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A former Trump voter said that the cost of healthcare was driving her to support any party "that can help me afford to stay healthy."
While President Donald Trump's poll numbers have been sinking to second-term lows ever since his unconstitutional war on Iran sent gas prices soaring, pain at the pump isn't the only concern Americans face when it comes to affordability.
The New York Times reported on Tuesday that voters' anxiety on the cost of healthcare is once again on the rise, with insurance premiums spiking dramatically for tens of millions of Americans after Trump and his Republican congressional allies failed to extend enhanced subsidies for plans purchased through exchanges established by the Affordable Care Act (ACA).
Shawn Spencer, a 48-year-old Virginia resident, told the Times that while she voted for Trump in the 2024 presidential election, she'd be open to supporting any party "that can help me afford to stay healthy."
"Healthcare costs are out of control," emphasized Spencer. "I don’t have insurance, so I’m paying a boatload when I need care."
In addition to the increases to ACA premiums spurred by the lapsed subsidies, Republicans last year also slashed $1 trillion over the next decade from Medicaid as part of their One Big Beautiful Bill Act.
The Times noted that those cuts aren't expected to kick in until after the 2026 midterm elections, but they have already resulted in healthcare layoffs and hospital closures throughout the country, as some facilities are projecting they will not be able to stay afloat with reduced Medicaid reimbursements.
The Times pointed specifically Iowa's 3rd Congressional District, where "a healthcare company has closed clinics and laid off 67 staff members at a hospital in Des Moines, blaming the federal cuts for a projected $1.5 billion in annual revenue reductions."
Sarah Trone Garriott, a Lutheran minister and former hospital chaplain who is running in the district for the US House of Representatives against incumbent Rep. Zach Nunn (R-Iowa), has made the healthcare cuts central to her campaign message, mocking her rival for saying it's a "myth" that local hospital cuts are due to the GOP budget law.
Dr. Peter Reiter, who worked for decades at one of the shuttered clinics, was quoted in the Times blaming Nunn for its closure.
“Zach Nunn owns this,” Reiter said. “He needs to pay the price of accountability."
The Times report was flagged on Tuesday by Unrig Our Economy campaign director Leor Tal, who said it was yet more evidence that the GOP is out of touch with the needs of working-class Americans who are struggling to afford basic necessities.
"If Republicans spent half as much time focusing on lowering costs as they did giving handouts to billionaires, working Americans wouldn’t be so concerned about affording care," said Tal. "Congressional Republicans clearly aren’t prioritizing making life more affordable for their constituents. If they did, they wouldn’t have repeatedly voted to send their healthcare costs soaring and put millions at risk of losing insurance altogether."
New data released by KFF underscores how "universal, seamless coverage throughout the life course remains an urgent prerogative for the nation," said one physician and advocate.
About 24.3 million Americans were enrolled in healthcare plans within the Affordable Care Act marketplace last year, but a survey released Thursday by KFF found that about 1 in 10 of those people had no choice but to make a difficult and risky calculation at the end of 2025 when ACA subsidies expired due to Republicans' refusal to support an extension.
According to the research, 9% of people enrolled in plans under the marketplace last year are now uninsured, having dropped their coverage—and costs were a deciding factor for the vast majority of those who left the marketplace.
The expiration of the enhanced tax credits sent premiums skyrocketing by an average of 114%, according to KFF.
The decision was unavoidable for one 54-year-old man in Texas, who told KFF simply, "Without the subsidy, I cannot afford the premium payments.”
A 56-year-old woman in Illinois said her income was too high last year to qualify for subsidies, but the increase in cost this year was "so high even for those without subsidies."
"I simply cannot afford to pay $1,200 a month for insurance," she said. "It used to be high premiums meant low deductibles and copays, but not anymore. This is ridiculous. $1,200 for a healthy person, and an $8,000 deductible. Really?”
A Florida resident named Kelly Rose told The Wall Street Journal that the $1,700 monthly premium she was quoted for an ACA plan would have been more than her mortgage. She missed the enrollment window for health coverage through her job at a bank—assuming her ACA plan would cost less—and is now uninsured and relying on a Canadian pharmacy to get her asthma medication, which would cost $800 per month without insurance in the US.
Cynthia Cox, a senior vice president at KFF, told the Journal that the survey results were “about on target” what the health policy research group had expected last year when the subsidy expiration was looming and Democrats were demanding that the GOP vote with them to extend the tax credits.
“Not only is there significant coverage loss, but there could be more to come,” Cox said.
An estimated 25 million Americans are uninsured, said Harvard Medical School professor and former Physicians for a National Health Plan president Adam Gaffney—a fact he called "abhorrent" as he suggested the new data makes the latest case for "universal, seamless coverage throughout the life course," or an expansion of the Medicare program to the entire US population.
That proposal, which has been introduced in Congress numerous times by lawmakers including Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.), would put the US in line with the healthcare systems of other wealthy nations, improve healthcare outcomes, and save an estimated $650 billion per year.
A poll released late last year by Data for Progress found that 65% of likely US voters supported "creating a national health insurance program, sometimes called ‘Medicare for All,’ that would cover all Americans and replace most private health insurance plans."
The fact that millions of Americans have chosen to opt out of the country's for-profit health insurance system—putting their health and finances at risk—is representative of "a profound hollowing-out and weakening of America," said writer and markets researcher Ben Hunt.
The economic justice campaign Unrig Our Economy emphasized that Republicans' cuts to healthcare last year—via the expiration of the subsidies and slashes to Medicaid—put an estimated 15 million Americans at risk of losing health coverage.
“Republicans knew that healthcare tax credits were critical to helping millions of Americans afford their health insurance, but they chose to get rid of them to fund more tax breaks for their billionaire buddies,” said Unrig Our Economy campaign director Leor Tal. “Costs are higher, millions are without insurance, and working Americans are having to make sacrifices just to afford basic healthcare—and they know that Republicans are to blame. It’s time Republicans finally started listening to their constituents and fixing the healthcare crisis they created.”
KFF's polling also found that among people who still have health insurance under the ACA, higher premiums and deductibles have left a majority concerned that they wouldn't be able to afford emergency care even with their coverage. Nearly half of respondents said they were worried that even routine medical care will be unaffordable this year with their ACA plans.
Due to Republican attacks, the cost of coverage offered by the program is now forcing 55% of people using the ACA to cut back on spending money on food, household items, and clothing in order to afford it. Forty-three percent said they are trying to find another job or extra income to afford healthcare payments, and nearly a quarter said they are skipping or delaying payments on other bills to afford their health coverage.
More than half of people polled by KFF said they blame Republicans in Congress for their rising healthcare costs.
"Americans are blaming them because it’s true," said Unrig Our Economy. "Congressional Republicans’ massive cuts to health care have put a projected 15 million Americans at risk of losing health insurance and left millions more struggling to keep up with rising costs. Republicans made these cuts all so they could give more tax breaks to billionaires and corporations."
Our healthcare ‘system’—with or without the Affordable Care Act—is unsustainable: we have reached the end of the line.
Those without employer sponsored insurance (or Federal insurance like Medicare or the VA) in Red states, who signed up for the Affordable Care Act (aka Obamacare), are now learning what they voted for: higher premiums for health insurance, maybe unaffordable. Meanwhile, premiums continue to rise relentlessly for employers and employees.
Our healthcare "system" is unsustainable: we have reached the end of the line.
Americans pay more for healthcare (about18 percent of GDP) than any other developed country, with mediocre outcomes. Yet the other countries, with better outcomes, have universal coverage.
It is time for change. Extend traditional Medicare to all Americans (gradually, over the course of several years). Medicare is familiar; it works. Private for profit-health insurance, less than a century old, makes no sense today.
Sick and injured patients have turned to medicine—to healers—since time immemorial. Health insurance is new: Blue Cross started as a community non profit organization in 1929, to cover surgery in hospitals.
Private for profit-health insurance, less than a century old, makes no sense today.
Yes, we are a capitalist country, and markets are efficient at producing many things, like commodities: groceries, shoes, cars, even some insurance, when it is straightforward and highly regulated, like auto insurance. But for-profit health insurance does not work.
The idea of insurance is to spread risk over a maximum number of subscribers, each of whom is at the same low risk of unpredictable casualty, like fire. This was essentially the situation of Americans a century ago—illness and injury were acute and unpredictable, patients either recovered or died. Everyone was at similar risk, only surgery was expensive.
Today is different: illness is not only predictable, it can be chronic, even life long. Moreover, today’s scientific care is expensive. The social determinants of health—income security, education, adequate food and shelter, social support (your zip code, not your genetic code)—plus public health, keep healthy people healthy.
Medical care is for the sick.
For-profit health insurers maximize premiums, minimize cost (provider fees), keep the difference, and most important, avoid the sick. Insurers exclude those with “pre-existing” conditions whenever allowed (not under the ACA), deny "authorization" where they can. They tailor "plans" with carefully engineered restrictions you don’t discover until you file a claim. They are not even providing insurance: the payments from the Federal government are risk adjusted, so the insurers are paid more for riskier patients (and they are now illegally upcoding). The providers are not. Making this happen entails huge administrative expense, which adds no value for patients or providers, only massive returns to investors. United Health Group is the third largest company in the Fortune 500.
Healthy people don’t know what plan is "right for them"; they hate the annual "choice." They only know what they can afford. (Sick people know what they need.) They do want to choose their doctor.
Traditional Medicare eliminates these problems for its beneficiaries: by law, everything medically necessary is covered. The Federal government determines fees for doctors and hospitals based on cost, as it did historically when markets didn’t work. Beneficiaries pay premiums based on income.
Fee-for-service works when we pay the right fees for the right services. Today, based on 1950’s medicine, Medicare pays too little for office visits, so-called ‘cognitive’ services (versus procedures) both primary and specialized, so there are too few providers, especially as Medicare rolls expand with retiring
Boomers. No office doctor can make a living from Medicare anymore. That is, however, easy to fix: pay providers more to care for the sickest people, who need the services only highly skilled, experienced physicians can provide. Pay surgeons less.
Best of all, Medicare is simple—ask your grandmother.
But where will the money come from?
Start by eliminating Medicare Advantage (MA) and Part D, while updating Medicare to cover prescription drugs, along with vision, hearing aids, etc. MA was supposed to save taxpayers money by providing care more efficiently. Instead, Medicare pays MA companies 20 percent more than traditional Medicare for comparable patients.
Then, require all employers (including those who currently don’t provide insurance) to pay premiums to Medicare based on payroll. Require employees to pay Medicare premiums based on wages. Just like Social Security (of which Medicare is technically a provision). The Federal government continues to pay a share.
Everyone pays, everyone gets the care they need and nobody is left out. People can choose any qualified provider. Providers remain private, and are paid enough to attract and sustain the clinicians we want and need.
We have tried every kind of private for profit health insurance there is: employer sponsored, government subsidized, market based, capitation, value-based, catastrophic, health savings accounts—it no longer works for employers, taxpayers, or the sick. This year premiums will go up, coverage will go down.
Americans’ health will suffer.
Americans need care, not coverage. We clinicians have dedicated our lives to providing it. Medicare has served millions of us well for 60 years. We cannot allow opportunistic capitalists to stand in the way for the rest.