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“These subsidies have to get bigger and bigger and bigger to keep the ACA affordable,” said US Senate candidate Dr. Abdul El-Sayed. “The fight for healthcare right now can’t end with ACA subsidies. It has to be bigger.”
As the government appears poised to reopen, with Republicans having successfully avoided concessions on their goal of eliminating Affordable Care Act tax credits, President Donald Trump has proposed his own solution to the looming explosion in health insurance costs.
By agreeing to reopen the government without a deal, Democrats have given up their main leverage to force Republicans to extend the credits set to expire at the end of the year. If this happens, over 22 million Americans are expected to see their monthly insurance premiums more than double. As enrollment data for next year shows, Americans are already seeing skyrocketing healthcare costs, not just for ACA recipients but for everyone.
While Republicans successfully strong-armed their opposition into caving by using the shutdown to turn the screws on government workers and food stamp recipients, they still have to weather the political fallout of the coming healthcare apocalypse. A poll released Thursday by KFF found that 74% of Americans—half of whom are self-identified Republicans—want to see the credits extended. Three-quarters also say they'd blame either Trump or Republicans in Congress if they weren't.
On Truth Social Saturday, as a shutdown deal appeared likely, Trump proposed his own idea:
I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE, and have money left over. In other words, take from the BIG, BAD Insurance Companies, give it to the people, and terminate, per Dollar spent, the worst Healthcare anywhere in the World, ObamaCare.
Trump is correct that under the current scheme, Americans don't actually receive money directly. But experts warn that while there’s a visceral populist logic to his proposal, the flaws of replacing those annual subsidies with a one-time payment become obvious with the barest of scrutiny, especially when it is paired with a proposal to fully repeal the ACA.
"You have to read between the lines here to imagine what President Trump is proposing," said Larry Levitt, the executive vice president for health policy at KFF. "It sounds like it could be a plan for health accounts that could be used for insurance that doesn’t cover preexisting conditions, which could create a death spiral in ACA plans that do."
One of the Senate's most prominent proponents of eliminating the ACA and other parts of the social safety net, Sen. Rick Scott (R-Fla.), said he was "writing the bill right now," and clarified that it would indeed involve "HSA-style accounts" for Americans in place of subsidized insurance.
On Sunday, Sen. Adam Schiff (D-Calif.) noted that this was just a reheating of the "same old, tired proposal of repealing the Affordable Care Act, giving people a benefit in the form of a health savings account, but allowing insurance companies once again to cancel policies and refuse to write policies for people who have preexisting health conditions."
HSAs were a key component of the Republicans' failed 2017 plan to "repeal and replace" the ACA, which many critics pointed out would allow insurers to skyrocket the costs of insurance for those dealing with preexisting conditions.
Sen. Chris Murphy (D-Conn.), who sits on the Senate Committee on Health, Education, Labor, and Pensions (HELP), called Trump's new plan "unsurprisingly nonsensical."
"Is he suggesting eliminating health insurance and giving people a few thousand dollars instead?" Murphy asked. "And then when they get a cancer diagnosis, they just go bankrupt?"
But while many Democrats decried yet another effort to dismantle the ACA, some progressives pointed out that health insurance costs, and healthcare costs more generally, have still exploded under Obamacare, which—despite introducing new guardrails—still leaves profit-driven insurance intact and requires all Americans to purchase it.
"Yes, Mr. President: You’re right. We do have 'the worst healthcare' of any major country," replied Sen. Bernie Sanders (I-Vt.), the HELP committee's ranking member, who has long decried the profiteering of insurance companies. "Despite spending twice as much per capita, we are the only major country not to guarantee health care to all as a human right. The solution: Medicare for All."
He was joined by Rep. Ro Khanna (D-Calif.), who ripped Trump's plan on Fox News.
"Healthcare premiums... they are going to spike about 100% in some cases," Khanna said. "Now, if you take the tax credits and you just give them to the American people, who is the president expecting them to buy the plans from? Is he expecting them to get junk insurance?"
"I agree with him that the system is broken," he continued. "And we should be expanding Medicare to have Medicare for All. But in the meantime, we've got to give people help so that their premiums don't spike."
On social media, Khanna pointed to a 2020 analysis by the nonpartisan Congressional Budget Office (CBO), which found that the US would spend about $650 billion less on healthcare per year in 2030 if it adopted Medicare for All because it would drastically reduce the administrative waste and non-healthcare-related spending inherent to private insurance. It would also allow the government to use its massive leverage as America's primary insurer to negotiate dramatic price reductions for drugs and medical services.
Those arguments have also been made by Dr. Abdul El-Sayed, a long-time Medicare for All proponent who is running for the open Senate seat in Michigan in 2026. He explained to a crowd that the fact that Republicans "can muck around with subsidies" in the first place is evidence of a broader healthcare crisis that stems from the preeminence of privatized healthcare.
"The very fact that we're watching as these subsidies have to get bigger and bigger and bigger to keep the ACA affordable, the very fact that we're relying on Medicaid to be expanded, that, to me, is the reason why in a moment like this, it's not enough just to protect what we have," he said.
He continued on social media: "The fight for healthcare right now can’t end with ACA subsidies. It has to be bigger. Too many Americans are suffering over medical debt and spiraling costs. It should be nothing short of Medicare for All."
"We don’t need more corporate Democrats in the Senate. We need Peggy Flanagan, who’ll fight for working people."
Calling for more Democratic lawmakers who have “the guts to stand up for working people," Sen. Bernie Sanders weighed in on another US Senate primary on Monday, hours after a handful of Democrats agreed to reopen the federal government without Republican concessions on healthcare.
Sanders (I-Vt.), who earlier this year announced his support for Democratic Senate candidates Graham Platner in Maine and Abdul El-Sayed in Michigan, has now formally endorsed Minnesota Lt. Gov. Peggy Flanagan's candidacy for the US Senate.
In his endorsement, Sanders said that the Senate needs lawmakers who will stand up "against the billionaires and the corporate interests," and argued that Flanagan understands the needs of working-class people personally due in part to her own blue-collar background.
"Peggy knows what it is to struggle," he said. "She was raised by a hard-working single mother who needed [the Supplemental Nutrition Assistance Program] to help put food on the table and Medicaid for healthcare. And she’s dedicated her career to fighting for working families."
Sanders also hailed Flanagan's accomplishments as both lieutenant governor and Minnesota state legislator, and he said she would work to fight for progressive priorities on a national level.
"Peggy fought to raise the minimum wage and she got it done," he said. "She fought for paid family leave and she got it done. We need fighters who are from the working class and for the working class here in the Senate. Peggy will fight for Medicare for All, to raise the minimum wage to a living wage, and to address the crises we face in childcare, education, and housing."
Sanders concluded his endorsement by arguing that "we don’t need more corporate Democrats in the Senate. We need Peggy Flanagan, who’ll fight for working people."
Progressive political consultant Rebecca Katz hailed Sanders' endorsements of Flanagan, Platner, and El-Sayed, whom she described on X as "three good candidates who understand the stakes and know how to fight back."
Flanagan is running to replace retiring Sen. Tina Smith (D-Minn.), who has been serving in the Senate ever since former Sen. Al Franken (D-Minn.) resigned in 2018. Flanagan will be facing off against Rep. Angie Craig (D-Minn), a centrist Democrat who has several endorsements from the Democratic establishment, including House Minority Leader Hakeem Jeffries (D-NY) and former House Speaker Nancy Pelosi (D-Calif.).
According to Minnesota Reformer, Flanagan has also scored endorsements from Sens. Elizabeth Warren (D-Mass.) and Ed Markey (D-Mass.), who both stumped for her at the Minnesota State Fair this past summer.
“Starbucks must reverse course from its current posture, resolve its existing labor disputes, and bargain a fair contract in good faith with these employees.”
As Starbucks workers prepare to strike amid stalled contract talks with management, more than 80 US lawmakers on Monday demanded that bosses at the world's largest coffee chain stop union busting and negotiate a fair deal for employees.
Starbucks workers—who have been in talks with company bosses led by CEO Brian Niccol for over a year—accuse management of stonewalling on key contract issues including higher pay, more hours, and an end to unfair labor practices and union busting. Last week, members of Starbucks Workers United overwhelmingly voted to authorize an unfair labor practices strike—they're calling it a "Red Cup Rebellion"—at over 650 locations if the company fails to finalize a fair contract by November 13.
Members of the Congressional Labor Caucus led by Sen. Bernie Sanders (I-Vt.) in the Senate and Rep. Pramila Jayapal (D-Wash.) in the House sent letters to Niccol expressing their concern over management's "failure to reach a fair first contract with its baristas" and a "troubling return to union busting."
"In February 2024, Starbucks and Workers United announced a path forward to commit to negotiating a foundational framework for contracts, establishing a fair process for organizing, and resolving outstanding legal issues," the Senate letter states. "We were hopeful that the company would abide by this commitment and bargain in good faith with Starbucks workers who exercised their right to form a union."
The lawmakers continued:
As you well know Starbucks is not a poor company. Last year Starbucks made over $3.6 billion in profit and paid out nearly $5 billion in stock buybacks and dividends. In fact, in the first three quarters of the year, Starbucks made $1.7 billion in profit and paid out over $2 billion in dividends. Last year, you made $95 million in compensation for the four months you worked in 2024, roughly 6,666 times more than what your average worker was paid for the entire year.
Despite that extravagant spending on executives and shareholders, Starbucks refuses to reach an agreement with its own workers even though you are less than one average day’s sales apart from a contract. To make matters worse, Starbucks recently began closing stores across the country and laying off hundreds of workers as part its $1 billion restructuring plan. It is clear that Starbucks has the money to reach a fair agreement with its workers.
"Starbucks must reverse course from its current posture, resolve its existing labor disputes, and bargain a fair contract in good faith with these employees," the letter demands.
Starbucks Workers United has already filed more than 100 charges against the coffee giant over the past 11 months, alleging unfair labor practices including reprisals against unionizing baristas. The union calls Starbucks "the biggest violator of labor law in modern history," as administrative law judges and the National Labor Relations Board (NLRB) have found that the company has committed more than 500 violations of labor law.
Niccol—who last year became Starbucks’ fourth CEO in just two years—brought with him a history of union busting during his previous job as the head of Chipotle. Under his leadership, the fast-food chain closed a store in Augusta, Maine in 2022 after employees there tried to make it the company’s first unionized location. The workers filed a complaint at the NLRB, which ruled that the closure was an illegal act of union busting.
Workers at more than 600 Starbucks locations across the United States have voted to unionize since baristas at a store on Elmwood Avenue in Buffalo, New York became the first to do so in late 2021.
“Union baristas mean business and are ready to do whatever it takes to win a fair contract and end Starbucks’ unfair labor practices,” Michelle Eisen, a Starbucks Workers United spokesperson and 15-year veteran barista, said in a statement announcing last week's strike authorization. “We want Starbucks to succeed, but turning the company around and bringing customers back begins with listening to and supporting the baristas who are responsible for the Starbucks experience."
"If Starbucks keeps stonewalling, they should expect to see their business grind to a halt," Eisen added. "The ball is in Starbucks’ court.”