Rep. Sean Casten (D-IL) warns that letting COVID-era ACA tax credits expire could spike premiums by $2,000/month, harming 20 million Americans’ coverage and efficiency—like Switzerland’s universal system. He calls Venezuela strikes unconstitutional, including a "war crime" boat attack, and Trump’s ICC funding threats a sign of legal fear. Casten argues tariffs, not Fed cuts, drive inflation, criticizing political interference in economic data. The episode underscores urgent healthcare risks, executive overreach, and fragile economic independence amid partisan gridlock. [Automatically generated summary]
Well, we should be very thoughtful, and that's why I go back to the district every weekend.
I mean, I've been doing this for nine years, going on ten years.
You try to go back every weekend, and I try to go to as many local events where you hear from people's concerns, and you try to reflect that in Congress.
And one of the things that we did do during COVID is we put these tax credits on, and they were supposed to be temporary, but in a sense, now they're becoming permanent.
And so that concerns the Republican side, and the costs keep going up.
And so it gets back a little bit, just playing off what the caller said.
We've got to find something better.
We've got to find a little more deeper reforms in the long run here to lower these costs because they are unsustainable.
But I would tell my Republican colleagues, if we do nothing, it's overmer, say we're not going to do these tax credits.
They're going to expire.
Well, that means the average person's premiums are going up about $2,000 a month.
That's not acceptable.
It's not their fault, right?
And it may not be our plan that we put in place is largely done by Democrats, but we're in charge.
So we've got to find a way to at least temporary help and then find a deeper solution.
It's a pleasure to be on after my friend Don Bacon, and I'm sorry he's retiring.
We're going to miss him around here.
I don't think I share his optimism, unfortunately.
We know that the path to get through, I would agree with him that the path to get through requires 60 votes in the Senate.
To get 60 votes in the Senate, you're either going to have to have something like the extension of the A subsidies that just failed, or on the Republican side, there's just a lot of push to put a lot of poison pills, not provide women with access to full maternal health care services, and then you're going to lose Dems and not get the 60 votes.
It's unfortunately true that we got all of the benefits of the ACA on a straight party line vote when the Democrats controlled the Senate.
We got the extensions of the ACA subsidies that gave 20 million more Americans access to health insurance during COVID on a straight party line vote.
And I guess what makes me sad is to the point of one of your last callers with Mr. Bacon is that the ACA is a Republican idea.
It came out of the Heritage Foundation and was adopted by Mitt Romney and was a really good idea.
And when Obama came in and said, let's take this good idea that was created in the Republican Party and let's make this a national idea, all of a sudden it then became a partisan idea, but it's still a good idea, right?
We still need to find some way to address the health care needs of folks who don't have private health insurance than their employer, aren't old enough to qualify for Medicare, aren't veterans that don't qualify for the VA, aren't Native Americans that don't qualify for the Indian Health Care Service, aren't poor enough to qualify for Medicaid.
That's a big gap of people that the ACA was designed to fill in.
And every time we cut people out of that program, we cut huge chunks of people out of dignity, out of the ability to have a healthy life.
And it drives up the overall cost of our health care system.
I'd love to be optimistic, but I really have a hard time seeing the Senate or the House getting to consensus on what's sort of blindingly obvious and should be bipartisan.
Speaker Mike Johnson this week saying there will be a vote on a health care proposal.
If moderate Republicans are able to secure a vote on these compromises that have been put forth by the likes of Congressman Brian Fitzpatrick and Congresswoman Jen Kiggins, who have teamed up with Democrats, if he allows a vote on their proposals that folks are trying to get a discharge petition on, do you think they could pass in the House?
Well, look, I'm all for Mike Johnson bringing votes to the floor.
Let's not have these conversations in back rooms.
I'm not sure I have something intelligent to add beyond what I said a moment ago.
It really, the devil's in the details.
If you have a clean extension of the ACA, and look, if they're concerned, if they think there's tweaks they want to make, okay, fine, but do a clean extension for one, two, three years.
Give time to have that policy conversation.
I think the idea that we're going to make major structural reforms to the ACA with everybody having time to think through what those are, whether that means means-adjusted payments, blocking out access to certain people who are currently eligible for the ACA, the idea that we're going to do that in seven days and really think through the details, I'm not sure I buy that.
So I think if there's a vote for a clean temporary extension, I think that probably could pass, could certainly get all Democratic support.
The more it's constrained, the less optimistic I am that that has the votes in the House.
One of the proposals by the problem solver caucus chair, Josh Gottheimer, along with Jen Kiggins, a Republican, one-year extension, income limits and fraud protection, so close to what you're talking about here for extending these enhanced tax credits.
What have you heard from your leader, Hakeem Jefferies, in the House about what leadership is thinking the next move is for Democrats?
I have not spoken directly to Hakeem or other leadership about that question.
I do just think there's a general question.
I mean, if you start saying we're going to put fraud protections and income limits, you know, for who?
How is that done?
We saw in the huge, the big, ugly bill that the Republicans passed earlier this year, we saw things that said they were putting in fraud protection for Medicaid.
What that did practically is made it really hard for people who are struggling, maybe can't access the necessary paperwork, maybe need social service support to fill out those forms.
Those people just fell out of the health care system.
I'm not saying fraud protection is a bad thing to do, but I'm just saying the devil is in the details.
And I think everybody in the Democratic Party, from leadership on down, is keen about not making major structural to our health care system without enough time to really think through those.
So just personally, I think we are better off with just a clean short-term extension and then get to trying to tweak this if we think there's appropriate and a good consensus to do so, but not try to do that between now and December 31st.
I listened to the debates about the health care and what the Republicans are having trouble with, they're not explaining in English that the people can understand what their plan is.
I mean, if they explained it, maybe we could get on board with it.
But I knew more about it before they ever started than I do now.
I mean, they've got these plans and they talk in politic language and nobody understands what they're talking about.
Look, I mean, and I want to come back to the fact, well, I said before, that this was originally a Republican idea.
If you look, every country in the world that has universal health care coverage, and there's a lot of different ways to have universal health care coverage.
Maybe that's a government-provided program.
Maybe that's a lot of public-private sector involvement.
Every country that has universal coverage has higher quality health care than the U.S. does and lower costs, which makes sense, right?
Because if you're uninsured, you still might get hit by a car.
You still show up at the hospital.
You still consume resources for those hospitals.
You still would like to have preventative care, but you don't do it because you don't have insurance.
And now all of a sudden, by the time you go to the hospital, you have really expensive and hard-to-diagnose needs.
So the whole idea of this heritage plan back in the 90s for creating what became the ACA was let's fill in that gap so that everybody has coverage.
I don't think that's really hard to understand because everybody understands the need to get health care coverage.
Yes, the system's complicated.
But the fact that it became so partisan to defend the ACA meant that any conversation about how to tweak it gets caught up in a lot of gobbledygook that ultimately the reason why Betty can't understand it is because it doesn't make any sense.
I just heard the congressman outline some significant facts regarding how uncompetitive we are relative to our country peers in terms of health care, where the universal health care in other countries seems to deliver more effective health care for all of their citizens at lower costs.
He's 100% right on that.
I agree with him.
And I would hope, and I would quickly summarize the following what I recommend we do, and that is we move, try is get an extension now as an interim measure to leave time to educate and promote legislation for a universal health care system funded as follows by direct issuance of a sovereign currency funding because we don't need to raise taxes.
We don't need to issue bonds.
We just need for Congress and the Senate and the President to initiate legislation to direct the U.S. Treasury to pay, to fund health care as defined by the head of our health care system.
Essentially, it's a single-payer health care system.
Yeah, so just so just quickly, and I've got to try to say this as succinctly as I can.
Universal health care coverage, there's a lot of ways to get there.
Single payer is one way to do that.
The British famously had the National Health Service.
Lots of countries have universal health care with mixed public and private systems.
I think given the structure of the U.S. system, lots of Americans do have health insurance.
Most of them don't like it very much, but lots of Americans have health insurance.
And really the goal of the ACA originally was to try to address those people who currently don't.
It didn't go all the way ultimately because, and this is a bit of a deep cut, if you recall, Joe Lieberman at the time, the senator objected to the public option that would have made sure that everybody ended up being in there, I'm sorry, the individual mandate.
So the ACA got a lot more people in, but not everybody.
There's some interesting academic research that the countries that still maintain a healthy amount of competition in the system, which you don't get in single payer, actually have better outcomes than the ones that go to pure single payer.
All of them have lower costs.
So, you know, I don't want to make the perfect enemy of the good, but I think within our political system, dealing first with the people who are currently uninsured is probably more efficient than saying, let's rip the whole thing down and start from scratch.
So the reason that these were temporary was not because they were intended to be temporary.
It was because when we brought this package forward to try to make them permanent, Joe Manchin said he would only support the package if they were temporary.
So this was Joe Manchin's decision to make them temporary, not some larger policy purpose.
I think what's important to recognize is if, you know, when we use the word subsidy, I think there's this assumption that, okay, government is paying money and they, you know, and that's just pure waste.
We don't talk about a lot of things government does that way.
Like, do we talk about the government subsidizing our military?
Do we talk about the government subsidizing our border security?
No, we recognize that when government does that, that gives us all the ability to do other things we wouldn't otherwise have to do.
And this goes back to the point about universal health care.
If you are paying for health insurance out of your own pocket, you're not taking a dime from the federal government for it, and you go to the hospital in an emergency and that emergency room is short-staffed or doesn't have enough beds or is full of people who aren't insured but have urgent needs in front of you, your quality of health care falls.
So the idea of government providing people with that access is it makes all of our health care systems better.
We should be, for totally selfish reasons, we should want to have a system where everybody has access to health care.
And to put this in context, the Swiss that have the best health outcomes in the world spend two-thirds as much per capita as we do.
We spend a little over $3 trillion per year on health care.
So if you want a trillion dollars, subsidize health care.
That's where the math is, right?
So it's in our self-interest to make sure that everybody has access to health care.
How have insurance companies responded, though, to these enhanced tax credits?
And before they were enhanced during the COVID era, the subsidies or the tax credits given to those who are enrolled in ACA.
How have the insurance companies responded?
Because you've heard from the president Republicans that said they just, they have no incentive to lower their costs because of the way this is structured.
There's about 20 million Americans who have access to health care because of those ACA tax extensions that were done during COVID.
Those people didn't get access to health care because the insurance companies were mandated to provide them.
They got access to health care because the insurance companies who were involved in that program were able to lower their rates because of those subsidies and more Americans were now able to afford buying into the ACA.
So it's an affordability issue that made access possible.
Anybody who was on the ACA is now seeing the flip side of that because if you got the notification from your insurance company and you were on the ACA, which was obligated to go out after November 1st, you invariably saw a huge spike in the premiums you're going to have to pay next year.
And I'm not saying insurance companies don't try to make money.
Every company tries to make money, that's fine.
But you're seeing the impact of the insurance companies saying, I could give you a lower rate when there was a subsidy.
In other words, that savings was passed on to you.
And now that the subsidy isn't there, I'm going to have to raise your rates.
And that's going to push, you know, if the math follows what it did last time, that's going to mean that 20 million Americans can't afford health insurance anymore and go off the system and get sicker.
So the idea that this was just a subsidy to insurance companies, there's no evidence that that's the case.
I have a question that I think is, you know, you go back to naming individuals who held this up, like Manchin would had to have it temporary.
But if that was temporary, that was years ago.
You know, every time you guys give a free benefit or free subsidies to somebody, you really think they're going to want to give it up?
If you know that was coming to an end, why didn't you take corrective actions and look at some type of logical plan that either would continue that or that we'd develop some other type of plan?
And here we are again at the 11th hour.
People are going to see big increases.
And both you sides, your Republicans and Democrats, act like a bunch of children.
You never get it together.
So you look at the betterment of what you can do for this country.
All you're concerned about is what you can do to get re-elected.
Well, I guess I first want to assure you, Bob, that as someone once said, walk around Washington, D.C. and look at the statues to politicians and note that they're all built after politicians die.
If your goal is to have glory and celebrity, this is not the line of work to do it.
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I don't think getting re-elected is the only reason to do this.
But on a more serious note, those extensions weren't that many years ago.
It was three years ago.
It was in COVID that that was put in place.
And what's unfortunately true is it's not a political issue, but it is a process issue.
That under the rules of the Senate, virtually anything requires 60 votes, so a supermajority to get something to pass.
And one of the few exceptions to that is if you are doing what's called reconciliation, which is to say once a year, if you are doing something related to spending consistent with the annual budget, you can pass it on a simple 50-plus-one vote majority.
And so when that was passed three years ago, if you recall, what Joe mentioned was the swing vote, the Democrats could pass things purely on a party-line basis, but we had to have every Democrat on board.
You saw that more recently, the huge cuts to Medicaid, the huge cuts to food assistance.
That was passed on a straight party line vote.
And the one big beautiful bill, as Trump calls it, I don't think it's that beautiful, but that was passed on a straight party line vote as a set of Republican priorities.
What's happened in the intervening three years is there have been a lot of proposals.
My colleague from Illinois, Lauren Underwood, has been introducing bills every single term since she and I were elected in the 119th to make those expanded subsidies permanent.
There haven't been the votes in the Senate to do that because the Senate depends on supermajorities, except in that reconciliation process.
I'd love to have a conversation with you about how to reform Senate procedure, how to make the Senate more responsive to public will, because these sorts of things, as I think Bob notes, these are very popular with the American people.
They would rather we do things that are popular than get into long diatribes about procedure, but that requires changing the procedure, and until they change, we're left with these issues.
But again, it's only three years ago, and there's very broad consensus in the Democratic Party and has been for a while to bring it forward.
I mean, look, I pushed for permanent before and we settled on three years.
So, you know, of course there's always opportunities for extension.
I think the red line for me, as I mentioned earlier, is let's not be overly cute with a bunch of additional tweaks in there.
If we can get to a point where we have a clean extension of subsidies and that bill's on the floor and we've got a way to get that through, yeah, let's do it and get it done and live to fight another day, knowing that the American people can go home with some confidence that their health costs aren't going to go through the roof and they're going to get sick when we, as decent legislators, could prevent them from getting sick.
I just don't know if that can get through the Senate.
Congressman, let's turn our attention to Venezuela and the actions by this administration, both the boat strikes, the seizure of that oil tanker, and the president not ruling out some sort of land invasion to rid the country of their leader, Maduro.
Is the actions so far that you've seen legal in your opinion?
No, and I have some serious concerns about what this White House is doing.
The argument that the White House can engage in war against another country without congressional consent, that is plainly unconstitutional.
What the White House has argued to date is that they have the right to target these attacks without congressional intent because they're going after non-state actors, specifically drug runners.
That's also pretty shaky.
They've essentially argued that because drugs can kill people, anybody who sells drugs is selling something that's deadly and therefore drug runners are at war on the American people.
If you want to pick a hole in that logic, ask if Venezuelans would have the right to conduct military operations against U.S. gun manufacturers that have the potential to kill Venezuelans, do kill some Venezuelans.
Does that mean Smith ⁇ Wesson is a terrorist organization?
I think you can quickly see how that falls apart.
As the Trump administration is now pushing closer to saying this is really a specific attack on Venezuela As a country, that becomes even more problematic without congressional approval.
And all of this is before getting to the point of what appears to have been, I haven't seen the video, but this idea of targeting that second hit on the boat, targeting people who had no means of attack, who were completely vulnerable, that sure looks like a war crime to me.
And there are huge problems.
I think the fact that Donald Trump, I believe yesterday, said that he was going to try to block support for the International Criminal Court unless the International Criminal Court agreed never to prosecute him or his team suggests, as I noted, that he's sort of like a football player who can hear the defender closing in and is nervous about the footsteps right now.
But these are people who I think are very concerned about their own guilt and complicity, and I'd be much more comfortable if they would come to Congress, provide open sharing of information.
If they want to declare war, make the case for us, and we'll see if Congress votes on it and approves it.
But they do not have the authority, as I understand the law, to do what they're doing right now.
Number one, I think it is very important that the Federal Reserve Board be independent of politics.
And so while I can have opinions on that, I'd prefer they acted independent of political pressures.
I think the Fed is in a very difficult situation right now because they have a dual mandate to keep unemployment low and to keep inflation low.
We have inflation in the economy right now that is substantially driven by tariffs.
And no change in interest rate makes a tariff move.
Changes in interest rate make demand and supply for goods move.
And so the Fed's a little bit squeezed on there.
I think you should understand what the Fed is doing, therefore, is not responding to inflation as much as it's responding to some jitters in employment markets and unemployment being a little higher than they'd like it to be.
We'll see what happens.
We'll see what happens going forward with the new jobs reports.
It's a little, I think it makes us all a little bit nervous that there's been a slowdown in data.
The Bureau of Labor Statistics was gutted by Doge and slowed down.
So I think the economy is not in a terrible place right now, but it certainly is in a very brittle place.
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Remarks now from European officials on President Trump's ongoing negotiations with President Putin to end the Russia-Ukraine war.
They also discuss European security at the Aspen Institute's National Security Forum held here in Washington.
Thank you, Neve.
I must say, I don't think I've ever seen anyone out talk Susan Glasser before.
So maybe it's a good sign on Ukrainian persistence that we can take away from this.