The USA’s federal government has been shut down for six weeks due to a deadlock in Congress over planned budget cuts, leaving thousands of federal workers unpaid and endangering healthcare coverage for the poorest families.
The budget changes threaten to slash Medicaid spending by $1 trillion over ten years, starting in two years’ time, and to withdraw subsidies that have kept health insurance costs low for millions of Americans on November 1. This will cause significant cost increases for families on low and middle incomes.
The cutbacks are part of the ‘One Big Beautiful Bill Act’ that was forced through Congress at the end of June. The Democrats, who all rallied against it as it went through, have now chosen to fight over one of the most immediate and sensitive aspects of the legislation: slashing health and public spending to push through a $3.8 trillion tax cut, mainly for the wealthiest minority, over 10 years.
Democrats therefore refused to lend the necessary support to put through a temporary budget to keep the federal government running until the end of the year – demanding that the Republicans back off the Medicaid cuts and agree to extend the Affordable Care Act tax credits.
According to a new poll from KFF (an independent source for health policy research, polling, and news) 78% of US voters want the tax credits to continue – including nine in ten (92%) Democrats, eight in ten (82%) independents, and six in ten (59%) Republicans. Even a majority of Republicans who align with the MAGA movement (57%) also say Congress should extend these subsidies.
There is good reason why the tax credits are so important to people: the 10 states that will see the highest premium increases for health insurance range from 234% in North Dakota to 387% in West Virginia. This will put even the limited insurance they have been able to afford since Obamacare out of reach, leaving millions more families uninsured.
The polls have produced a surprising split in the Republican ranks, with far-right conspiracy theorist Marjorie Taylor Greene taking to x/Twitter to state “I’m absolutely disgusted that health insurance premiums will DOUBLE if the tax credits expire this year.”
But the Republicans have cynically accused the Democrats of wanting to squander taxpayer dollars on “illegal immigrants.” House Speaker Mike Johnson has told Republicans to stay away from Washington – not least because it delays the swearing in of a new Democrat representative who would be a crucial extra signatory to force a vote on bipartisan legislation mandating the Department of Justice (DOJ) to release all unclassified Epstein documents within 30 days.
Meanwhile, an impressive and unprecedented line-up of six former Surgeons General (the top American doctors under every president since George HW Bush), have written an open letter to the Washington Post warning of the threat to health posed by Trump’s unhinged anti-vax Health Secretary, Robert F Kennedy Jr:
“Over recent months, we have watched with increasing alarm as the foundations of our nation’s public health system have been undermined. Science and expertise have taken a back seat to ideology and misinformation. Morale has plummeted in our health agencies, and talent is fleeing at a time when we face rising threats — from resurgent infectious diseases to worsening chronic illnesses.”
“Discrediting vaccines undermines one of the most important public health tools in American history. Thanks to widespread immunization, we eradicated smallpox, eliminated polio in the U.S. and prevented an estimated 1.1 million deaths and 508 million infections among children born between 1994 and 2023. Operation Warp Speed, initiated under President Donald Trump, brought lifesaving mRNA vaccines to the world in record time.
“Yet Kennedy continues to ignore science and the public’s wishes. Most recently, HHS proposed new warning labels on products containing acetaminophen (Tylenol), citing a supposed link between prenatal use and autism. This move has been widely condemned by the scientific and medical communities, who have pointed out that the available research is inconclusive and insufficient to justify such a warning. In an extraordinary and unprecedented response, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and other leading health organizations issued public guidance urging physicians and patients to disregard HHS’s recommendation. Instead of helping pregnant women make informed decisions during a critical period in their lives, Kennedy’s decisions risk causing confusion, fear and harm.
“Rather than combating the rapid spread of health misinformation with facts and clarity, Kennedy is amplifying it. The consequences aren’t abstract. They are measured in lives lost, disease outbreaks and an erosion of public trust that will take years to rebuild.”
It seems unlikely that the Trump administration will change course no matter what the level of opposition they encounter. The focus seems to be on seeking any possible pretext for gagging opposition and tightening repression.
* Out now: Wealth versus Health – Trump’s Global War on Health and Science, a new book by John Lister just published as a paperback by Bite-Sized Books: available at https://tinyurl.com/vzdys8py
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