in other ways, hoping that it will lose power and fade away through a thousand little cuts. And so not extending the subsidies is one of the ways it can do that, because people will opt out.
Sargent: It’s not as if Republicans don’t know what sort of political predicament they’re in. Punchbowl News had this amazing report about how Republicans are receiving the news that Marjorie Taylor Greene is retiring. We should probably insert here that she was one of the few Republicans who was saying, ‘We’ve got to do something about health care costs for people.’ Now, you know, she’s not ideologically where you or I are, but at the same time, she recognized that it’s an actual problem to some degree, and many Republicans won’t allow that.
So you’ve got like a number of these Republicans telling Punchbowl that they, too, are thinking of retiring. One senior House Republican messaged this to Punchbowl. I want to read from it: “Regular rank and file random members are more upset than ever. Members know they are going into the minority after the midterms. More explosive early resignations are coming. It’s a tinderbox. Morale has never been lower.” Monica, if they fear that, maybe they should consider extending the ACA subsidies. How do you explain this disconnect?
Potts: I can’t. Because the Democrats shut down the government to try to get the subsidies extended; that was a really popular position. Most people supported the Democrats in their efforts to do that. The Affordable Care Act is more popular than it’s ever been. It’s just gained popularity since it was passed. The idea that the subsidies should be extended is also really popular with Americans.
And Republicans were heading into the midterms in a bit of a deficit anyway. The party who’s not in the White House almost always gains seats in midterm elections. And so, you know, you would think that they would be scrambling to deal with this because it’s going to hit people who purchase their insurance on their marketplaces. They’re going to see higher premiums. It’s also probably going to hit people who get their insurance from their employer because, again, it has to do with the particular economics of health care. So everyone’s facing higher costs already.
Trump had run on affordability issues, had promised he was going to lower prices, and the prices of almost everything are going up, and insurance is really going to hit people hard. It’s a big bill to pay.
Sargent: Well, I want to switch to Trump because he knows he’s got a problem. He just exploded in this wild Truth Social tirade. He urged Indiana Republicans to gerrymander their state. He ranted falsely that Democrats stand for open borders and DEI and said, ‘Republicans must stop the destruction of our country by these people who hate America.’ He called Dems quote “far left infiltrators.” He also said Democrats are standing in the way of Republican tax cuts and deregulation. And Monica, I think that’s an interesting tell because Trump is saying Democrats are standing in the way of our plutocratic agenda, the GOP’s plutocratic agenda of tax cuts and deregulation. But that is really unpopular as an agenda. So then he turns right around and says, ‘Hurry up and rig the midterms, Republicans.’ Isn’t that like the perfect window into Republican politics?
Potts: Yeah, it really is. And of course, it conveniently leaves out that Republicans were trying to gerrymander Texas first. They’ve been seeing the writing on the wall since Trump was elected. They know they’re likely to lose seats in the midterms, and they’ve been trying to do everything that they can to prevent that from happening. And it seems like everything that they do makes it worse, like Trump’s rants, which kind of say the quiet parts out loud always.
Sargent: If we go over the things that Trump and the Republican Party did this term, there was the ‘big, beautiful bill,’ which analysts showed was really a massive upward transfer of resources from the bottom to the top, right? That happened. Then they stood in the way of extending the ACA subsidies, which is also a deeply unpopular policy. It just seems to me like they just got through discovering that plutocracy is deeply unpopular, and instead of correcting it, they’re saying, ‘Let’s do more to rig the elections.’ And that to me is a really almost horrifying tell about how Republican politics really functions.
Potts: Yeah, it really seems like that they feel like their only chance is to lock down power as when they have it now. And then that way they won’t face consequences from the voters, which I think is just another scary thing that’s happening in Trump’s second term.
Sargent: And they won’t face consequences for transferring wealth from the bottom to the top and kicking millions off healthcare. That’s the thing that they don’t want to face the voters over. You know what I mean?
Potts: That’s right. Yeah. And I think that when you look across the country, working Americans are suffering so much right now. The people in immigrant communities who are scared to go to work because of ICE raids that are picking up even people who were born in the United States because of hostility from all different corners of the Trump universe and because gas is expensive. Energy bills are expensive. The labor market is not very good right now. People feel stuck in their jobs. They feel like they’re not making enough. They feel like they can’t move forward. And so people aren’t very optimistic right now. And I think that all the things that Trump is doing are really making it worse to a huge degree.
Sargent: Right. So the agenda of transferring resources upward as rapidly as they can and terrorizing immigrant communities is turns out to be really unpopular. So let’s just gerrymander our way out of the problem. That’s the Republican approach.
Potts: Yeah, and consolidate power and use the wealth and the power we have to get more of it. I think, you know, that’s what we see across the board, the alliance between politics and the big tech companies and Wall Street. I mean, I think that’s what all of this boils down to.
Sargent: And if you step back and look at what’s happened with Obamacare, it’s really kind of interesting. The Affordable Care Act has been like a central fact about our public life for over 10 years now, over a decade.
Republicans did win a couple elections on it, right? In 2010 and 2014, the midterms, they won both those on the ACA to one degree or another. Maybe to some degree it helped Trump win in 2016, I don’t know, but let’s just grant that.
But the funny thing is then the worm kind of turned on them, right? Because in 2018, all of a sudden Democrats won this blowout midterm victory precisely because Trump and Republicans had tried to repeal the ACA and had successfully cut taxes on the rich another time with their tax bill at that time.
But I just want to bear down on this one point, Monica. Trump’s takeover of the GOP was supposed to be about a rejection of GOP plutocratic, anti-safety-net politics, right? Trump himself kind of talked a good game about getting people health care. He spoke a little differently than, say, Paul Ryan, at least rhetorically. And that might be why he won in 2016, but they’ve had literally a decade to sort this out—to sort their own response out on this—and they’re still lost. I just don’t get it.
Potts: Yeah. I think that rhetorically Trump pays lip service to those things. He has been good at the way that he rallies to a sort of working-class ideal, like an image of what the working class was in the past. And he traveled to factories, and sometimes he’ll put on a hard hat and get in a truck, and he talks about what he thinks of as manly jobs. And it’s always been a very masculine, retro image of what it means to work in America, and it has ignored the realities of working-class America to some degree, too, which are that they’re service jobs, they’re jobs in health care and education, and the kinds of jobs that women do a lot, too. And the working class in America really needs a lot of help, and America is a diverse country. And I think that for Trump, that kind of harkening back to this false sense of nostalgia worked in 2016, and it’s going to stop working soon. And I think that maybe that’s what the GOP is seeing is that there’s going to be a time after Trump. He’s not a magician.
Sargent: Yeah, you know you could actually look at Trump’s terrorizing of immigrant communities as a piece with this, because as you said, Trump kind of presents this idealized picture—idealized from his point of view—picture of the working classes as heavily white, heavily male, heavily concentrated in industrial work, Appalachian fossil fuel mining, that type of thing. But the working class today is really quite diverse. It’s got a heavy immigrant component to it.
And so when he and JD Vance go out there and say, ‘We’re going to crack down on immigrants to make working people whole,’ there’s a disconnect there too. He’s missing the fact that a big chunk of the working class is non-white immigrants. And so it’s kind of funny because it’s contradictory in a way because Trump did make these inroads with non-white working people in 2024. That’s a real thing. We can’t dismiss that. But it’s now looking like that was really pretty shaky, right? In Virginia and in New Jersey, both Mikie Sherrill and Abigail Spanberger actually erased the Republican advantage with non-college voters. And I think the stuff you just brought up is the reason why working people are quickly figuring out that all the stuff that Trump was selling them is all a bunch of bullshit, basically.
Potts: I think that’s right. Somos Votantes, which is an organization that does outreach to Latino voters and also does polling, has found that Trump has steadily lost support from Latinos over the course of the past year.
I think that one thing to keep in mind, which is something I always try to remember, is that most people just do not pay that much attention to the ins and outs of politics or every single thing that every President does. And so, you know, in a lot of people’s minds, Trump was still a successful businessman, and they had a, maybe a false memory or they had a kind of a rosy memory of the economy before Covid and they thought, well, things were better then. And he’s a businessman, maybe he can get us out of this mess because Biden had the bad luck to serve for four years that included a really weird post-Covid era and high inflation.
And so I think that some people just thought, well, he’s a businessman, he can bring us jobs, he can straighten out the economy. Without thinking too much more about it. And so I think that there were some voters who voted for Trump for that reason, and they’re no longer fooled. They can see now what’s happening.
Sargent: Well, and just to wrap this up, the Affordable Care Act subsidies issue is really the most important place where a lot of these tensions will have to be resolved in one way or another. What are Republicans going to do? Are they going to just not do anything about the ACA subsidy issue and then just take the hit in the midterms because they’re so ideologically opposed to helping people or will they find some kind of way of doing something? What do you think?
Potts: At this point, I think they may just have to not do anything and take the hit because they’re running out of time. Open enrollment for plans that start January 1 ends December 15, which is just a few short weeks away—it’s two or three weeks away, actually. And they really don’t have time to do anything other than just extend the subsidies that already exist. It’s too late for insurers to change their premium prices. It’s probably too late to introduce anything new next year for next year’s plans. I think their choices are either to quickly vote to extend the enhanced subsidies, or to not. I think those are the only two choices available to them. And so I think the answer might be that they’re just not going to do it. A lot of people are going to lose their insurance. A lot of people are going to face really, really high bills if they want to keep it. And that’s what we’re going to see next year.
Sargent: Well, I guess to them, it’s worth sacrificing the majority to make sure that all these people get hurt really badly. I guess that’s really the size of it. Monica Potts, always great to talk to you. Thanks so much for coming on.
Potts: Thanks so much for having me.