Trump/GOP Are Trying To Destroy Our Healthcare System

The following post is from the website of economist Paul Krugman: 

On the eve of the midterm election, American families are feeling financially stressed As the chart above shows, the percentage of families who say that their financial situation is good has plunged. For the first time since the post-Covid inflation of 2022, it has fallen below the percentage who say that their financial situation is bad.

Rising prices are the obvious explanation for this stress. And while presidents usually have much less influence on the economy than is generally recognized, the current outbreak of high inflation is all on Donald Trump. He began this with two wars of choice: one, a trade war with his destructive tariffs, and then an unwinnable military war in the most important energy transit point in the world.

There is, however, a third factor behind Americans’ anger, and it isn’t getting nearly as much attention as it should. There has been a catastrophic decline in health insurance coverage combined with sharply rising premiums for many of those who have managed to hang on to their coverage. And this, too, is all on Trump.

Here’s what happened: Trump and his congressional minions refused to renew the expanded subsidies that had made health insurance affordable for millions of Americans during the Biden years. At the same time the One Big Beautiful Bill imposed punitive work requirements that made it far more difficult for families to obtain Medicaid coverage.

And we haven’t felt the full effect of these changes yet — Republicans tried to backload the effects of the OBBB so that much of the pain will come after the midterms. But the consequences of this attack on healthcare have already been dire.

By June 2026 enrollment in Medicaid and the Childrens’ Health Insurance Programhad declined by more than 6 million since January 2025; 2.5 million of those losing coverage were children. KFF estimates that enrollment in individual plans, mainly via the Affordable Care Act, was down almost 5 million by June. The redoubtable Charles Gaba, putting these numbers together with other information, estimates that around 12 million Americans have lost health insurance under Trump 2.0.

That’s a lot of lost coverage, even in a nation as big as ours. And because many of the savage cuts Trump and his allies have imposed on healthcare have yet to kick in, the situation will get much worse in the years ahead. It’s worth noting thatkicking children off healthcare coverage is especially personally and socially destructive because it compromises their health and earnings potential for their entire lifetimes.

By the way, Trump, after all these years, is once again promising that he’ll come up with a “truly great” healthcare plan any day now. He’s now saying that he’ll send money directly to Americans, stopping payments to insurance companies — thereby demonstrating that he still has no idea how insurance works.

In any case, we’re now in the midst of an enormous healthcare disaster — a disaster that is receiving surprisingly little media coverage with, as far as I can tell, no recent articles on massive coverage losses in any of the major newspapers. I know that there’s a lot going on, but this seems odd. . . .

So if there is a blue wave 13 days from now, it won’t just be the result of inflation andTrump’s vainglorious wars. It will also in part be the result of a quiet but massive healthcare disaster.

And ultimately, of course, the political implications are a secondary concern. What really matters is that Trump and his party have done all they can to deny healthcare to millions of Americans. They have done this partly to save money — not to reduce the budget deficit, but to make room for tax cuts for the wealthy. They have also done it out of sheer cruelty.

There are many terrible things happening in America right now, from the debacle in Iran to the depredations of ICE. But the healthcare disaster, which will ruin many people financially and in some cases kill Americans who can no longer afford essential care, deserves much more attention than it is getting.

Voters Are Unhappy With The Access And Affordability Of Health Care

 

The charts above are from the recent Navigator Poll -- done between April 23rd and 27th of a nationwide sample of 1,000 registered voters, with a 3.1 point margin of error.

Health Care Costs Will Be A Big Issue For Most Voters This Year

 

The charts above are from the Kaiser Family Foundation Poll -- done between April 14th and 19th of a nationwide sample of 1,343 adults, with a 3 point margin of error.

It's Not Just The Insurers - Hospital Costs Are Rising Too Fast

The following is from an article by Assistant Professor Zack Cooper (Yale School of Public Health) in The New York Times: 

There is boiling rage at health insurers among the public — for instance, over the fact that premiums for a family health plan can exceed $27,000 a year, even as patients routinely get their care denied. Such is the rage that when an insurance executive was murdered in 2024, one poll found that 41 percent of American voters under 30 perversely thought the killing was acceptable.

Republicans and Democrats have been eager to haul insurance executives to hearings and grill them. President Trump tried to justify removing subsidies for Americans to buy health insurance — a policy that will lead to 4 million people losing coverage and thousands of deaths — by arguing it would mean less money going to insurers.

Responding to the wrongdoing of insurers is imperative, but it won’t do much to address the unsustainable cost of health care. We are directing our anger at the part of the system that is most visible and frustrating (insurers’ restrictions on care) while ignoring the part of the health system that is most responsible for high costs and economic pain: hospital prices. At a time when two-thirds of the public are worried about the price of health care — a greater share than are worried about affording groceries, gas or housing — we need to have an honest conversation about what is driving high premiums and how to lower them.

Americans receive a similar amount of care as people in other countries, but we pay much higher prices for the care we receive. Take hip replacements. Hospitals in the United States earn $29,000on average for a replacement covered by private insurance and $16,000 for one covered by Medicare. In Germany, the public system of nonprofit insurers, which covers 90 percent of the population, pays hospitals $9,400.

Hospital prices are the leading driver of the 320 percent increase in insurance premiums that Americans have experienced over the past 25 years. Since 2000, prices at hospitals have grown faster than prices in virtually any other sector of the economy. They have grown three times as fast as inflation and twice as fast as prescription drugs and doctor visits.

The reason hospital prices are so high: hospitals’ accumulation of market power, which brings them more bargaining heft when they negotiate prices with insurers. Since 2000, there have been more than 1,300 hospital mergers among the nation’s approximately 5,000 hospitals. When hospitals that were once competitors merge, prices go up, often by double-digit percentages, with no measurable improvement in patient outcomes. Even though we rely on competition to determine hospital prices, 21 percent of hospitals are effectively monopolies — they have no competitor within a 30-minute drive — and an additional 24 percent face only one competitor. . . .

Politicians from both parties have called for reining in insurance denials. They’re right to. Such denials, and the bureaucratic processes that accompany them, are stressful for patients, and, in the worst cases, lead to patients missing out on lifesaving care. Likewise, research shows the high out-of-pocket costs included in many insurance plans can drive up death rates. We need to lower out-of-pocket costs and make insurance less bureaucratic. However, unless we pair such reforms with a focus on addressing hospitals’ rising prices, rolling back insurer restrictions on care risks driving growth in health spending that, in turn, will slow economic growth and drive job losses among low-wage workers.

If hospital prices are such a key driver of rising costs, why aren’t elected officials doing more about them? Partly the answer is politics. Hospitals are the largest or second-largest employer in many counties in America, and a formidable lobbying force — spending more than $100 million annually in Washington, often more than health insurers spend, to protect their interests. Politicians who represent places with dominant hospital systems are not eager to pick a fight with these institutions. Moreover, when an insurer denies your claim, you know it immediately. When a hospital merges and its prices go up, the harms — slower overall economic growth and job losses outside the hospital sector — are real but diffuse.

Another reason so little has been done about hospital prices is the chronic underfunding of the Federal Trade Commission. Each year, there are approximately 20 potentially harmful hospital mergers, but the cost of pushing back on all of them would potentially exceed the agency’s entire budget for antitrust enforcement across all sectors of the economy.

Addressing this issue would require regulating the prices for at least some hospitals. Economists generally prefer to rely on competition to determine what companies get paid. But in hospital markets that are effective monopolies, regulation isn’t a departure from sound economics — it’s the only tool left. Congress should cap the prices monopoly hospitals can negotiate with private insurers, using Medicare rates or prices in other competitive markets as benchmarks.

Perhaps more than anything else, what makes hospital prices so hard to confront is that the relationship we have with our health care providers is very different from the transactional relationship we have with our insurers.

The physician and scholar Jay Katz spent his career writing abouthow vulnerability, fear and gratitude make it difficult to hold doctors and hospitals to the kind of scrutiny that we apply to other powerful institutions. We lean on hospitals when our children are born, when our parents get sick and when we approach life’s end. That kind of reliance requires trust.

U.S. Health Care System Is Collapsing (But The Billionaires Are Doing Great)

 This is from Thom Hartmann at The Hartmann Report:

America’s Healthcare Collapse Is Here, and It Was Written Into Law. 

Just as Democrats predicted when the One Big Beautiful Bill passed with all-Republican votes, millions of Americans are now uninsured. In addition to giving billionaires around $5 trillion in tax cuts, the OBBB also did away with the most recent Obamacare subsidies, jacking people’s healthcare premiums into the stratosphere. The result has been that millions of families — about one in ten previously covered by the Affordable Care Act — are now lacking any sort of medical insurance whatsoever. Republicans are delighted, and Trump’s offering a new “cheap” ACA plan with $31,000 deductibles, a genuinely insane idea in a country where 60% of Americans can end up homeless if they’re hit with an unexpected $1000 expense. 

But, hey, the billionaires got their tax cut so now they’re paying virtually nothing in taxes, including billionaire Trump, his multimillionaire kids and wife, the 13 billionaires in his cabinet, and the hundreds of billionaires who’ve ponied up hundreds of millions to fund his campaigns, ballroom, library, crypto, and every other scam he can dream up. Life’s good when you’re morbidly rich; the rest of us can “just eat cake” — when we can find stale packages of it in the dumpsters behind America’s grocery stores.

A Majority Of Americans Favor A Single-Payer Health Care System

The chart above is from the Strength in Numbers / Verasight Poll -- done between January 14th and 20th of a nationwide sample of 1,532 adults, with a 2.5 point margin of error. 

Americans Are Very Unhappy With Trump Over Economy And Healthcare

 

The charts above are from the latest CBS News / YouGov Poll -- done between December 17th and 19th of a nationwide sample of 2,300 adults, with a 2.5 point margin of error.

Republicans Are Playing With Fire Again By Trying To Kill Obamacare

Vaughn Hillyard and Laura Barron-Lopez (at MS NOW) tell us the congressional Republicans are again trying to kill the Affordable Care Act (Obamacare) - without a viable plan to replace it.

With six weeks left before the health insurance premiums of nearly 22 million Americans skyrocket, Republicans in Washington are floating alternatives to the Affordable Care Act that would fundamentally reshape how Americans buy coverage — and which, health experts warn, could “collapse” the entire marketplace.

The political stakes are enormous: In 2017, the last time Republicans tried to gut the ACA, they paid for it with a wave election that cost them the House and effectively derailed much of President Donald Trump’s first-term legislative agenda.

Now, less than a year before 2026 midterms, they’re wading back into the same treacherous waters — and some GOP strategists are experiencing a dizzying sense of deja vu.

“Republicans are very good on issues like taxes and national security. We don’t do healthcare very well,” said Brendan Buck, a former top adviser to Speakers John Boehner and Paul Ryan, the latter of whom he helped in 2017 to shepherd the GOP’s doomed attempt to repeal and replace the ACA. “We fell flat on our face in 2017.”

In the midterms that followed, 15 House Republicans who voted for a partial repeal of the ACA law lost reelection, while an additional 19 members opted to forgo their reelection and retired.

The immediate issue is the expiration of certain Covid-era ACA tax credits at the end of December. Some 74 percent of Americans support extending the ACA tax credit, including 50 percent of Republicans, according to recent polling from KFF, the nonpartisan health care research group. But that looming deadline has spurred a broader conversation among Republicans eager to make progress on Trump’s longtime goal of rescinding President Barack Obama’s signature policy achievement.

This time, Republicans are not necessarily using the words “repeal and replace.” But the plans floated by Trump and other top Republicans would effectively do just that, said Larry Levitt, KFF’s executive vice president for health policy.

“It would be a back-door way of returning to the old system where healthy people may have had cheaper insurance, but sick people had no options,” said Levitt. “Healthy people would buy cheaper insurance that doesn’t cover pre-existing conditions or simply go without insurance altogether and use their health account dollars to pay for health care directly. ACA plans would be left with a sicker pool of people, leading to a premium death spiral and ultimate collapse.”

Mindful of all of this — and the potential for political blowback from rising health care costs — some Capitol Hill Republicans have floated extending the credits for a year to allow a more fulsome policy conversation to take place.

Standing in their way is the president of the United States.

“The only healthcare I will support or approve is sending the money directly back to the people,” Trump wrote Tuesday in an all-caps post on Truth Social. “Congress, do not waste your time and energy on anything else.”

But even if it’s clear what Trump does not want, specifics about what policy he actively supports — and which can pass both chambers of Congress — remain elusive.

In April 2019, Trump posted online that Republicans “are developing a really great Healthcare Plan” that would “be far less expensive & much more usable than ObamaCare.” No comprehensive plan ever came to fruition. . . .

On the 2024 campaign trail, Trump said he had “concepts of a plan” to replace the ACA. A year later, Republicans have yet to issue one.

It's Time To Make Healthcare A Right For All U.S. Citizens

The following is part of an excellent article by Thom Hartmann at The Hartmann Report:

In the richest nation in the history of planet Earth, millions of Americans are dying from treatable illnesses, rationing insulin, and running GoFundMe campaigns for chemotherapy. This isn’t just a policy failure, it’s a moral collapse. . . .

Most Americans have no idea that the United States is quite literally the onlycountry in the developed world that doesn’t define healthcare as an absolute right for all of its citizens. That’s it. We’re the only one left.

As a result, we spend more on “healthcare” than any other country in the world: about 17% of GDP.

Switzerland, Germany, France, Sweden and Japan all average around 11%, and Canada, Denmark, Belgium, Austria, Norway, Netherlands, United Kingdom, New Zealand and Australia all come in between 9.3% and 10.5%.

Health insurance premiums right now make up about 22% of all taxable payroll, whereas Medicare For All would run an estimated 10%.

We are literally the only developed country in the world with an entire multi-billion-dollar for-profit industry devoted to parasitically extracting money from us to then turn over to healthcare providers on our behalf after they’ve skimmed hundreds of billions off the top. The for-profit health insurance industry has attached itself to us like a giant, bloodsucking tick. . . .

Medicare For All, like Canada has, would save American families thousands every year immediately and do away with the 500,000+ annual bankruptcies in this country that happen because somebody in the family got sick. But it would kill the billions every week in profits of the half-dozen corporate giants that dominate the health insurance industry and heavily subsidize the GOP.

Bernie’s efforts — which were entirely sensible and would have saved the nation and our working class people trillions of dollars in the years since 2016 — were defeated by a coalition of the insurance industry, Republicans, and a handful of bought-off Democrats who went along with the GOP’s charge that it was “socialism” and therefore a bad thing.

You know, like our “socialist” fire departments, or public highways, Social Security, Medicare, Medicaid, SNAP benefits, FEMA, CDC, etc., etc. . . .

It’s time for a bold change in the Party’s position on healthcare.

Democrats are looking for a simple message that will resonate with voters and prove that they’re on the side of working class people while Republicans are all-in for the plutocrats. They should look to the progressives’ healthcare positions. 

Voters are sick and tired of both Republicans and “centrist” Democrats with their hands in lobbyists’ pockets, too timid to take on the issues that are ripping American families apart. That are bankrupting a half-million families every year, something that doesn’t happen in any other developed country in the world. 

Fully two-thirds of Democrats — the party’s base and more — want their party’s leadership to be more aggressive. To lead instead of following. To tell the truth and not cower when Republicans scream, “Socialism!” To promote bold solutions to real problems.

As we head now toward the midterm elections next year, affordable healthcare via a public option to buy into real Medicare at any age should be at the top of that list.

“Healthcare for All” isn’t a slogan: it’s a test of who we are as a nation. It asks whether we believe in shared humanity over corporate profit, and whether our politics can still serve the living instead of the lobbyists.

The promise that could heal America isn’t abstract; it’s written in the stories of every family that is one accident, one diagnosis, or one pink slip away from ruin. 

If Democrats have the courage to run on this truth — that survival shouldn’t depend on wealth and status — they won’t just win elections. They’ll change for the better what it means to be an American.