Everybody’s required reading today is Paul Krugman’s substack column, Understanding the Coming Premium Apocalypse: Why health insurance is about to become unaffordable. It might also be subtitled “Why Republicans really ought to listen to Democrats and restore Medicaid and ACA subsidies.” This relates to the looming government shutdown and to our stupid mess of a health care system.
As you know, the Big Ugly Bill is slashing Medicaid spending. There’s a timeline at the Center for American Progress that explains exactly what happens when. Some changes to benefit programs have gone into effect already. The big stuff starts to happen in January 2026. It’s not all waiting until after the Midterms. There will be a lot of pain before the Midterms, and it could drive up the cost of premiums for everybody.
One big factor is that enhanced subsidies enacted by the Biden Administration for people buying insurance through the ACA exchanges will expire at the end of this year (blame Joe Manchin for the temporary subsidies). Krugman explains,
Now the enhanced subsidies are about to expire, and the financial hit to many Americans will be apocalyptic. Gaba estimates what will happen to the insurance premiums net of subsidy for different groups in different states. …
… Many people will face huge increases in their insurance costs. And these increases will be magnified by the effects on the risk pool: some healthy people will be dropping out, raising premiums for those who remain.
In other words, millions of Americans will soon be screaming about unaffordable health care.
Which takes me to my perpetual gripe, which is that if our so-called for-profit free market capitalist (Blessed Be It) health care system can’t survive without massive government subsidies, who are we kidding, exactly? Eliminate the for-profit insurance companies that do nothing but suck profit out of the system and just subsidize the whole thing.
Also, per the Center for American Progress, a possible sequestration of Medicare funds could happen in January 2026. If it does, I believe voters will notice. and blame Republicans.
The Democrats are threatening a shutdown to get Republicans to back off the Medicaid and other cuts to the health care system. This is the right fight to pick, I believe. The question is, will most voters know what the Dems are doing here? Or will they just hear the Republicans’ side of the story?
In other news — you may have heard that Trump is inexplicably giving $20 billion to Argentina to bail out its economy. And you may have thought, WTF? Judd Legum at Popular Information explains,
Last week, Treasury Secretary Scott Bessent announced a $20 billion package to rescue the Argentinian economy. The risky taxpayer-financed deal, which involves trading U.S. dollars for Argentine pesos, has little upside for ordinary Americans. Argentina is not a significant U.S. trading partner, and its economy, long in turmoil, has little impact on the United States.
However, Bessent’s announcement had massive economic benefits for one American: billionaire hedge fund manager Rob Citrone, who has placed large bets on the future of the Argentine economy. Citrone, the co-founder of Discovery Capital Management, is also a friend and former colleague of Bessent—a fact that has not been previously reported in American media outlets. Citrone, by his own account, helped make Bessent very wealthy.
There’s more. It’s worth reading all of it. The $20 billion bailout will not benefit U.S. taxpayers in any way. This is about Bessent using taxpayer dollars as his personal slush fund.
In more other news, there were five mass shootings in the U.S. this weekend, according to this mass shooting tracker. It’s so hard to keep up. A lot of them don’t even make the news any more. Note that the now-deceased individual suspected of attacking a Mormon church in Michigan was by all appearances a big Trump supporter.
Also, too, I’m a big Jesse Welles fan now.
Update: It appears Trump has no clue about what he’s doing to health insurance costs.
bro we are so cooked
— April Glick Pulito (@aprilglick.bsky.social) September 29, 2025 at 4:54 PM
Catchy Tune! Good Hook.
I've been wondering how hard Trump / the Rs are going to push their suicide march by decimating Medicaid / Medicare.
They threw out a $50 billion sop to rural hospitals, which won't solve anything but might sweeten the pain from their main plan.
And then there's the smoke and mirrors MedBeds, right out of QAnon. Heather Cox Richardson:
Any stupid ruse is possible with these idiots. I can't quite figure out the Tylenol flap, whether it's just distraction, an effort to show Pharma who's boss and to extort something from them or what. I have heard that Tylenol's makers are suing; one of the psychics I follow says they'll win.
I'm way more concerned about tomorrow's meeting with the top military brass. I don't believe for a minute that this is just about espirit-de-corps or TV personality Hegseth's desire to press his little boy idea of warrior culture upon seasoned professionals. What would you expect a TV person, a little boy playing a man, with his childish view of the world, to say?
I expect Trump to "revamp" their mission, which will be to serve him and not the Constitution, whether it's expressed that way or not. If Trump can extort $billions out of American corporations for favorable treatment, can you imagine what he could do with the world's most powerful military behind him? He can, and this is where this is headed. Blowing up small boats off Venezuela, murdering the people on board, with no repercussions is just the appetizer.
Because the brass he's gathering know this dark side of power extremely well, and because they take their oath seriously, it's going to be a moment of truth for them. If I'm right about the meeting's real purpose, I expect them to remove Trump from power at some future point. There's that phrase in their oath, "enemies foreign or domestic" that's been burned into their brains.
Jesse Welles can hit all the right notes from time to time, and he's getting better at it.
"Eliminate the for-profit insurance companies that do nothing but suck profit out of the system and just subsidize the whole thing"
Health insurance companies do plenty wrong but one thing they do well is keep the for-profit healthcare industry from running up costs on needless procedures. For profit health care companies love Medicare because there isn't anyone telling them no. If you're going to eliminate insurance companies and just have the federal government "subsidize the whole thing" then you better create a federal agency of real experts to evaluate how all that money is spent. If you leave it up to the for-profit healthcare companies, we will be in deep shit within months.
Saw this on another lefty rag "JUST IN – Kash Patel asks public for patience as FBI decides what to write on Church Shooter's bullets"
They also veto needed procedures. And often when you're getting a procedure it's not clear if insurance will pick it up or not. There must be a better way. Other countries seem to manage to keep costs down while providing better outcomes.
A big problem with health insurance is that some of them suck. I had three or four different ones during my working career and one of them (united healthcare) was horrible. The rest of the time I was covered by blue cross but several different corporations. I can only speak for my own experience, I had cancer, hip replacements, hernia surgery, neck surgery, a bunch of health issues over the years and was never denied any care? The plans approved and paid for everything according to the terms, deductibles, out of pocket et,. even United Healthcare it was just alot more red tape. I think it would be better to have single payer but it has to be something different than medicare (as it is currently designed), someone needs to keep for profit healthcare corporations in check as well. Not every doctor has your best interest top of mind, many of them (at the direction of the bosses) just want to make money.
The quality of insurance company offerings can vary greatly from state to state. I had a Humana Medicare Advantage plan when I was living in Missouri. I was generally pleased with it. Then I moved to New York and decided to just switch to the same basic Humana plan for NY. It was terrible. No doctors within 50 miles take Humana, or at least none that were accepting new patients. I found a broker who helped me switch to another company called Wellcare. They are pretty good about paying the bills but I could never get access to my account on their website. I complained and complained and got nowhere. I’ll be switching again at the nearest opportunity.
The military rescue of Portland appears to involve approximately 200 soldiers sleeping on floors somewhere in the town. One report is that the Governor of Oregon talked to Trump on the phone and Trump was disconnected from the reality of the situation. I don't think the Oregon National Guard will start trouble – they may have a hard time finding anything at all.
The meeting between Trump and Schuemer reportedly revealed the same disconnect about how rising health care costs will hit voters (before the midterm.) As with the conversation between Trump and the Governor of Oregon, Trump seemed unaware that the demands of the Democratic leadership may resonate with a lot of voters as soon as next year.
The actual content of the meeting tomorrow will not be a secret for long, IMO. Some of these Generals will leak secretly, but some may not give a damn, and disclose the nature of the demands by Trump and Pete Hogsbreath verbatim. It's not that Generals and Admiirals are not used to taking orders – they are. They aren't used to being treated as toys on the board by idiots who have NO idea what military ethics are.
We'll know more tomorrow, but if I was placing a bet, I would say this will go down as one of the greatest strategic blunders in history. If Pete and Trump get a major smackdown from military brass, it will resonate with the troops. Trump is counting on the military to back a coup.
I was out of the loop on Alex Bolton who has credentials and credibility. His association with The Hill is a plus. Blue Sky commenters were interesting, and many noted other examples of fearless leader being out of the loop on health care and other large issues. I am in the loop there.
Alex communicated Chuck Schumer's apparent surprise at how out of the loop fearless leader appeared to be in the meeting about health care the way the ordinary Citizen has to deal with it. Schumer had to work hard be that uninformed about fearless leader. I am sure his staff knows well and will tell him if he will listen what he is up against. Schumer is quite a bit late and not doing his homework. Worse yet, he may have similar issues to fearless leader. We all lose listening comprehension as we age. It takes work to counter the normal path of aging. In the long run age wins though.
In a few rare cases the decay is slower, but the Warren Buffets of the world are not many. To deny this reality is folly. Just as few have Keith Richard's liver, but many try to live his rock musician lifestyle. Examples of those my age, who made that mistake, are not above ground much anymore. The brain is not the liver. It has layers built on layer with a long evolutionary history. People do lose the higher functioning skills and still remain above ground for quite some time. Some stay quite mentally adept but there is no guarantee. Schumer and fearless leader are both going downhill. Fearless leader appears to be picking up speed on his steeper path. Neither seem to be "Warren Buffets". His partner Charlie Munger stayed quite sharp till other parts gave out. He slowed a bit and worked hard to stay mentally adept. In your 90s though, all body parts are at risk of failure. They call certain organs vital for a reason.
But anyway, Schumer may only be feigning surprise on fearless leader's mental decline. We hope so. In being "surprised" he brought his own mental decline into question. Out of the loop corrected is better than chronically loopy. Self-reflection is a rare skill for a professional politician, however. It too may decline with age. No data on that one.
Diaper Don says "let the military use dangerous cities as training grounds" let me translate for cadet bone spurs: " let's use the nigg#rs as target practice"!
digby:
I've been rooting for a coup for a long time. We're one step closer after today.
Insecurity at its Finest
Sure I don’t imagine Generals who have worked hard for their positions like getting talked down to by an alcoholic FAUX news booble-head what got promoted three times in 17 years in the weekend warriors. He’s a fucking stroke and every last one of them know it!