Trump’s shutdown win just landed Republicans with a huge political headache

This is the Trump ship that never sailed.

The president returned to the topic Monday, promising an imminent solution to America’s growing health care crisis — something he has repeatedly failed to do in the past.

“I’m telling you, in the next little while, we’re going to be working very hard on this issue where the public is going to get the money,” President Donald Trump said, referring specifically to Americans dragged into crisis. Advanced Affordable Care Act subsidies are expiring. “We’re talking about trillions and trillions of dollars that the public is taking money from,” he added, without elaborating on the vague idea. send cash to affected policyholders shifting subsidies by bypassing insurance companies.

Trump’s offhand response was typical of the pancake he sometimes creates to escape the jam at a photo op. However, he could not hide the negative side of his “win” in shutting down the government, which seemed to end after the Democrats failed to meet their most important demand: these improved Obamacare subsidies.

Trump and the Republicans, along with millions of citizens, once again took ownership of the health issue. not just those in ACA plans – affected by rising premiums and high deductibles wider cost of living crisis. And Trump, just like his first term, lacks a comprehensive, detailed plan to provide relief to citizens who lack health care, can’t afford the plans they have, or know that job loss could leave them without any coverage.

If the GOP can’t solve the pressing problem of subsidies and convince voters that they have a serious solution to this and other affordability problems, 2026 midterm election hopes can take a dive.

Trump’s fuzziness on healthcare is nothing new. Repeated, unfulfilled promises to take action led to his much-reviled “infrastructure weeksTrump’s promise to replace Obamacare flashed with hype but came to nothing, and the 2010 law persists despite multiple efforts by Republicans to kill it.

During the 2016 campaign, Trump promised to repeal Obamacare and replace it with something “awesome.” At rallies, he promised Americans new, cheaper but much better health care. If this sounds impossible, that’s probably because it is.

Trump promised early in his first term that change was on the way. “Despite what you hear in the press, the health service is doing great. We’re talking to a lot of groups and it’s going to result in a good picture!” he wrote on the website formerly known as Twitter in March 2017. The GOP’s failure to repeal Obamacare, in part because it failed to produce an alternative, did not stop Trump’s optimistic predictions. “The Republican Party will soon be known as the party of the health sector” the president announced In March 2019.

The second period is the same as the first. Trump was mocked during his debate with Democratic nominee Kamala Harris in 2024. saying you have “plan concepts” to make healthcare “better and cheaper.” More than a year later — and despite Trump’s significant efforts to lower the cost of some prescription drugs — Americans are still waiting for his more far-reaching solutions.

Republicans’ divisions boil over health care

The fight over health care wasn’t just at the center of the government shutdown battle with Democrats. It is tearing apart the unity of the Republican Party. It even alienated Trump and one of his most outspoken supporters. Marjorie Taylor Greene. The representative of Georgia switched sides early in the shutdown and emphasized: ACA insurance premiums for his family, which he said would double in price due to subsidies expiring. Even though he wasn’t a fan of the ACA, he attacked his own party. “Not a single Republican in the leadership has talked to us about this or offered a plan to help Americans deal with doubling health insurance premiums!!!” Greene wrote on X in October.

Greene’s persistent criticism is a warning sign for House Speaker Mike Johnson, who is recalling the House this week to vote on a Senate plan to reopen the government. It may explain why the GOP has been so eager to keep the chamber dark during a shutdown that has left its internal dissent boiling over. Greene distanced herself further from Trump on Monday, telling X that he should spend less time meeting foreign leaders and instead have “non-stop” meetings on domestic policy.

The president told CNN’s Kaitlan Collins: “I don’t know what happened to Marjorie. She’s a good woman, but I don’t know what happened. I think she lost her way.” Greene later told CNN: “I haven’t lost my way. I am 100% the first and only America!”

Greene may now be viewed as a MAGA heretic by some in Trump’s orbit. But his comments on health care raise another possibility: He’s far more in line with the economic insecurity felt by ordinary Americans than a billionaire president and his wealthy cabinet.

He is not alone. During the shutdown, a group of endangered House Republicans wrote to Johnson encouraging government to address expiring increased ACA subsidies when it reopens. “We did not create this crisis, but we now have the responsibility and opportunity to address it,” they wrote.

Senate Republican leader John Thune has agreed to vote in December on increasing Obamacare subsidies as part of a deal with moderate Democrats to reopen the government. A bill written by Democrats has a slim chance of passing. But the vote will put GOP senators on the record and make a political point.

Johnson has not promised to hold a similar vote; That’s one reason why progressive Democrats are angry about centrist Senate Democrats’ compromise to end the shutdown.

The speaker told CNN’s Jake Tapper on “The Lead” on Monday that he was always willing to talk about rising health care costs, but Democrats wasted weeks of valuable time by triggering the shutdown last month. He promised to discuss a plan to get to the “root cause” of the health problem. But this is unlikely to help ACA policyholders who have to decide between giving up health plans they can’t afford or paying punitively increased premiums.

Johnson couldn’t tell Tapper whether a vote on the issue would be held anytime soon. “I’m not committing or committing to that. What I’m saying is that we’re going through a deliberate process. That’s how it always works and we need to have time to do that,” the speaker said. But the GOP’s slim majority gives little reason to be optimistic that a complex and divisive issue like health care reform is something the fractious GOP and an out-of-office president can handle.

One tangible win for Democrats in the shutdown drama was their highlighting of the ACA problem and their attacks on Republicans for failing to fix health care. Inside an NBC News poll In a closing poll taken last month, 10 percent of respondents cited the cost of health premiums as the most important issue determining their vote for Congress next year. While 49 percent of those surveyed said Democrats would do a better job on health care, the rate of those who thought the same about Republicans was 26 percent.

Most Democrats are angry He said his moderate Senate colleagues made a deal with Republicans to reopen the government because they saw it as a betrayal of Americans on health care. But Sen. Jeanne Shaheen, who brokered the deal and joined seven other Democratic factions in supporting it, told CNN’s Kate Bolduan that the deal will show whether Republicans are serious.

“Finally, because of the shutdown fight, we had some Republicans who realized that this was a problem for them,” the New Hampshire Democrat said. “Now we’ll see. We’ll see if they’ll actually work with us to make sure Americans can afford their health insurance.”

Looking at Democrats’ tactics, a cynic might wonder whether the party, which failed to make permanent Obamacare credits expanded during the Biden administration, is setting Republicans up on an issue its rivals have not always been able to resolve, especially during the Trump era.

How has Trump tried to lower some health care costs?

Republicans say Trump’s “Big Beautiful Bill” domestic policy legislation has already taken significant steps to make health care more affordable by loosening the power of insurance companies and restoring choice and control, in part because Giving states more responsibility. However, many health analysts and groups say the bill Cuts to Medicaid funding It could put millions in danger of losing insurance coverage and put many rural hospitals in danger of closing.

The administration has several initiatives to lower the costs of prescription drugs for Americans. plans to launch TrumpRxa direct-to-consumer website early next year. Last week the president announced a plan some obesity medications It can be purchased for as low as $149, an arrangement that provides tariff discounts to pharmaceutical companies such as Eli Lilly and Novo Nordisk. If this plan works, it could be lifesaving for many patients who can’t get their medications through insurance companies and can’t afford to buy them out-of-pocket.

The initiative reflects Trump’s desire to use government power to intervene in markets, which is also seen in other sectors and runs counter to conservative orthodoxy. A recent plan to send money directly to ACA policyholders rather than offering subsidies appears to stem from a similar motivation to shake up the industry.

But the idea is fraught with uncertainty, including whether such payments would close the gap in all subsidies. Another question is whether this will compensate for the shortfall in subsidies for premium payments. Or will there be a separate payment that patients can use to directly pay for their treatment?

In the event of a second payment, which eliminates insurance companies, recipients may incur large costs if they receive a negative diagnosis.

And rising healthcare costs don’t just affect ACA policyholders. If the government sends cash to certain Americans, how is that fair to other taxpayers? And wouldn’t government-funded payments for health care go against everything the GOP believes in?

Such thorny questions and the president’s past failures to deliver health care explain the Republican Party’s new but familiar political nightmare on an issue that worries tens of millions of voters.

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