\n Trump\u2019s off-the-cuff answer was a typical example of the waffle he sometimes conjures to escape a jam in a photo-op. But he could not disguise the downside of his \u201cwin\u201d in the government shutdown, which looks set to end after Democrats failed to secure their top demand: the extension of those enhanced Obamacare subsidies<\/a>.\n <\/p>\n \n Trump and Republicans once again own the issue of health care, with millions of citizens \u2014 not just those on ACA plans<\/a> \u2014 afflicted by rising premiums and high deductibles against the backdrop of a wider cost-of-living crisis<\/a>. And just as in his first term, Trump lacks a comprehensive, detailed plan to bring relief to citizens who lack health care, who can\u2019t afford the plans they have or who know that the loss of a job could leave them without any coverage at all.\n <\/p>\n \n If the GOP cannot fix the immediate issue of the subsidies \u2014 and convince voters they have a serious solution to this and other affordability questions \u2014 their 2026 midterm election hopes<\/a> could take a dive.\n <\/p>\n \n Trump\u2019s fogginess on health care is nothing new. Repeated unfulfilled promises to act took their place alongside his much-lampooned \u201cinfrastructure weeks<\/a>\u201d as punch lines in his first term. Trump\u2019s pledges to replace Obamacare shimmered with hyperbole but delivered nothing, and the 2010 law survives despite multiple Republican efforts to destroy it.\n <\/p>\n \n During the 2016 campaign, Trump pledged to repeal Obamacare and replace it with something \u201cterrific.\u201d At rallies, he promised Americans new health care that would cost less but be far better. If that sounds impossible, it\u2019s probably because it is.\n <\/p>\n \n Early in his first term, Trump promised that change was on the way. \u201cDespite what you hear in the press, healthcare is coming along great. We are talking to many groups and it will end in a beautiful picture!\u201d he wrote<\/a> on the website formerly known as Twitter in March 2017. The GOP failure to repeal Obamacare, partly because it couldn\u2019t come up with an alternative, didn\u2019t stop Trump\u2019s sunny predictions. \u201cThe Republican Party will be soon be known as theparty of health care,\u201d the president declared<\/a> in March 2019.\n <\/p>\n \n Second term, same as the first. In his debate with Democratic nominee Kamala Harris in 2024, Trump was mocked for saying he had<\/a> \u201cconcepts of a plan\u201d to make health care \u201cbetter and less expensive.\u201d More than a year later \u2014 and despite some significant efforts by Trump to bring down the cost of some prescription drugs \u2014 Americans are still waiting for his wider solutions.\n <\/p>\n \n The fight over health care was not just at the center of the government shutdown battle with Democrats. It\u2019s tearing at Republican Party unity. It\u2019s even estranged Trump and one of his most outspoken supporters, Marjorie Taylor Greene<\/a>. The Georgia representative broke ranks early in the shutdown to highlight ACA insurance premiums<\/a> for her family that she said would double in price due to expiring subsidies. While no fan of the ACA, she lashed out at her own party. \u201cNot a single Republican in leadership talked to us about this or has given us a plan to help Americans deal with their health insurance premiums DOUBLING!!!\u201d Greene wrote on X in October.\n <\/p>\n \n Greene\u2019s persistent criticism is a warning sign for House Speaker Mike Johnson after he called back the House to vote on the Senate plan to reopen the government this week. It might explain why he was so keen to keep the chamber dark during a shutdown that set internal GOP dissent simmering. Greene further distanced herself from Trump on Monday, saying on X that he should spend less time meeting foreign leaders and instead hold \u201cnonstop\u201d meetings on domestic policy.\n <\/p>\n \n The president told CNN\u2019s Kaitlan Collins, \u201cI don\u2019t know what happened to Marjorie. She\u2019s a nice woman, but I don\u2019t know what happened. She\u2019s lost her way, I think.\u201d Greene then told CNN, \u201cI haven\u2019t lost my way. I\u2019m 100% America first and only!\u201d\n <\/p>\n \n Greene might now be regarded as a MAGA heretic by some in Trump\u2019s orbit. But her comments on health care raise another possibility \u2014 that she\u2019s far more in tune with the economic insecurity felt by regular Americans than a billionaire president and his wealthy Cabinet.\n <\/p>\n \n She\u2019s not alone. During the shutdown, a group of endangered House Republicans wrote to Johnson<\/a> to urge him to address expiring enhanced ACA subsidies when the government reopens. \u201cWhile we did not create this crisis, we now have both the responsibility and the opportunity to address it,\u201d they wrote.\n <\/p>\n \n Senate Republican leader John Thune agreed to hold a vote in December on extending enhanced Obamacare subsidies as part of the deal with moderate Democrats to reopen the government.Chances of a Democrat-written bill passing are slim. But the vote will put GOP senators on the record and on a political spot.\n <\/p>\n \n Johnson hasn\u2019t pledged to hold a similar vote \u2014 one reason why progressive Democrats are angry about centrist Senate Democrats\u2019 compromise to end the shutdown.\n <\/p>\n \n The speaker told CNN\u2019s Jake Tapper on \u201cThe Lead\u201d Monday that he\u2019d always been willing to talk about rising health care costs, but that Democrats had squandered weeks of valuable time by triggering the shutdown last month. He promised debate on a plan to get to the \u201croot cause\u201d of the health care issue. But that is unlikely to help ACA policyholders forced to decide now whether to give up health plans they can\u2019t afford or pay punitively rising premiums.\n <\/p>\n \n Johnson could not tell Tapper whether there\u2019d be a vote on this issue soon. \u201cI\u2019m not committing to it or not committing to it. What I\u2019m saying is that we do a deliberative process. It\u2019s the way this always works and we have to have time to do that,\u201d the speaker said. But the tiny GOP majority gives little cause for optimism that an issue as complex and divisive as health care reform is something the fractious GOP and an absent president could handle.\n <\/p>\n \n One tangible gain for Democrats in the shutdown drama was their highlighting of the ACA issue and attacks on Republicans for failing to fix health care. In an NBC News poll<\/a> taken last month during the shutdown, 10% of respondents cited the cost of health care premiums as the single top issue deciding their vote for Congress next year. And 49% of respondents said Democrats would do a better job dealing with health care compared with 26% who thought the same of Republicans\n <\/p>\n \n Many Democrats are furious<\/a> that their moderate Senate colleagues made a deal with Republicans to reopen the government because they see it as a betrayal of Americans on the health care issue. But Sen. Jeanne Shaheen, who helped broker the deal and joined seven others in the Democratic caucus to back it, told CNN\u2019s Kate Bolduan the deal would show whether Republicans were serious.\n <\/p>\n \n \u201cFinally, because of the shutdown fight, we\u2019ve had a number of Republicans who have figured out that this is an issue for them,\u201d the New Hampshire Democrat said. \u201cSo, now we\u2019ll see. We\u2019ll see if they are really going to work with us to make sure that Americans can afford their health insurance.\u201d\n <\/p>\n \n Viewing Democratic tactics, a cynic might wonder whether the party, which failed to make the enhanced Obamacare credits permanent during the Biden administration, laid a trap for Republicans on an issue their rivals always failed to solve, especially under Trump.\n <\/p>\n \n Republicans argue that Trump\u2019s \u201cOne Big Beautiful Bill\u201d domestic policy law had already made significant steps to make health care more affordable by loosening the power of insurance companies and by restoring choice and control, partly by handing more responsibility to the states<\/a>. But multiple health care analysts and groups say that the bill\u2019s cuts to Medicaid funding<\/a> could leave millions vulnerable to losing coverage and threaten many rural hospitals with closure.\n <\/p>\n \n The administration has several initiatives designed to reduce the costs of prescription drugs for Americans. It plans to launch TrumpRx<\/a>, a direct-to-consumer website, early next year. Last week, the president unveiled a plan to make certain obesity drugs<\/a> available for as little as $149 in an arrangement that gives pharmaceutical firms like Eli Lilly and Novo Nordisk tariff breaks. If this plan works, it could be lifesaving for many patients who can\u2019t get the drugs through their insurers and can\u2019t afford out-of-pocket prices to buy them.\n <\/p>\n \n The initiative reflects Trump\u2019s willingness to use government power to intervene in markets, which has also been seen in other sectors, and which flies in the face of conservative orthodoxy. A plan he recently floated to send money directly to ACA policyholders, instead of offering subsidies, also seems to spring from a similar motivation to shake up the industry.\n <\/p>\n \n Yet the idea is fraught with uncertainties, including whether such payments would cover the shortfall of all the subsidies. Another question is whether it would simply make up the shortfall in subsidies to pay for premiums. Or would it be a separate payment that patients could use to pay for the costs of treatment directly?\n <\/p>\n \n In the latter case of a payment that bypasses insurance firms, recipients might be exposed to massive costs if they get an adverse diagnosis.\n <\/p>\n \n And spiking health costs don\u2019t only afflict ACA policyholders. If the government sent cash to certain Americans, how would that be fair to other taxpayers? And wouldn\u2019t state-financed payments for health care go against everything the GOP believes?\n <\/p>\n \n Such thorny questions, and the president\u2019s past failures to deliver on health care, explain the Republican Party\u2019s new but familiar political nightmare on an issue that causes anxiety for tens of millions of voters.\n <\/p>\n","protected":false},"excerpt":{"rendered":"It\u2019s the Trump ship that never sails. The president was back at it on Monday, promising an imminent…\n","protected":false},"author":2,"featured_media":256336,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":{"0":"post-256335","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom","12":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/256335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=256335"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/256335\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/256336"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=256335"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=256335"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=256335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"Rep.](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2025\/11\/gettyimages-2232923947.jpg\")
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