Up First from NPR
Republican Healthcare Vote, Susie Wiles Interview, Nuclear Reactor Regulations
17 Dec 2025
Chapter 1: What urgent healthcare issue is Congress facing before the holiday recess?
With two days left in their session, House Republicans prepare to vote on a health care plan.
The roots of Obamacare, they've gotten so deep that it's no longer possible to just pull it out at the root and start over.
So what is Speaker Mike Johnson planning? I'm Steve Inskeep with Michelle Martin, and this is Up First from NPR News. The president's chief of staff, Susie Wiles, offers a behind-the-scenes look at the White House in a Vanity Fair story. What did she say about the administration and the people in it?
And the Trump administration is fast-tracking new nuclear reactor designs. Some safety advocates are worried about the government's approach to regulation.
This is not okay, and this is not going to lead to success. This is how to have an accident.
Stay with us. We'll give you the news you need to start your day. Congress has two days to take action on health care subsidies before lawmakers head out of the Capitol for the holiday recess.
The enhanced subsidies for Affordable Care Act marketplace plans will expire at the end of this year. Millions of Americans can expect their premiums to increase by thousands of dollars, and some plan to drop their coverage. There is no sign of anything that Congress will do about it, although the House plans a vote today.
NPR congressional reporter Sam Greenglass has been tracking this story from Capitol Hill. He's with us now. Good morning, Sam.
Hey, Michelle.
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Chapter 2: What insights did Susie Wiles share about the Trump administration?
Now, we know that without them, premiums could double or triple. So why are we down to the wire here on addressing this?
Well, Michelle, there is not consensus about how to extend the subsidies. And among Republicans, there is disagreement about whether to extend them at all. Now, the deadline to sign up for plans on the Affordable Care Act marketplace has passed now. And some people have said they'll forego insurance because they can no longer afford the premiums.
The Congressional Budget Office estimates next year 2.2 million people may lose their coverage.
Tell us more about the fault lines here. Is it strictly along party lines?
No, not exactly. Democrats want to simply extend the subsidies for three years. A vote to do that failed in the Senate last week, though it did attract four Republican votes. Now, Republicans have their own proposals to cut health costs. Senate Republicans came up with a plan. to deposit up to $1,500 in health savings accounts for high-deductible ACA plans. That also failed last week.
Republican leaders in the House are setting up a vote today on their own plan, but neither of these two Republican measures would extend the subsidies. What do you expect in the House today? So this House bill is a package of ideas long favored by conservatives to cut health costs. like association health plans and new regulations for pharmacy benefit managers.
But they would not do much to prevent the ACA plan premiums from spiking next year. You know, since the ACA passed 15 years ago, Republicans have tried to repeal and replace it. House Speaker Mike Johnson says the new aim is reduce and repair.
The roots of Obamacare, the Unaffordable Care Act, have gotten so deep in the system that it's no longer possible to just pull it out at the root and chop it off and start over. It's too deeply ingrained. And so now we have to take it step by step to reduce cost and repair the system.
Johnson says subsidies are just expensive taxpayer handouts to insurance companies.
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Chapter 3: How are healthcare subsidies impacting millions of Americans?
Republican Congressman Mike Lawler slammed GOP leadership for blocking a vote on the subsidies and Democratic leaders for insisting on a three-year extension without reforms to sway Republicans.
It is idiotic and shameful. This place is disgraceful. Everybody wants the upper hand. Everybody wants the political advantage.
They don't actually want to do the damn work.
So down to the wire here, Sam, any changes likely? Bipartisan talks are still happening among some rank-and-file senators, but most lawmakers have acknowledged a solution is not going to happen this year, which means premiums for many Americans are going to shoot up on January 1st.
NPR congressional reporter Sam Greenclass. Sam, thank you.
Thank you.
The White House chief of staff offered some edgy assessments of President Trump and others in the administration. Susie Wiles gave her opinions, not in some passing remark, but in months' worth of interviews.
The resulting article in Vanity Fair illuminates a woman who rarely made headlines up to now. She has acted as the president's facilitator. Since before the inauguration, she's also been ducking out of White House meetings to tell a reporter how Trump's White House works.
NPR White House correspondent Danielle Kurtzleben is here to talk about that fallout. Good morning, Danielle. Hey, Michelle. So what was in this piece that got so much attention?
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Chapter 4: What disagreements exist among Republicans regarding healthcare subsidies?
You know why I really love Susie Wiles? Because Susie is who she is in the president's presence. She's the same exact person when the president isn't around. I've never seen Susie Wiles say something to the president and then go and counteract him or subvert his will behind the scenes.
He also blamed the news media. But again, this was more than a year's worth of interviews, meaning Wiles agreed repeatedly to give Vanity Fair this access.
OK, so quickly, Danielle, the Trump administration at war with the media is not a new thing. So why is this such a big deal and why the concerted pushback?
Well, first of all, like you said, that it's just rare for Wiles to talk to reporters and be this unfiltered. Secondly, the drama got attention, as drama does. But beyond all that, there's the context that the administration has been trying to focus on the economy.
Here we see just how easily that can be derailed, just as Trump himself did earlier this week when he disparaged the slain liberal film director Rob Reiner. Now, tonight, the White House is going to try to get back on course with the primetime address. which is expected to focus on the president's first-year wins.
NPR's Danielle Kurtzleben. Danielle, thank you.
Thank you.
The Trump administration has ambitious plans for nuclear power.
Yeah, a program unveiled earlier this year is supposed to get nuclear reactors up and running just months from now.
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