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Good conversation (with transcript) about the ACA, and the “coming premium apocalypse”.

The coming premium apocalypse, the shutdown, and more
https://open.substack.com/pub/paulkrugman/p/talkin...

“Thanks in part to enhanced subsidies, more than 24 million Americans now get health insurance through the exchanges established by the Affordable Care Act. But those enhanced subsidies expire Dec. 31, which will be apocalyptic for many people; and Democrats have made extending them their key demand in the shutdown fight.

So this seemed like a good week to talk with Jonathan Cohn, who has been following the ACA and its ramifications since the beginning, and wrote a terrific piece about Republican lies regarding what’s at stake now. Transcript follows:”

Here’s that piece about Republican lies:
https://www.thebulwark.com/p/republican-trump-gop-...

Seriously, how do these people live with themselves? Vance, Johnson, et al claim to be devout Christians, and yet spew these lies. The means justify the ends, I guess.

Nice to see them *finally* bringing up a very powerful topic.

Welcome aboard....

Good conversation (with transcript) about the ACA, and the “coming premium apocalypse”.

I was planning to post some excerpts from this——thanks for beating me to it.

It's a very good history and summary of where we are today and how we got here since the ACA passed in 2010. Especially clear explanation regarding the three big "buckets" that comprise American health care: Medicare, Medicaid, and the premium subsidies; and clearly details why the subsidy cliff that is approaching on December 31 of this year is going to be much more destructive for older and rural voters in red states.

One pullout:

"You could see this narrative bubbling up in the places where these things bubble up—in the conservative media here and there. But it was very prominent a week ago. JD Vance went on Fox and said, “Democrats want to spend a trillion dollars on free care for illegal immigrants.” And Speaker Johnson said something almost exactly the same, which is ludicrous.

The single most important thing to remember when you hear this repeated is that by law, undocumented immigrants cannot get Medicare. They cannot get Medicaid. They cannot get federally subsidized insurance through the exchanges. They are not eligible for these things. Federal dollars cannot provide direct insurance under those three programs for undocumented immigrants with a tiny, tiny little asterisk I’m going to get to in a second.

The second thing to realize is that not only can undocumented immigrants not get those programs, many people who are here legally cannot. So for example, if you’re on your way to get a green card for permanent residency, there’s a five-year waiting period in general before you can get on these programs.

In general, people like Medicare. And it turns out they really like Medicaid. They like the Affordable Care Act now. They don’t want to cut these programs. They want to keep these programs going, if anything, and they want them to be more generous with less bureaucracy and more organized, all of which Democrats have lots of proposals to do. Republicans don’t believe in it, which again, I think that’s why we have politics. We should debate that. And if they want to go out and say, “We think it’s bad. We think the money is better spent on our tax cuts,” or, “This is causing healthcare quality to go down,” which they said, we can have that argument, but they don’t want to have that argument because they know they’re going to lose that argument.

So they are trying to plant the flag somewhere where they have an advantage. Immigration is an issue. So they’ve come up with this argument that “what Democrats really want is free care for illegal immigrants.” And I use that phrase deliberately because it’s the phrase the Republicans are using.

So that is the big lie they’re telling. JD Vance was out on TV this morning and then he was at the White House just before we got on to record this. And I noticed they’re kind of walking it back a little bit. They’re trying to narrow it down to something where they feel it’s more defensible. I would say JD Vance is the most enthusiastic proponent of administration lies.... It’s a lie in the sense that it is fundamentally untrue. They know it’s untrue. They are trying to create a misperception and distract from what the real issue is, which is that they don’t want to spend the money on Medicaid and Obamacare that would help millions of people get insurance."

"They are trying to create a misperception and distract from what the real issue is, which is that they don’t want to spend the money on Medicaid and Obamacare that would help millions of people get insurance."

I'm not happy about thinking the following: people are going to need to feel the pain
from the OBBB. And when the MAGA pol's come at them with the " it's all the radical-Left's
fault", people need to be smart enough to actually dig into that statement.

MAGA controls the Executive branch, the Legislative branch, and the Judicial branch.
Any American who allows themselves to be swayed by the argument that it's all
the radical-Left's fault needs to keep feeling the financial pain.

Hell, I'm still reading comments on FB from MAGA acquaintances that food prices
haven't gone up under Trump. Comments that tariffs are not paid by the consumer.
So there is still a long way to go before the reality of Trump hit these people.

So be it. MAGA is about what, 25% of the voting population ?
I'm hoping that the Trump voting Independents are rational enough to see
thru the blatant lies being spewed by Trump and MAGA.
Trump on the 2024 campaign trail saying he's "never heard of Project 2025"
Trump in the 2025 White House stating that he's going to unleash
Russell Vought on the "radical-Left" government programs.
So so many outrageously stupid lies spewed by Trump.
We will see if any lessons were learned come November 2026, assuming the election is still a thing in Trumplandia.

MAGA controls the Executive branch, the Legislative branch, and the Judicial branch.
Any American who allows themselves to be swayed by the argument that it's all
the radical-Left's fault needs to keep feeling the financial pain.

Agreed.

After 2024, though, I don't know whether I'd lay odds on solving the 'ignorance, illiteracy, innumeracy' problem that seems to characterize so much of the US electorate. Maybe the pain, sometimes severe, will change some minds, but cult members do not exit cults. As you say, we can hope that at the margins - the independents - may change the outcome.

Pete

“Thanks in part to enhanced subsidies, more than 24 million Americans

From the Google net sifter.

The population of the United States is currently around 342 million people,

The Dems are willing to die, for 7% of the population. It takes 50% to win. They chose the wrong hill to die on.

Steve

"The Dems are willing to die, for 7% of the population. It takes 50% to win. They chose the wrong hill to die on."

gotta disagree with ya on that. Trump ain't gonna honor any promise he makes to the
Dem's if they agree to vote Yes. Plenty of Americans getting hurt on things other
than healthcare,too. Call Trump/MAGA bluff. Nobody thinks any MAGA are going to
quit worshipping at the altar of Trump, but plenty of non MAGA voted for him.

Keep it shut down, let the cleansing ( pain ) begin and continue.Trump and MAGA own it.

As this writer has been saying for a few months (yes, i'm usually before the bloody headlines of the moment)....

This is an AMAZING hill to die on.

Trouble is - I'm not sure DEmocrats are messaging it right *and* you've still got the NutRoot Bubble Swellers - like the Sheeple on this board not focusing on it properly.

Oh it's only a small percentage?

My Republican Congress dude - Fitzpatrick - was ABSENT at a previous ACA vote or two. ABSENT. He's now falling all over himself to get the subsidies extended.

7%? 1%? 10%? Doesn't matter a shit - in a tribal country with micro-castes forming.

Many swing states, and swing districts have MORE than enough people who will be pissed when they get the news.

IF Dems ever learned ho to do this right - i'd say - don't settle for an extension. Get it permanent *and* get a sweetener be it a tax bump on somebody, a SCOTUS pick, whatever.

People. Get out your bubble life for a moment. Ok better yet let e put it in your parlance. Ok, put on teh emplyoee badge. Hang your gad damn degree on teh aall. "Hey, Schmuck. Yeah, you, you legennd in your mind who is just a number to us. Get your ass to HR now". PutzCockTard goes to HR. HR says "we've changed things. You'll now pay another $800 a month for your health insurance . Oh, and it's not a payroll deduct so you don't feel it. You gotta send in the money monthly"

That is what is about to happen to people.

It's the best thing to happen to Dems.

I'm truly flummoxed that they aren't running with it properly.

At least not yet.

Trump and MAGA own it.

Maybe. But they'll blame Dems. The Felon never owns anything. The Dems better rev up their spin machine, or the maga spin machine will have people believing they (maga) are pure as the driven snow.

Why do you sit there like a deer and let him?

Don't you want to govern?

Or is this talk about "save democracy" bullshit bumper stickers? Stop the "we're too smart to do it that way" snobbery. And figure out why he shoved the price of an egg up Kamala's ass.

Pretend the shoe was on another foot. Pretend it's Dem President. Pretend ACA was a GOP policy......and DEMS were about to jack people's bills $800 a month.

Can you imagine....what MAGA would do to you people?

I am starting to question if the 'save democracy' shit iss serious.

I know MAGA is dead serious in what they say.

Maybe that's why the beat the faculty lounge ....and even when the faculty lounge wins in 2026 and 2028 -its nowhere near gonan reverse things like the SCOTUS.

If Dems are serious - please - let me know.

I am starting to question if the 'save democracy' shit iss serious.

At the federal level, the Dems are outgunned and shellshocked. At least that’s my perception.

The state and local level- that’s where the battle is being fought. That’s where the creativity is found. That’s where the leadership is emerging.

That’s where the leadership is emerging.

This funny.

"Maybe. But they'll blame Dems. The Felon never owns anything"

Of Course ! Have you ever heard Trump take responsibility for 1 single thing ?
I can't.
It is 100% certain that Trump and the MAGA spin machine are going to blame anything
and everything on the Dem's. That is all they ever do. So who cares when they
once again blame the shutdown on Dem's ?? Same thing, different day.

But Dem's do need to ramp up their spin machine. Follow Newsome's lead.
Most people I know think his take on Trump is quite amusing. He isn't copying
Trump, he is holding up a mirror to Trump, and using his own words against him.
( seen that somewhere on utube )

Trump is a bully, metaphorically punch him in the face and watch him break
down crying. He is never going to stop, unless he gets his head handed to him.
I'm thinking the time for rational civil discourse is past. Trump plays dirty,
Dems should play just as dirty. And Dem's sure as hell better not believe any
promise Trump or his toadies make about just pass the CR, and we'll negotiate after
that. Eff That !

Trump plays dirty, Dems should play just as dirty.

Earlier today, I posted a perfectly plausible conspiracy theory. A whispering campaign could work it's way around, for months, and there is no way to fight it. It's the Dem version of "birtherism": anyone who claims to disprove the conspiracy, is part of the conspiracy. Has it engendered any discussion? Nope.

Here's Lutnick talking about Epstein. In this piece, Cenk is pointing his finger at Mossad. I think it's the FSB, because Lord Trump has diverged from the Kremlin line about how the war is all Ukraine's fault, and Ukraine needs to give up territory, to ranting about Putin's intransigence. As Lord Trump does his 180, the chatter about Epstein ramps up, because Epstein was greased, before he could barter tapes of Trump, for another phony sentence. I bet if Trump suddenly toed the Kremlin line again, the Epstein chatter would suddenly go away.

Did Lutnick Just ADMIT That There Are Epstein Tapes?

https://www.youtube.com/watch?v=NjEBwaCSN0Q

Howard Lutnick speaks out on Jeffery Epstein's illicit activities

https://www.youtube.com/watch?v=NiP131VlaVM

Here's Steve conspiracy theory 1.1: Trump is having Lutnick talk about this, openly, to inoculate his followers, to the existence of the tapes, so the tapes lose their value to Putin.

Steve...HBTT

From the OP video: "It seems to me there are three demands Democrats have put forward.
The first is that they want some guardrails so that money will actually be spent. ...
And then they want to undo these healthcare cuts ...
And then on the subsidies, same thing."

The OBBBA was the largest cut in federal support for health care in American history, reducing federal health care spending over 10 years by about $2 trillion:

$335 billion ACA subsidies
$950 billion Medicaid
$500 billion Medicare

U.S. healthcare spending in 2024 was about $5 trillion, and so the $2T cuts are about 4%. Most of these cuts are going to land on those least able to afford them. The OBBBA made tax cuts for billionaires while cutting the health care safety net for everyone.

"If either scorecard indicates a net increase in the deficit, OMB is required to
order a sequestration to eliminate the overage. ... Under S-PAYGO, reductions in Medicare spending are limited to 4 percent—or an estimated $45 billion for fiscal year 2026."
https://www.cbo.gov/system/files/2025-08/61659-SPA...

I'm serious. But I'm just some guy, like you. I'm not going to run for anything ever.

I agree Dem leadership is lacking. I'm not sure what to do about it. I didn't vote for Jeffries or Schumer. If it were up to me, Warren would be near the top of my list. She's smart, and advocates for the little guy

Most of these cuts are going to land on those least able to afford them.

In the minds of the "JC" dominated GOP, that is good. It forces those people to work/work more hours. After all, the "JCs" need to replace the thousands, if not tens of thousands of willing workers Trump is deporting to satisfy his base.

Steve

If it were up to me, Warren would be near the top of my list. She's smart, and advocates for the little guy

I think the crowd we're trying to win over is a little sexist though. My canvassing taught me there are very few real independents and the real independents like granola, yogurt, make your own avocado toast, and still think NADER IS GREAT. The faux independents are Republican light. For some reason they don't wanna call themselves Republicans. Find that reason and dwell on it.

The faux independents are Republican light. For some reason they don't wanna call themselves Republicans. Find that reason and dwell on it.

Good point. A lot of people are not the flaming racist, knuckle dragging, goobers, that seem to dominate MAGA. But they are pissed off. Trump presents himself as the defender of the working man. Dems are, for instance, going to the wall for health insurance subsidies that only benefit 7% of the population. The average working person has insurance provided by his employer. What will matter to working people, will be the elimination of their worker's rights, by Trump crippling the Dept of Labor, but no-one is talking about that, except the unions.

According to the Department of Labor’s official contingency plan, more than 9,700 of the agency’s 12,916 employees are furloughed. Only 3,141 are on duty, with most limited to emergency functions. The vast majority of the department’s enforcement, oversight, and support work is suspended.

“Over three-quarters of the department’s workforce has been furloughed,” NCFLL President Brent Barron said. “No wage theft investigations, no safety inspections, no checks on retirement plans, and no protections for working families. This shutdown is an attack on American workers and hurts everybody.”

https://www.afge.org/publication/department-of-lab...

Steve...HBTT

Unions?! Less than 10% of the population belongs to unions. That's almost as small as the people that will be hurt by lost tax credits.

By your logic, you need to find a larger segment of the population to target.

"The Dems are willing to die, for 7% of the population. It takes 50% to win. They chose the wrong hill to die on."

gotta disagree with ya on that.

I also disagree, but for a different reason: the percentage of the population that actually changes its vote, even if only half 7%, is enough to sway the vote in most swing states (even in some non-swing states).

Pete

By your logic, you need to find a larger segment of the population to target.

The larger segment is Proles in general. The unions know what is happening. Most people have been brainwashed that unions are nothing but gangsters who steal from their members, so ignore everything unions say. The fights for safer working conditions, better pay, and pensions, have pretty well passed from living memory. The vast majority of Proles have no idea what their working lives would be like, if everything unions fought for was washed away. No-one else is talking about the impact of the Labor Dept being gutted. For several years, I have been saying that the entire body of US labor law was on pretty shaky ground, Constitutionally. The Proles may find out how shaky within the next couple years.

Steve

I don't disagree with you about unions. They were vital in establishing labor laws were now take for granted.

I suspect you're correct about the gutting of the LD.

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