Finally: Trump asked the question he feared most - Brian Tyler Cohen

(Press conference at the Oval Office)
Reporter: At the end of uh this year, those extended Obamacare subsidies expire. What's your message to those 24 million Americans who will see their insurance premiums go up?

Trump: Don't make it sound so bad because, you know, obviously you're a, you know, sycophant for Democrats. You're obviously a provider of bad news for Republicans. Let me just say something. the Republicans. I think I can speak for Tom and most other people. I think what most Republicans want to see is what I want to see and I leave it to them and hopefully they're going to put great legislation on this desk right here.

We want to see all of the money that's been squandered and given to insurance company because Obamacare is horrible health insurance. It's far too expensive and it always has been. But what it really is is a way of making insurance companies rich. We want the money not to be paid at all to insurance companies. You know, insurance companies have gone up 1,700% over a short meaning to stop 1,700% over a short period of time. And they've taken in hundreds of billions and even trillions of dollars. And we want the money to go to the people.

They'll go in the form of a insurance account, healthcare account, or any other form that we can create. We a lot of different forms. We want to give the money to the people and let the people buy their own great healthcare and they'll save a lot of money and it'll be great. Now, the problem we have is that the Republicans are not at all uh controlled by the insurance companies. But you know who is the Democrats.

(cut to studio camera)
BTC: Finally, Trump was asked the question that's on the minds of 24 million Americans given the fact that Republicans have successfully managed to strip funding away from the ACA and voted against this week's effort to extend those subsidies for the next 3 years in the Senate. And of course, Trump's answer here was exactly what you'd expect. He starts naturally by calling the reporter asking the question a sycophant for Democrats and a provider of bad news for Republicans. Why? Because when you can't answer the question, you attack the person asking it.

But let's be real here. 24 million Americans are about to see their health insurance premiums more than double because these enhanced ACA subsidies are expiring. So yeah, maybe it does sound bad because it is bad. That's not bias, that is reality.

But okay, Trump then claims that he wants to take money away from insurance companies and give it directly to the people in the form of insurance accounts or health care accounts. Sounds great, right? Very populist, very people-powered. Only small problem here, that's not actually what Republicans are proposing. What they're actually trying to do is replace the ACA subsidies that help people afford their monthly premiums with health savings accounts. And here's the kicker. HSAs, health savings accounts, cannot legally be used to pay insurance premiums. I'll repeat that. The accounts cannot pay for the thing that is about to skyrocket in price. So Trump's big solution here to people facing double, triple, quadruple premiums is to give them accounts that can't pay those premiums. No notes, Donald. No notes.

So let's talk about what these Republican proposals actually look like. The Crapo-Cassidy plan, that's the Republicans plan that's leading the pack right now, would give people under 50 just a 1,000 bucks per year in an HSA. And those between 50 and 64 would get $1,500. That sounds nice until you realize that the average bronze plan deductible in 2026 is nearly $7,500. Five to seven times larger than what they're proposing to put in these accounts. So again, tell me, how exactly is a 1,000 bucks supposed to help when you're facing a $7,500 deductible plus premiums that just doubled or tripled or quadrupled? It's offering people, as one Georgetown professor put it, a one-foot rope to get out of a 10-foot hole.

But wait, there's more. These HSAs aren't even available to everyone. They are only available to people who buy bronze or catastrophic plans. Those are the plans with the highest deductibles and the least coverage. So, Republicans want to push people into the worst insurance plans available, give them a pittance to help with costs, and then pat themselves on the back for empowering the patients because populism or something.

Now, let's address Trump's claim that insurance companies have seen their stocks go up 1,700% over a year. First of all, that is not even close to true. Not in the universe of true. Health insurers stock prices have gone up a little over a thousand percent since 2010, over 15 years ago when the ACA was first enacted. But more broadly, you know what would fix that? Take these insurance companies out of the equation? Universal healthcare, single-payer system like what the rest of the industrialized world has. And yet, guess how many Republicans are actually in favor of that? Literally zero. Otherwise, all this plan by Republicans does is return us to a pre-ACA world where those same insurers that Trump is pretending to criticize can go back to denying Americans coverage due to pre-existing conditions. If you can find me any regular Americans who want to go back to that world, that system where they have to put all of their faith in the goodwill of predatory insurance companies, I'd love to see it.

So, look, Trump is right that insurance companies have made a killing, but here's the difference. Democrats want to extend the subsidies so that people can afford coverage. Republicans want to let those subsidies expire, which means that insurance companies still get paid. They just get paid by you instead of the government. The premiums don't go down. You just pay more of them. Without the subsidies, average premium payments for subsidized enrollees would more than double. A 114% increase from $888 annually in 2025 to $1,904 in 2026. So, who's really lining the pockets of insurance companies here?

And let's talk about who this hurts most. Trump acts like this is about sticking it to greedy insurance companies. But the reality is that the ACA enrollment has tripled in states like Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee, states that Trump carried in 2024. So, the people getting crushed by these expiring subsidies, they are largely in red states. They are largely Trump voters. In other words, the people who Trump would be screwing over here most are the people who trusted Trump to do the polar opposite of what he's doing right now.

So, here's the bottom line. Trump wants you to believe that he's taking on insurance companies by giving money directly to the people. But what he's actually doing is letting subsidies expire that help people afford premiums, replacing them with accounts that can't pay those premiums, pushing people into worse insurance with higher deductibles, and giving them pocket change to try and deal with it. All while insurance companies continue raking in record profits. And the worst part, these Republican HSA proposals would trigger a premium death spiral where healthy people leave the marketplace for cheaper, skimpier plans, leaving sicker people in ACA plans with skyrocketing premiums until coverage becomes overall unsustainable. That's not reform. That is sabotage, which to be clear is what Trump actually wants and his party wants. They want this system to fail because the GOP has been engaged in a 15-year long plan to hobble the ACA. They don't care that it helps Americans. Their focus is destroying Obama's legacy because they can't handle that a popular Democratic president got a win. And so, as a result, Americans losing their health coverage and dying is a price that they're willing to have us pay.

So, when Trump says that he wants to help the American people and take money away from insurance companies, what he really means is, "I'm going to make your costs go up while insurance companies keep getting richer, and I'm going to gaslight you into thinking that it's for your own good." Do not fall for it. The data is clear. The facts are clear. And Trump's plan, if you can even call it a plan, is nothing more than smoke and mirrors designed to dismantle healthcare for millions while pretending to be some populist hero. It is shameless. It is transparent. and it needs to be called out for exactly what it is, a con job.