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"Mike Johnson's callousness is appalling," said one healthcare campaigner.
Americans are skipping meals and falling behind on bills, lines at food banks are expanding, and millions are watching with alarm as their health insurance premiums skyrocket, but Republican House Speaker Mike Johnson said Thursday that he's prepared to "let this process play out" rather than negotiate with Democrats to end the longest government shutdown in US history.
During a news conference, Johnson (R-La.) said he would not agree to hold a vote on extending Affordable Care Act (ACA) subsidies in exchange for Democratic votes to end the shutdown.
"I am not promising anybody anything," said Johnson, confirming Democrats' warnings that the GOP can't be trusted to uphold what would amount to a pinkie promise for an ACA vote.
"I am going to let this process play out," he added.
Johnson's remarks drew swift backlash. Leslie Dach, chair of the advocacy group Protect Our Care, said in a statement that "as Trump-GOP policies devastate Americans from coast to coast, and congressional Republicans continue the longest government shutdown in history, Mike Johnson's callousness is appalling."
"He won't even agree to allow a vote in the House to restore the healthcare tax credits that Republicans stripped away from millions of Americans," said Dach. "He'd rather more small businesses be financially annihilated, more hospitals vanish out of thin air, and more Americans—including in his own district—empty out their life savings just to go to a doctor."
"It's unconscionable," Dach added, "and voters, as they demonstrated in the November 4th bellwether elections across the nation, will hold the GOP to account for playing with their lives and selling out the American people—all so Republicans can provide more tax breaks to their billionaire buddies."
On Friday, as shutdown chaos and pain continues to spread nationwide, Senate Majority Leader John Thune (R-SD) is planning to call a vote on a plan that would temporarily fund the government and advance several appropriations bills. The proposal also includes a promise of a future vote on the ACA tax credits, which expire at the end of the year.
It's unlikely that Senate Democrats, who convened for a lengthy meeting Thursday afternoon, will accept the proposal, as they've demanded more concrete concessions from Republicans on the ACA subsidies. Republicans need at least seven Democratic senators to break ranks for the bill to pass.
Politico reported Friday that "Senate Democrats are splintered over how much stock to put into Thune's commitment, given the South Dakota Republican has also said he cannot guarantee an outcome of any such vote."
Sen. Chris Murphy (D-Conn.) told the outlet that Democrats shouldn't "proceed without knowing that these healthcare premiums are not going to go up by 200%."
Democrats won big by fighting against Trump’s attempts at tyranny and pledging to do everything in their power to make America affordable for everyone.
Tuesday night, American voters sent Democrats a message: In the face of President Donald Trump’s lawlessness, the American people want you to fight—not fold.
Congressional Democrats must respect the will and mandate of the people. Americans voted for their elected officials to stand up to Trump and make America affordable for everybody.
For months, Trump has behaved like a tyrannical dictator. He’s broken Social Security by pushing out thousands of dedicated public servants. He’s gutted Medicaid, which will force rural hospitals and nursing homes to close—all to give tax cuts to billionaires. And every time Americans go to the grocery store, prices are up again due to Trump’s tariffs.
All across the country, from Virginia to New Jersey to Georgia to New York City, Americans resoundingly voted against Trump and MAGA. Democrats won big by fighting against Trump’s attempts at tyranny and pledging to do everything in their power to make America affordable for everyone.
From moderate governors-elect in Virginia and New Jersey to a democratic socialist mayor-elect in New York City, and everywhere in between, there was only one message: Fight Trumpism and make America affordable.
Congressional Democrats have done just that for the last 35 days. They are refusing to sign off on a partisan Republican government funding bill that does nothing to stop health insurance costs from doubling (and in many cases, tripling) for tens of millions of Americans or to reverse the massive cuts to Medicaid. Republicans control the House, Senate, and White House. But instead of negotiating with Democrats to protect our healthcare, they shut down the government and left for a weeks-long paid vacation.
Going into this week’s elections, rumors were flying in DC that a gang of Senate Democrats was preparing to cave to Republicans. They want to provide Republicans with Democratic votes on their funding bill in exchange for nothing more than the promise of a vote on healthcare later.
Polling shows that Americans rightfully blame Republicans for both the government shutdown and exploding healthcare costs.
After this week’s elections, it’s Republicans who are feeling the pressure. If Democrats stand strong, they can win this fight—and save healthcare for millions of Americans.
From moderate governors-elect in Virginia and New Jersey to a democratic socialist mayor-elect in New York City, and everywhere in between, there was only one message: Fight Trumpism and make America affordable. The only people who cannot see the unified message of the entire spectrum of Democrats are people like TV pundits who are paid to not see it.
Eight Democratic Senators cannot be allowed to subvert the will of the voters clearly expressed Tuesday night.
Democratic leadership in the House and the Senate sent a letter this morning to Trump. It said: “We write to demand a bipartisan meeting of legislative leaders to end the GOP shutdown of the federal government and decisively address the Republican healthcare crisis. Democrats stand ready to meet with you face to face, anytime and anyplace.”
And yet, a gang of Senate Democrats are signaling to the press that they are going to not fight Trump and not make America affordable, by caving on the shutdown without securing lower healthcare costs. Overriding their own Senate leadership and colleagues, while also undermining the will of the American people.
Eight Democratic Senators cannot be allowed to subvert the will of the voters clearly expressed Tuesday night. Sen. Catherine Cortez Masto from Nevada and retiring Sen. Jeanne Shaheen from New Hampshire are ringleaders of the cave-for-nothing caucus. Call them today and tell them to listen to the people, fight Trump, and make America affordable by fixing the Republican healthcare crisis!
The Trump administration’s rural hospital fund, meant to soften the impact of the brutal Medicaid cuts in HR1, will require a murky submission process and will not come close to closing the gap for rural communities.
Amid furious efforts to cover their tracks, Republicans included $50 billion in new funding to offset the disastrous cuts that rural hospitals will face as a result of President Donald Trump’s House Resolution 1. Trump’s new Centers for Medicare and Medicaid Services Director, Dr. Mehmet Oz, gave an explanation which would be laughable if this weren’t so serious. He stated that the Rural Health Fund “is part of a broader effort to modernize rural healthcare… [and that] innovation is the reigning theme” citing growing opportunities for rural providers to become more engaged in the healthcare system.
The “Rural Health Fund” was established by HR1 to soften the impact of the legislation, which cuts $911 billion in federal Medicaid spending over 10 years, due to start after 2030. The good news is that the distribution of the $50 billion will begin before the Medicaid cuts take effect (conveniently before the midterms). The bad news is that the temporary $50 billion in new funding will offset a little over one-third (37%) of the estimated $137 billion in permanent cuts to federal Medicaid spending in rural areas. People everywhere can do the math. Fifty is a whole lot less than 137.
On September 15, Centers for Medicare and Medicaid Services (CMS) released a Notice of Funding Opportunity for states to apply for the funds. Half of the funds, $25 billion, will be distributed by CMS equally across all states with approved applications, and the other half distributed based on four factors identified by CMS, including priorities that align with the Make America Healthy Again agenda. While some of the goals are welcome, such as expanding access to opioid-use and substance-use disorder treatment and mental healthcare and recruiting and retraining clinicians in rural areas, other priorities, such as supporting value-based care, alternative payment models, and other innovative delivery arrangements that shift risk to practitioners away from insurance companies and that have been demonstrated to increase costs in Medicare, are worrisome. Predictably, no funds can be used to pay for abortions for women living in rural areas.
Each state, regardless of the size of their rural population and needs, will receive the same amount from the first $25 billion tranche. States with few rural hospitals, such as Delaware, with three rural hospitals, will receive equal funding as California, with 66 rural hospitals, some of which have closed and many which are at risk of closing, and that assumes that both states are approved for funding.
We urge residents of rural communities to stand together and demand the right to excellent healthcare that our wealthy nation can and must provide.
Disbursement of the funds promises to be a cronyism gravy train requiring applications, murky decision criteria, no administrative or judicial review, and nonexistent information as to the amount a state will receive, how the funds will be distributed, or even if the funds will go only to rural hospitals. A merit review panel will review the state applications with final award decisions made by CMS. The program runs for five years, but because CMS will reevaluate state initiatives every year, CMS could withhold, reduce, or even recover funding from the state depending on a state’s progress or if continued funding is “in the government’s best interests.” The only thing that is clear is that hospitals and their administrators will spend countless hours and resources on evaluation, reports, and contractors hired to write these reports.
The stakes for rural hospitals couldn’t be higher. As a result of the Medicaid cuts, hundreds of rural hospitals are at risk of closing. But even before cuts, rural hospitals have been shuttering: From 2005 to 2024, 193 rural hospitals closed. In the wake of HR1Sen. Ed Markey (D-Mass.) and others asked the Sheps Center to identify rural hospitals at risk of closing because of the Medicaid cuts. The Sheps Center identified 338 hospitals which either experienced three consecutive years of negative total margins, serve the highest share of Medicaid patients, or both. These are the hospitals that, because of their heavy reliance on Medicaid funds, will likely shutter.
What will happen to the millions of people who live in these rural communities when these hospitals close? The median travel distance to the next hospital, emergency room, substance-use, or heart specialty care center will jump seven- to eightfold. This translates to higher mortality from many common conditions: heart disease, cancer, stroke, and unintentional injury.
In "The False Promises of VA Privatization", author Suzanne Gordon highlights the plight of healthcare access for veterans and Americans who live in rural communities, the majority of whom already live in so-called medical and mental health deserts. For example, 81% of rural communities do not have even one psychiatric nurse practitioner and 65% do not have a single psychiatrist. The shuttering of rural hospitals will also mean the loss of thousands of healthcare worker jobs and the ensuing negative economic impact on those communities.
The $50 billion rural health fund earmarked by the Trump administration will not transform these rural medical deserts, will not protect the livelihood of workers and their families, nor will it safeguard their communities. The piddly funds will not staunch the bleeding the brutal cuts to Medicaid will cause.
National Single Payer has launched a “Save Our Rural Hospitals with National Single Payer” campaign. We believe that a national, improved Medicare for All, free from profit in the financing and the delivery of care, would provide the reliable, equitable funding needed to help hospitals and physicians not only survive, but thrive in rural areas. The funding from global budgets would be based on community healthcare needs and not on industry interests.
We urge individuals who live in districts where the at-risk hospitals are located to contact their representatives and ask them to cosponsor HR3069, the Medicare for All Act. If your representative is already a cosponsor, tell them to do more to put national single payer on the nation’s agenda.
People can also pass a resolution in their local organization or city council going on record in favor of saving and sustaining their rural hospitals by calling on Congress to pass national, improved Medicare for All, free from profit.
We urge residents of rural communities to stand together and demand the right to excellent healthcare that our wealthy nation can and must provide. The 46 million people living in America’s rural communities don’t need a temporary Band-Aid—they deserve what everyone deserves, no matter where they live—healthcare as a human right, free from profit.