Stephen Dennis breaks down the House GOP’s $10K+ premium healthcare bill, which skips subsidies and HSAs, risking millions’ coverage amid partisan gridlock. Moderates like endangered district reps may block it, while Trump’s lack of bipartisan engagement fuels ACA sabotage—like pre-existing condition exclusions—to cut costs but leave vulnerable populations exposed. Callers clash over ACA failures, cannabis rescheduling, and SpaceX vs. NASA’s moon race, with China as the ultimate driver. Impeachment looms if Democrats flip four Senate seats (Maine, NC, Iowa, Ohio, Alaska), but removal hinges on 20 GOP defections. Epstein files face Friday’s deadline, with Republicans pushing for grand jury leaks and Democrats fixated on Trump’s ties, though FBI redactions may persist despite estate releases. [Automatically generated summary]
Yeah, so we're expecting the House to try and vote on a Republican leadership plan on health care that doesn't really directly address this issue of the expiring ACA subsidies.
It does have a number of provisions in there that might unite Republicans.
The problem for them is there's a fairly large number of moderate Republicans who want to extend those ACA subsidies, particularly Republicans in districts that are endangered in next year's midterm elections.
And so here's the problem.
Can they even bring it up to the floor and pass a rule?
If those moderates revolt, as we saw them revolt last week for an hour or two on the House floor on the defense bill, they can block bringing up this Republican leadership bill.
They want amendments.
They have even done what's called a discharge petition to go around Speaker Johnson and force a vote.
They've been trying to get votes all year, as has the Democrats on the House floor to extend these subsidies in one way or another.
And it's a pickle here for Mike Johnson at the end.
I'm going to put it actually on the screen that House GOP leadership proposal.
It's here.
It says it expands association health plans, which allow employers to band together to purchase coverage, funds a cost-sharing reduction program meant to lower premiums for certain ACA enrollees, imposes new transparency requirements on pharmacy benefit managers in a bid to lower drug costs, and does not extend soon-to-expire ACA subsidies.
And it does not include that Senate GOP plan to provide 1,000 or 1,500 in health savings accounts.
Where is this all going?
I mean, it seems like everybody's got something going on, but nobody's got enough support to move things along.
unidentified
Right.
Even if these moderates succeed in passing a version of these ACA subsidies in the House with a narrow majority with a discharge petition if the Democrats joined them or if they joined the Democrats have their own discharge petition.
Even if they pass that, if it's a narrow passage in the House, it probably won't get 60 votes in the Senate and you still need the president's signature.
The odd person out here is the president.
If President Trump wants a deal and some senators, Tom Tillis said he's been communicating with the president, thinks he wants a result.
Well, he could probably get one even at this late moment if he started calling both sides together and said, let's hammer out a deal.
I think that that seems unlikely because they've had 12 months at this point to try and do that.
And there really hasn't been a lot of interest on the part of Republican leadership in doing that kind of bipartisan deal.
Why do you think the president is not engaged on this issue specifically?
And I know you don't cover the president, you cover Congress, but what are your thoughts on that?
unidentified
Well, I think for probably not just him, but certainly a lot of Republicans on Capitol Hill, this is Obamacare.
This is a different president's health care plan.
He wants his own thing.
And if you think about a lot of these Republicans that are facing this vote or these series of votes, many of them have voted their entire careers to repeal the ACA in its entirety or to repeal most of it.
And here they're being asked to extend it and keep an expansion when most of them want to spend much less money.
And there are different ways to do that.
You can shrink the benefits.
Some of these association health plan ideas are sort of an end run around the ACA, so you don't necessarily get the same benefits that you have with an ACA plan, but it could be cheaper.
Other people are talking about let's have another way out where you can bring back pre-existing conditions, which if you have pre-existing conditions in an alternative plan, yes, the premiums would be lower because you're excluding sick people from getting their coverage.
The ACA plans, though, aren't going anywhere, the original ACA plans, but they only cover, the subsidies only cover up to 400% of poverty.
That means there's a big chunk of folks in the middle class who will get no subsidies and much higher premiums.
And in some of these states, like Alaska, which is a high-cost state, you're talking about thousands of dollars a month in premiums that are going to snap back on January 1st.
And people have to make that decision today, tomorrow, as open enrollment ends, not knowing whether or not Congress is going to act.
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On a different topic, there is the ban on lawmakers trading stocks.
Where is that and what's going to happen this week?
unidentified
Yeah, I mean, I think we're still seeing if that's going to have enough support to get a vote.
That's something that tends to be wildly popular with the public.
And a lot of lawmakers secretly don't like that idea.
And you can tell because they are trading stocks.
You know, you can go and look on websites and see what they're trading.
This would prevent them from doing that in the future.
I think the speaker has come out against it.
And I think traditionally the response from leadership has been, we don't like this because we don't want to limit who will come and serve in Congress.
That the only limit should be what's in the Constitution, your age and your citizenship.
And so I think that that's been a concern.
But the public has seen many members of Congress get very wealthy trading stocks, and they know that these members of Congress get access to briefings that they don't get.
And I think that that concern about insider trading has been around for a long time.
And right now you have a bipartisan effort, and it's very popular.
So the question is whether you can get a vote in the House and then if it passes the House, can you get 60 for the same legislation in the Senate?
Will it get votes in the Senate?
I think if passed as prologue, it won't happen.
But we're facing this midterm elections.
And when folks are worried about losing their seats, that's when these kinds of things can actually happen.
We'll get to calls, but I want to ask you about the war powers resolutions going on, I believe, in the House and the Senate.
Tell us the latest on that.
unidentified
Yeah, so there are war powers resolutions that have been filed in both the House and the Senate.
Those are privileged, so we could see votes on them this week.
I think people are expecting those votes in both chambers.
And they're both bipartisan in both chambers, where people like Rand Paul in the Senate, Thomas Massey in the House, don't think the president has authority to do what he's been doing in the Caribbean, sinking these ships, potentially talking about going into Venezuela on land without an act of Congress.
And so there are likely going to be votes.
There's also going to be a classified hearing for all senators this week on the Caribbean.
And it's expected that we'll see top administration officials brief senators on what's going on there.
Well, you do have winners and losers in these situations.
People who pay taxes that they wish they weren't paying.
People who are seeing high premiums and high deductibles that they didn't have before.
But they also have health care plans that cover people with pre-existing conditions that don't have lifetime caps, that have other benefits to them that maybe their old plan didn't have.
And so things like medical bankruptcies are down.
They're not zero.
That was one of the things that the ACA was trying to do is so that fewer people would go bankrupt because they got cancer and they had a cheap insurance plan that didn't cover enough of their costs.
So there's a lot of complaints about health care.
Mostly, though, I'm not seeing real big efforts on Capitol Hill to lower the actual cost of health care, the underlying cost in America versus other countries, which is we tend to pay twice as much and we have lower life expectancy.
So what I've seen is, okay, well, let's change who's paying for it.
Maybe we can find other cheaper ways that don't cover as many benefits or as many people.
But, you know, it is problematic if you end up with tens of millions of people who are uninsured and then where do they get their health care?
It says, President Trump suggested he'll loosen federal restrictions on marijuana use, something many Democrats and advocates have been pushing to happen for years.
Go ahead, Stephen.
unidentified
Yeah, so I think this is something where the president can act.
And unless Congress sort of tries to override him somehow, I think that he can reschedule.
And this is something that Biden teased, and previous presidents have teased, including President Trump, have teased doing something on marijuana.
And we haven't seen really legislation.
You know, you have a lot of conservatives, particularly in the Republican Party, who still do not support legalizing marijuana, even though many of their states have.
And so what we have is this sort of weird system where it's illegal under federal law, but then they pass these riders in the appropriations bill saying you can't enforce federal law with tax dollars in states that have legalized it for various reasons.
And so you end up with sort of this patchwork that doesn't really seem sustainable.
But at some point, if you look at the polling, the polling seems to suggest that especially younger voters as they get older, more and more people are supporting some kind of regulated legalization.
But it doesn't feel like this Congress is going to do anything on it.
Because marijuana is a discriminated, made-up word.
And I would just like to refer to as cannabis and for the medical research part.
And my second question is got to do with Trump about I heard that he wanted or he was giving Elon Musk a grant for getting man back on the moon before the end of his term.
Is that true?
Yeah, so I'll take your point on cannabis.
On the man on the moon issue, yeah, I mean, Elon Musk's SpaceX is the largest space company in the world by far.
It's the only company that has regularly landed rockets and relaunched them, which makes them much, much cheaper.
There are other contractors who have rockets that cost billions of dollars a launch because they crash every time.
So, you know, we have a third company, Blue Origin, that's landed a rocket.
And so they're still probably years away from really competing with SpaceX.
So it's SpaceX robust at this point.
In addition to the Artemis program, which is closest to getting us to the moon after many, many years and many expensive billions and billions of dollars of delays.
So we've got sort of an older kind of system with this Artemis program that has a lot of support in Congress because there's lots of jobs for that system all across the country.
And then you have SpaceX, which is trying to get its Starship program, its next generation launch vehicle ready to go to the moon.
And we'll see if they can innovate fast enough to meet these deadlines and get us to the moon before the next, mainly before China.
And we also might have a new NASA administrator this week.
unidentified
Yes, Jared Isaacman.
He's an entrepreneur.
He's a pilot.
He's a commercial astronaut.
He had been nominated before, and then Trump withdrew his nomination and complained that he had donated previously to some Democrats in the past.
And then he re-nominated him.
And so that kind of delayed things for months.
But I think he's likely to get a fairly large bipartisan vote this week.
And, you know, he has talked about getting us to the moon faster than China.
He's also talked about sort of reordering NASA and really focusing on what could be a booming market in space.
We could have a big space economy if we can bring down the cost of space travel dramatically with reusable rockets, with having the ability to get to space cheaply.
That opens up things.
And we've already seen with SpaceX the Starlink Internet system being a major force in connecting people, particularly in remote areas all around the world.
Let's talk to Dan in Pittsfield, Massachusetts, Independent Line.
Go ahead, Dan.
unidentified
Hi.
Regarding health care, I'm just wondering if you think there's any possibility that the Democrats and the Republicans would get together and at least recognize that the affordable health care plan doesn't make affordable health care if you need to give subsidies.
Over the Obama years, there were a lot of regulations that came in, such as the High Tech Act, the CHIPS and MACRA Act, the PQRS Act, all of which make health care more expensive to provide and make it harder to find health care providers who've largely left the field.
Also, every time there's a new pharmaceutical discovery, there then tends to be a press for everyone to use tests that are more expensive, such as MRI and others, to look for rare diseases so that a drug that costs $200,000 a year for one tablet a day can be used.
So the question is, is there any way to coerce Democrats and Republicans to have subsidies for a short time while actually looking into what is making the health care system unaffordable?
Thank you.
Yeah, so that's a good question.
It's hard to answer in a minute, but basically you have a lot of lobbying interests in Washington who are happy with the current system because they're getting paid.
So if you're drug companies, you have record profits.
If you're insurance companies, you have record profits.
A lot of hospital companies have been doing well.
So a lot of people are making a lot of money on the health care system, and they employ a lot of lobbyists to make sure that that continues.
So if you want to have a cheaper prescription drug system, and a lot of other countries pay less, and the president has recognized this and has talked about things like most favored nation drug pricing.
Well, that has yet to happen.
We still pay far more than other countries for most drugs.
And there are no efforts, at least by the Republican leadership in the Congress, to dramatically lower those prices.
There are sort of tweaking around the edges of patent law and some other things that people are talking about, but not going after the drug pricing directly.
Isn't that something the president can do directly without Congress?
unidentified
The President can do some things.
And you saw recently they implemented one of Biden's laws in the Inflation Reduction Act, which allows the government to negotiate some drugs in Medicare, but not all drugs.
So every year under that law, they can open up the negotiations for a few more drugs.
And that's resulted in dramatic price cuts for some drugs.
If you've got private insurance or ACA, you do not get afforded that.
unidentified
And this is just not how other countries deal with this situation.
Take something like Ozempic.
It's a lot cheaper in China.
It's a lot cheaper in other countries.
A lot of these drugs are a lot cheaper in Mexico or in Canada, where we still have people who will have a trip so they can get a cheaper drug because some of their drugs cost thousands of dollars a shot.
As he said, there is this situation where some of these new drugs do cost hundreds of thousands of dollars a year, and those bills add up very quickly.
Now, on the ACA, it's a common criticism that it has never been affordable.
And why do you need subsidies if it's supposedly affordable?
You shouldn't have to have subsidies.
Why are these subsidies necessary?
unidentified
Yeah, well, part of it is a lot of the people are lower middle class.
They're just right above the Medicaid line, right above the poverty line.
They can't go out and afford a $10,000 health care plan on their own if they're making $30,000 a year or $35,000 a year.
They just don't have the money.
So you could give them a really cheap insurance plan that only covered $1,000 or $5,000 or $10,000 or $100,000.
And yes, the premium would be lower, but if they got hit by a bus or they got cancer, it's not going to prevent them from going bankrupt, for example.
So that's one issue is you have people who are above the poverty line, make too much to go on Medicaid, do not have health insurance from their employer.
Many employers still do not offer health insurance, particularly for the lower middle class, working class folks.
And this was sort of an outlet for them to get care.
And with the subsidies, it's supposed to be affordable.
You know, that lower income cohort only has to pay about 2% of their income.
Right now, many of them are paying zero.
That's one of the complaints of the Republicans, is with these zero-dollar premiums, millions more people signed up.
The Republicans believe that many of these people don't even know they have the insurance, signed up by Boiler Rooms, who got paid to sign people up.
And so they want to have at least a minimum monthly payment of $5, $10, $25 so that people would have to see that bill, know they have insurance, so it's not just sort of opt into it and know that they've got it.
Yes, my question is, next year's elections are going to seem like the Democrats are going to take over the House, but I don't know about the Senate.
So what is your take on the chances, please, of Trump getting impeached?
And I'll hang up and listen to your answer.
Thank you.
All right.
So, you know, impeachment, I would say, is pretty high chance if the Democrats take back the House.
You've already seen some sort of pro forma impeachment votes which haven't gotten that many votes yet from Congressman like Al Green.
The issue here is you need 67 votes in the Senate.
So impeachment, we've already seen that twice.
If you do not have Republican senators en masse rejecting the president, the impeachment will be unsuccessful.
So you could have multiple impeachments.
You can have impeachment every week, but that doesn't mean you would actually remove the president.
I think that's very unlikely to get, you know, right now you would need 20 Republican senators, you know, to join with the Democrats to remove a president.
That's very unlikely.
It becomes a little bit more likely, probably, if there was some wipeout for Republicans next year.
You have, you know, it seems fairly unlikely at this point, given the Senate map, that we are going to see a wholesale wipeout of Republicans, given the states that are up.
The only state where a Republican is running where Trump lost is Maine with Susan Collins.
She, as the Republicans say, is a tough out.
But she faces a lot of blowback in the Trump era and her approval ratings are down.
Well, her approval ratings in her state, generally speaking, you know, she used to have sky-high approval ratings.
You know, she voted for the Supreme Court justices who overturned Roe v. Wade.
She hasn't had to face that At the polling booth, that's some of the turbulence that she's going to face.
Now, the Democrats have a primary.
Who knows what's going to happen in Maine?
But the Democrats, in order to take back the Senate, they need four seats.
They need to take back Maine.
They would need to take back North Carolina, which is an open seat being vacated by Tom Tillis.
They'd need to take a state like Iowa, which Democrats used to win in.
They'd need to find another state somewhere like Ohio, where Sherrod Brown is running to regain a seat he just lost, or Alaska, where the Democrats are trying to coax Mary Patola to run against Dan Sullivan.
That could be an interesting race.
And there's obviously a lot of interest in Texas, but it's been a long time since Republicans have lost a Texas Senate race.
Your food reviews around the Capitol are absolutely fantastic.
Just kind of curious to get your take.
One, what's the best house you've ever seen on Zillow?
And two, what's the hot eat around the Christmas time at the Capitol?
You know, probably the best house I ever saw was in California, one House of the Year on Friday Night Zillow, which is just like a fun little thing I do on Twitter.
And everything was wooden, and it looked like you went into some elven village and you overlooked the ocean.
It was fantastic.
Yeah, food in the Capitol, you know, by the end of the year, I'm usually sick of it.
You know, I spend so many times, so many days in the basement of the Senate.
So, you know, usually they'll have like a Christmas or a holiday feast with all the fixings, and that's always kind of a fun tradition.
And before you leave, I want to ask you about the Epstein files because that is, by law, has to come out by this Friday.
What are you hearing?
unidentified
You know, I think a lot of Republicans who supported that, people like Thomas Massey, are putting pressure on them to deliver.
You know, he said they'll be breaking the law if they don't release the Epstein files.
Others are giving them a little bit more leeway because they do have so many documents to go through and redact so that victims aren't named.
And I guess we'll see.
I mean, a lot of what's come out hasn't come from the Justice Department yet.
It's been coming from the Epstein estate, which gave a lot of photos and emails and other things to Congress.
And that's most of what people have seen.
But one of the things that Massey told reporters last week that he was encouraged by is that the Justice Department did go back to judges to get grand jury information released.
So potentially there are big troves of data.
And I think Democrats are looking to see what's in there, but also they're obviously very interested in the president's relationship with Epstein.
They've been sort of laser focused on that relationship.
And the president, of course, had been fighting this legislation tooth and nail.
And I think there's going to be a real question of what's being held back if everything hasn't been released.
Are there still things in the FBI's files that they are not making public?
Stephen Dennis, congressional reporter for Bloomberg News.
You can find his work at bloomberg.com.
Thanks so much for joining us.
unidentified
Thank you.
Friday, on C-SPAN's Ceasefire.
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Bridging the Divide in American Politics.
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She joins our host, renowned author and civic leader David Rubinstein.