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The current federal government shutdown is supposedly over a massive increase in ObamaCare insurance rates which will occur at the end of this year due to the end of extraordinary federal subsidies. PPACA,"the bill [passed] in order to find out what [is] in it", was supposed to reduce the cost of medical care. Instead, it has massively increased the cost of medical care and finally a few analysts are explaining why. Deane Waldman is one who makes the case for eliminating the PPACA altogether:
Insurance Sticker Shock Proves Need to Repeal ACA
By Deane Waldman - October 30, 2025News headlines usually make problems seem worse than they are. News outlets gain eyeballs believing “if it bleeds, it leads.” However, the warning that “20 million face health insurance sticker shock” is fact, not hyperbole. If anything, it understates the real issue: that the ACA cannot work, that it is making healthcare worse not better, and should be repealed.
Democrats seek to justify their ransom demands to stop the shutdown, by claiming that Americans must be protected from 30 percent increases in the cost of ACA health insurance premiums by extending ACA subsidies. These subsidies were set to expire by the Democrats.
Who has to pay the estimated $350 billion for extension of ACA subsidies? American taxpayers, more accurately future taxpayers as we don’t have the money and thus, the spending will have to be added to the bloated national debt of $37 trillion.
What do premium payers get for this huge increase in ACA spending? More timely care? More choices of physicians or facilities? New, innovative medical miracles or better drugs? None of the above.
What We the Patients have gotten from Obamacare is longer maximum wait times to see a doctor, such as 132 days’ wait in a 2022 study. Even a one-month delay in cancer diagnosis significantly increases mortality. Imagine what a four-month wait will do.
No imagination is necessary. There is data. Death-by-queue – Americans dying while waiting in line (a queue) for care – has been documented in two government insurance programs: Medicaid and the VA system. When we spend more money on government insurance, we get the opposite of what we want. We get death instead of health and life.
Obamacare – the ACA –is fundamentally flawed in design. The rise in premium rates without a corresponding increase in value received proves that there are no free market forces at work. In any functioning market, spending more gets more of what the consumer considers value. That is true only when individuals are spending their own money.
When people expend OPM (other people’s money) as is true in all government-run, i.e., socialist, healthcare schemes such as the ACA, spending will go up while quality of service and products goes down. This is known as the seesaw effect, and is a constant feature of all centrally controlled marketplaces, like the ACA, and the now-defunct U.S.S.R.
The free preventative care plan in the ACA is another example. Taxpayers paid billions to insurance companies for this benefit, which was touted to save money by making or keeping people healthy. First, the service was rarely used but always paid for. Second, millions of phantom enrollees fraudulently expended billions of taxpayer dollars.
Recall the promises made for the ACA. They were never realized. “If you like your doctor, you can keep your doctor” was not consistent with health plans’ narrow provider panels. You got whatever doctor signed up with that plan and had openings. Many did not. In fact, nearly one third of U.S. doctors refuse to accept new Medicaid patients. So what good is having insurance?
“The average family will save $2500” seems like a cruel joke when Americans are facing a 30 percent increase in already unaffordable insurance premiums.
Finally, consider the reason for these subsidies. When former President Biden locked down the nation, tens of millions lost their jobs and therefore lost employer-supported health insurance. To compensate for the misguided lockdown, the Biden administration expanded Medicaid eligibility and provided “enhanced” subsidies for ACA insurance. According to the Bureau of Labor Statistics, at least 60 percent of those locked out of work have returned and are again eligible for employer-supported health insurance. Yet millions of healthy workers remain in Medicaid or continue to receive ACA subsidies.
Clearly the subsidies are being abused and are a waste of taxpayer dollars. Nonetheless, Democrats have shut down the government saying extending the subsidies is a hill they’re willing to die on.
The only people who are dying are We the People.
The solution, politically frightening to Republicans and anathema to Democrats, is not merely to allow the subsidies to sunset but to repeal the ACA entirely. President Obama’s namesake legislation was flawed in concept, implemented expending $1.76 trillion we didn’t have, and is now demanding more money we don’t have, spending that will produce no benefit to We the Patients.
It is time to face facts. Repeal the ACA before more Americans die-by-queue and more trillions of dollars are added to the debt our children will have to pay.
Deane Waldman, MD, MBA, is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at the Texas Public Policy Foundation; and former director of the New Mexico Health Insurance Exchange. His latest book, Empower PATIENTS – Two Doctors’ Cure for Healthcare will be released by Thanksgiving. Follow him on X @DrDeaneW or visit deanewaldman.com.
Lest you have any doubt about the political importance of federal subsidies in offsetting massive ObamaCare premium increases, here is Michigan's own Congresswoman Debbie Dingell:
Dingell leads Michigan Dems urging GOP to restore health care tax credits, warns of spiraling costs
By Katherine Dailey - October 30, 2025Ahead of Saturday’s start of the open enrollment period for health care under the Affordable Care Act, Michigan’s Congressional Democrats are calling on their Republican colleagues to work to restore the Affordable Care Act tax credits set to expire.
Those tax credits have become a centerpiece of the federal budget debate and the ongoing shutdown of the federal government, which is approaching the one-month mark. Without them, health care premiums will skyrocket, U.S. Rep. Debbie Dingell (D-Ann Arbor) said in a virtual press conference held Thursday.
“At some point, you had to draw the line in the sand. I want to get this government opened again. That means Republicans have to go to work in Washington,” Dingell said. “I hope Speaker Johnson calls us all back. We all get back there. We reopen the government, they do something about health care, so that millions of Americans don’t lose it.”
Dingell and her colleagues have pointed to these health insurance tax credits as a defining budget issue for them since the shutdown began, and have repeatedly called on Republicans to extend them through the coming year.
“Because Congress has prioritized tax cuts for billionaires over Medicaid and the Affordable Care Act, working Americans ae now seeing their health care costs double,” said U.S. Rep. Kristen McDonald Rivet (D-Bay City) in a press release from her office. “We can’t afford to wait any longer. Speaker Johnson needs to call the House back immediately so we can stop the health care crisis from landing on Michigan families.”
Jodie Schanhals, a 62-year-old entrepreneur from Traverse City, joined Dingell and Hertel in the press conference. Her health insurance, she said, will increase by around $1,200 per year without the tax credits.
“Right now, the Republicans in the House of Representatives are placing me in the middle of this battle. Either we’re not gonna pay the health care subsidies that go along with the ACA, so everybody can get health care, or we’re not gonna feed 40 million people,” she said, referencing the lapse in SNAP benefits set to start on Nov. 1. “I am outraged that this is the choice. It’s so cruel.”
Schanhals, who had hip surgery in 2007, said that she is due to find out if she will need a hip replacement, which she is expected to need.
“I won’t die from this,” she added. “I just won’t be able to walk.”
“For weeks, they refused to negotiate,” Michigan Democratic Party Chair Curtis Hertel added during the press conference, referring to Republicans. “For weeks, they refused to extend the tax credits that would keep premiums affordable. And now, with open enrollment starting this weekend, they still refuse to fix the problem they created.”
Michigan Democratic Party Chair Curtis Hertel fails to acknowledge that the affordability crisis was actually created by ObamaCare, which no Republican voted for. It was exclusively a Democratic construct.
The Federalist's Chris Jacobs concurs.
I don't agree with everything he says, but his patient-owned alternatives are intriguing. They are both pro-freedom and likely to work economically - certainly better than ACA/ Obamacare.
Here’s How Republicans Should Fix Health Care Rather Than Bailing Out Obamacare
October 07, 2025
To state what should be obvious but isn’t to most members of Congress, an Obamacare bailout wouldn’t make anything more ‘affordable.’
Sometimes a few words can mean a lot. Take the debate surrounding an extension of health insurance subsidies — one of the reasons why Democrats have shut down the federal government. Here’s what retiring Sen. Thom Tillis, R-N.C., said about the issue in June: “[W]ith the ACA subsidies and other things, we should start thinking about a stream of bipartisan bills that we can work on.”
Tillis’ terminology has two problems — one of politics, one of substance. On the politics, Jimmy Kimmel (of all people) repeatedly showed how voters view “Obamacare” one way and the “Affordable Care Act” another. That Tillis used the latter term rather than the former, thereby embracing Democrats’ political framing, might have something to do with his departure from the Senate next year.
More importantly, Tillis’ phraseology brings up a bigger question: If the law is so “affordable,” why are Democrats demanding Congress pass a bailout costing $350 billion plus interest and shutting down the federal government until it does so?
To state what should be obvious but isn’t to most members of Congress, an Obamacare bailout wouldn’t make anything more “affordable.” It would merely steal money from most Americans — because that’s what taxation is: legalized theft — to give to the roughly 6 percent of the population with subsidized Exchange policies.
Better Solutions
Rather than throwing more money at a broken system, Congress should instead look to reform that system, to lower, or at least slow the growth of, health care costs and skyrocketing insurance premiums. I detailed some of these reforms in the last chapter of my 2019 book, The Case Against Single Payer. A short summary follows.First, Washington should look to make health insurance portable, so it follows people from job to job. If people have coverage that they — rather than their employers — own, and that they purchased while young and (relatively) healthy, they would be protected before they ever develop a preexisting condition.
Regulations finalized by the first Trump administration surrounding Health Reimbursement Arrangements (HRAs) should help in this regard. These accounts allow employers to contribute a defined amount each month to help fund a worker’s health insurance premiums. Unlike other forms of employer-based coverage, with HRAs, the worker, not the employer, owns the policy, so the worker can select the coverage that works best for him. And when a worker leaves his job, he can take the policy funded by the HRA with him.
An even better alternative would allow Health Savings Account (HSA) dollars to pay for health insurance premiums. Unlike funds in an HRA, which are controlled by an employer, the individual always owns HSA dollars. If HSA funds could pay for health insurance premiums, then employers could contribute directly to workers’ accounts, and workers would own both their Health Savings Account and the insurance policy connected to it.
There are other types of solutions for the problem of preexisting conditions, many of which try to increase access to portable coverage before people develop a costly medical condition. All of these solutions would represent a better alternative than the regulations that more than doubled individual market premiums in Obamacare’s first four years and have kept premiums climbing steadily since.
Change Incentives to Reduce Costs
Other types of reforms would focus on reducing underlying health care costs by altering consumers’ incentives. Health care costs so much in part because people do a great job of spending other people’s money. Case in point: the massive amounts of fraud on the Obamacare Exchanges once the enhanced subsidies — the ones Democrats have shut down the government to extend — made coverage “free” for many enrollees.An expansion of HSAs would help improve incentives by letting people roll over funds in their accounts from year to year if they serve as smart health care shoppers. A heart attack victim obviously can’t “shop” for care while in an ambulance on the way to the ER. But with chronic conditions comprising a large share of American health care costs, more treatments are potentially “shoppable” than one might first believe.
Of course, shopping around for care only works if patients have the right tools to do so. While price and transparency data have improved, recent personal experiences illustrate that many patients remain in the dark about what health care treatments cost. Better enforcement of transparency requirements by regulatory bodies, and smart financial incentives (e.g., insurers lowering cost-sharing for treatments performed at “high-performing” facilities), will encourage patients to seek more efficient care.
A Better Way
Recall that Barack Obama claimed his health care plan would lower premiums for the average American family by as much as $2,500 per year. To say that hasn’t happened would be the understatement of the century. Rather than lowering costs, Obamacare has encouraged a sprawling oligopoly of Big Insurance, Big Hospitals, and Big Medicine that has driven up costs, such that even Sen. Elizabeth Warren, D-Mass., has admitted care has become less rather than more affordable.Fifteen years of Democrat-led policy failure shouldn’t prompt Republicans to throw in the towel and concede the need for an Obamacare bailout. Instead, they must have the vision to plot a better pathway forward. Patients and taxpayers alike deserve better. Here’s hoping Congress can give it to them.
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