Shutdown fight highlights health care crisis in U.S.

Oct. 1 dawned with news of another government shutdown as Congress failed to pass a funding bill. 

At the heart of this shutdown is a fight over health care subsidies and budget cuts. Democrats want to extend a temporary program that lowered healthcare costs for 20 million Americans, and to unwind theMedicaid cuts passed in the “Big Beautiful Bill.’’

The “Big Beautiful Bill” passed under rescission, meaning it only needed 50 votes in the Senate. The current legislation needed 60 votes, and fell short.

The Democratic argument is based on affordability, a fairly straightforward case in these fraught economic times. The GOP rebuttals were a bit scattershot, from saying the issues could be addressed later to claiming Democrats wanted to pay for health care for undocumented immigrants. Those in the U.S. unlawfully can’t sign up for Medicaid or get subsidized coverage through the Affordable Care Act. And if you think an undocumented immigrant would identify themselves to the government in today’s political climate, we’ve got a secret prison in El Salvador we’d like to sell you.

In the background, Democratic voters are howling for members of their party to stand up against what they view as overreaches of the Trump administration, including spending issues. After all, past budget agreements have been neutered by aggressive new tactics on rescissions, such as yanking back approved spending on USAID and the Corporation for Public Broadcasting. The Constitution clearly gives the power of the purse to Congress, not the White House. However, the U.S. House has ceded that authority again and again. It doesn’t help that a number of Supreme Court justices were apparently out sick the day that was covered in law class.

Then, there’s the fact the White House was putting out AI videos featuring Democratic negotiators as Frito Bandito caricatures indicating, to put it politely as possible, a lack of seriousness on any negotiations.

So, the shutdown is here, and no one’s sure when or how it will end. What we do know for sure is that it will deliver real pain.

Democrats are right to fight for the restoration of the health care benefits axed in the “Big Beautiful Bill.” According to the Kaiser Family Foundation, as a result of that bill health care premiums will double for Marketplace enrollees currently receiving assistance via current tax credits; 3.8 million Americans will eventually become uninsured; and middle-class families will get a one-two punch, losing currently available subsidies and seeing premiums rise.

The News & Observer reports the elimination of the aforementioned subsidies, passed during the COVID pandemic, could put coverage in peril for nearly half a million North Carolinians. The “Big Beautiful Bill’’ also proposes SNAP cuts that put food assistance at risk; last year, 1.42 million North Carolinians were on SNAP, a number considerably swollen due to the wrath of Helene in the western part of the state.

The list goes on and on. The 13 National Park Service areas in the state will undoubtedly be impacted, farmers already in crisis can expect less from the USDA, etc. etc. There are, to paraphrase Donald Rumsfeld, known knowns and a ton of unknown unknowns.

This we do know: If you are going to raise obscene amounts of money and spend enormous amounts of time to gain elective office, you might consider doing your job and working through disagreements to help the American people instead of closing up shop and heading to your respective corner to take to the airwaves and TV studios to play the blame game. In a sense Congress has no skin in this game – they aren’t at risk of losing their own health care coverage.

For decades we’ve heard that America has the best health care system in the world. But for anyone who has had to wade into the Rube Goldberg-esque system of getting that health care delivered, it’s painfully obvious we can do better, like pretty much every other advanced democracy. Worldwide, for example, medical bankruptcies are relatively rare. 

In the U.S., they account for 66.5 percent of all bankruptcies.

Until we elect leaders willing to address why we’re such an aberration, we’ll keep finding ourselves in the position we’re in today.

Ball’s in your court, voters.