Currently, the country is in the middle of what’s called open enrollment, when Americans evaluate their healthcare concerns and select an insurance plan that best fits their needs for the coming year. Well, at least that’s how insurance companies describe it. Really, what happens is normal people look at how wildly expensive their premiums have gotten and realize they’ll never be able to pay insurance and buy a house, have children, save for retirement, and so on.
So it’s odd that the debate in federal healthcare policy is always about extending coverage and never about just making care more affordable. In an ideal world, health insurance would be like car insurance – something that’s there for an emergency and not something you need, or else every problem becomes an emergency. But alas, we don’t live in an ideal world.
Insurance companies sure do, though, at least since the passage of the Affordable Care Act (ACA) 15 years ago. Since the ACA became law, some participating health insurance stocks are up more than 1,000 percent – record profits while so many Americans struggle to stay healthy and pay their bills.
All of this puts President Trump in a difficult position as the government considers whether to continue ACA subsidies or not. Trump doesn’t want to extend the subsidies, but as he told the press in November, “It may be necessary.” Without them, more than 20 million Americans will see their monthly premium payments more than double, according to KFF, which calculates consumers would pay an average of $1,016 more in 2026.
But extending ACA subsidies is feeding a ravenous beast.
Over all of this looms the reality of the 2026 midterms. New polling by Gallup shows almost half of Americans are worried about their ability to pay for healthcare in 2026, with voters in Republican battleground districts more worried about healthcare costs than groceries or housing. The risk of letting the Democrats take control would bring the president’s agenda to a screeching halt and delight the insurance companies.
So again, as the president said, it may be necessary to extend the ACA. But if we do, it’s necessary to extend them with some much-needed reform.
Corporate insurers can’t continue picking Uncle Sam’s pockets while doing nothing to keep him healthy. Insurance claim denials and delays threaten patients’ lives and quality of life. Patients, especially those on Medicare Advantage, face delays and denials that can limit their access to needed regular care, nursing homes, rehabilitation facilities, long-term care, and on and on. This obstruction to providing care also hurts providers, with 35 percent of hospitals losing more than half a million dollars every year to denied claims.
Moreover, insurers are predicted to overbill Medicare Advantage by as much as $2 trillion in the next eight years. UnitedHealthcare is facing a federal investigation about its overbilling, which would threaten those juicy Obamacare profits. But don’t expect any hearings on the subject if Democrats get gavels in 2027. In the 2024 cycle, insurers gave five times more money to Kamala Harris than to Donald Trump. In the 2018 cycle, the health insurance industry gave 30 times more to Democrat candidates than to Republicans: $63 million to just $2.2 million.
So, when Democrats make a principled stand to extend Obamacare subsidies, it’s not about helping make sure Timmy gets his cough medicine: it’s just payback for their donors. Even Obama’s cheerleaders at The New York Times call the ACA a “blessing” to health insurance companies!
Patients who cannot afford insurance still need treatment, and they vote. Delaying important preventative care only increases health expenses down the road, and increases in uncompensated care impact hospitals’ ability to make ends meet. Congress must follow the president’s lead to address skyrocketing healthcare costs by reforming the ACA, not continuing to write blank checks to it.
Under the Affordable Care Act 15 years ago, insurers have robbed the American people while pretending it’s all to help sick people. We’re in a difficult position politically, because if we pull the plug, then yes, people will lose care – but if we go on the offensive, as the president has shown us we must, then we can force some reform on these corrupt insurers that they’ve long needed. And maybe next year, open enrollment won’t be so horrifying.
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