Republican Healthcare Vote, Susie Wiles Interview, Nuclear Reactor Regulations
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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.
So these subsidies, which some 22 million Americans get, have been in place since the pandemic.
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.
But there are some moderate Republicans who do want to preserve the subsidies, at least temporarily. What happened to that effort?
A dozen or so House Republicans have been vocally pushing to extend the subsidies. Some have pressed for a vote to tack them onto Johnson's bill. There are also efforts to maneuver around leadership using a tool called a discharge petition, but none have enough support so far. And some of these Republicans have been fuming this week.
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.
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Chapters
4 chapters
1
What urgent healthcare issue is Congress facing before the holiday recess?
0:02–1:29
2
What insights did Susie Wiles share about the Trump administration?
1:29–3:58
3
How are healthcare subsidies impacting millions of Americans?
3:58–7:28
4
What disagreements exist among Republicans regarding healthcare subsidies?
7:28–12:53
Speakers
9 identifiedMore from Up First from NPR
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