Republican Healthcare Vote, Susie Wiles Interview, Nuclear Reactor Regulations

Summary

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Up First from NPR — December 17, 2025

Main Theme:
Today's episode covers the looming Republican-led healthcare vote in Congress, an in-depth Vanity Fair profile of White House Chief of Staff Susie Wiles, and fast-tracked nuclear reactor regulations under the Trump administration.

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1. Republican Healthcare Vote and ACA Subsidies

[02:27 – 06:15]

Key Points:

• Expiring Health Care Subsidies:
  Congress has only two days left to decide on extending enhanced Affordable Care Act (ACA) subsidies, which are set to expire at year’s end. This could result in higher premiums and millions potentially losing coverage.

• Political Stalemate:

  • Democrats want a simple three-year extension, but their recent Senate vote failed despite support from four Republicans.
  • Senate Republicans offered an alternative focusing on health savings accounts, also unsuccessful.
  • The House, led by Speaker Mike Johnson, plans to vote on a Republican proposal featuring conservative-favored cost-cutting measures but does not extend the subsidies.

• GOP Internal Divide:
  Some moderate Republicans want to preserve the subsidies, at least temporarily, but their efforts—such as attempts to amend Johnson's bill or force a vote via discharge petition—lack sufficient support.

Notable Quotes:

• On the roots of the ACA:

  "The roots of Obamacare have gotten so deep that it's no longer possible to just pull it out at the root and start over."
  — Speaker Mike Johnson (cited by Steve Inskeep, [00:06])

• House Republican perspective:

  "The unaffordable care act have gotten so deep in the system... now we have to take it step by step to reduce and repair, reduce cost and repair the system."
  — Speaker Mike Johnson (quoted by Sam Gringlass, [04:14])

• GOP Moderate Critique:

  "It is idiotic and shameful. This place is disgraceful. Everybody wants the upper hand, everybody wants the political advantage, they don't actually want to do the damn work."
  — Rep. Mike Lawler, Republican (paraphrased/quoted by Sam Gringlass, [05:10])

Outcome:

• Most lawmakers believe a solution is unlikely this year, suggesting premiums will rise sharply on January 1. Bipartisan talks continue, but chances are slim.

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2. Inside the White House: Susie Wiles Interview

[06:23 – 10:11]

Key Points:

• Susie Wiles Speaks Out:
  Chief of Staff Susie Wiles offered rare, unfiltered views of the Trump White House in a long-form Vanity Fair article based on months of interviews. She discussed infighting and gave candid opinions on senior figures.

• Key Details from the Interview:

  • Wiles reportedly argued with Elon Musk over "gutting" USAID.
  • She and VP J.D. Vance tried to dissuade Trump from new tariffs.
  • Wiles criticized Vance (calling him a "conspiracy theorist") and Attorney General Pam Bondi for handling the Epstein disclosures.
  • Gave her perspective on President Trump, stating he has an "alcoholic personality," clarifying that she meant he has an outsized, driven nature — elaborating he "operates with a view that there is nothing he can't do."

• White House and GOP Reactions:

  • Wiles denounced the article as a "hit piece" on social media, accusing it of painting a chaotic, negative picture.
  • Trump and others, including Vance, publicly defended Wiles. Trump acknowledged the "addictive personality" line.
  • The administration accused the media of unfair coverage but acknowledged Wiles's repeated willingness to speak with Vanity Fair.

Notable Quotes:

• On Trump’s personality:

  "Trump has an alcoholic personality... [he] operates with a view that there is nothing he can't do."
  — Susie Wiles (via Danielle Kurtzleben, [08:00])

• Vance Defends Wiles:

  "Susie is who she is in the president's presence; she's the same exact person when the president isn't around. I've never seen Susie Wiles say something to the president and then go and counteract him or subvert his will behind the scenes."
  — JD Vance [09:00]

• Media Tension:

  "The administration has been trying to focus on the economy... just how easily that can be derailed."
  — Danielle Kurtzleben [09:37]

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3. Fast-Tracking Nuclear Reactor Regulations

[10:17 – 13:39]

Key Points:

• Reactor Pilot Program:
  The Trump administration is accelerating the approval of eleven new nuclear reactor designs, aiming for at least three to be operational by July 4, 2026 (the nation’s 250th birthday).

• Industry–Regulator Conflict:

  • Traditionally, the Nuclear Regulatory Commission (NRC) has been the chief regulator, but new startups see the NRC as too slow for innovation.
  • The Department of Energy (DOE) is taking a lead, with officials telling companies, "It's whatever we need to ensure that the government is not stopping you from reaching criticality on or before July 4, 2026." — Seth Cohen, DOE lawyer ([11:11])

• Safety Concerns:

  • Critics worry DOE’s dual role (developer and regulator) poses a conflict of interest, and that its safety oversight is inadequate compared to the NRC.
  • Allison Macfarlane, former NRC chair: "You cannot promote and regulate." ([12:45])
  • Some advocates warn this hurry could prompt accidents, even with planned “small test reactors”.

• DOE’s Response:
  DOE insisted to NPR they "uphold the highest standards of safety" in collaboration with NRC staff and maintain their July 4 deadline.

Notable Quotes:

• On regulator sufficiency:

  "The NRC is not built for R&D, it's built for... a plant that is 100 percent ready to build all over the United States."
  — Isaiah Taylor, Valor Atomics CEO ([11:50])

• On safety trade-offs:

  "This is not OK, and this is not going to lead to success. This is how to have an accident."
  — Allison Macfarlane, former NRC chair ([12:56])

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Memorable Moments

• Speaker Mike Johnson’s admission of ACA’s permanence:
  The remark about the ACA’s roots being too deep for full repeal ([00:06]) set the pragmatic, incremental approach of current proposals.
• Susie Wiles as an unexpectedly blunt insider:
  Her characterization of Trump and critiques of White House colleagues revealed rare candor and internal strife ([08:00]).
• DOE’s “do whatever it takes” mindset for nuclear startups:
  The explicit statement from a government lawyer ([11:11]) underscored industry-friendly urgency, fueling safety advocates’ concerns.

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Timestamps Overview

| Segment | Time | |----------------------------------------|--------------| | ACA Subsidy Deadline & GOP Vote | 02:27–06:15 | | Susie Wiles Vanity Fair Interview | 06:23–10:11 | | Nuclear Reactor Regulation Fast-Track | 10:17–13:39 |

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For full context, listen to the episode on the Up First NPR feed.

Transcript

[A]

With two days left in their session house republicans prepare to vote on a.

[B]

Health care plan the roots of obamacare have gotten so deep that it's no longer possible to just pull it out at the root and start over so.

[C]

What is speaker mike johnson planning i'm.

[A]

Steve inskeep with michelle martin and this is up first from npr news.

[D]

The.

[A]

President'S chief of staff susie wiles offers a behind the scenes look at the white house in a vanity fair story what did she say about the administration and the people in it and and.

[C]

The trump administration is fast tracking new nuclear reactor designs some safety advocates are worried about the government's approach to regulation this is not okay and this is not going to lead to success this is how to have an accident stay with us we'll give you the news you need to start your day.

[D]

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[C]

Congress has two days to take action on health care subsidies before lawmakers head out of the capitol for the holiday.

[A]

Recess the enhanced subsidies for affordable care act marketplace plans will expire at the end of this year millions of americans can expect their premiums to increase by thousands of dollars and some plan to drop their coverage there is no sign of that congress will do about it although the house plans a vote today.

[C]

Npr congressional reporter sam greenglass has been tracking this story from capitol hill he's with us now good morning sam hey michelle so these subsidies which some twenty two million americans get have been in place since the pandemic now we know that without them premiums could double or triple so why are we down to the wire here on addressing this well.

[B]

Michelle there is not consensus about how to extend the subsidies and among republicans there is disagreement about whether to extend them at all now the deadline to sign up for plans on the affordable care act marketplace has passed now and some people have said they'll forego insurance because they can no longer afford the premiums the congressional budget office estimates next year two point two million people may lose their coverage tell us more about.

[C]

The fault lines here is it strictly.

[B]

Along party lines no not exactly democrats want to simply extend the subsidies for three years vote to do that failed in the senate last week though it did attract four for republican votes now republicans have their own proposals to cut health costs senate republicans came up with a plan to deposit up to fifteen hundred bucks in health savings accounts for high deductible aca plans that also failed last week republican leaders in the house are setting up a vote today on their own plan but neither of these two republican measures would extend the subsidies.

[C]

What do you expect in the house.

[B]

Today so this house bill is a package of ideas long favored by conservatives to cut health costs like association health plans and new regulations for pharmacy benefit managers but they would not do much to prevent the aca plan premiums from spiking next year you know since the aca passed fifteen years ago republicans have tried to repeal and replace it house speaker mike johnson says the new aim is reduce and repair the roots of obamacare the unaffordable care act have gotten so deep in the system that it's no longer possible to just pull it out at the root and chop it off and start over it's too deeply ingrained and so now we have to take it step by step to reduce and repair reduce cost and repair the system johnson says subsidies are just expensive taxpayer handouts to insurance companies but there.

[C]

Are some moderate republicans who do want to preserve the subsidies at least temporarily what happened to that effort a dozen.

[B]

Or so house republicans have been vocally pushing to extend the subsidies some have pressed for a vote to tack them onto johnson's bill there are also efforts to maneuver around leadership using a tool called a discharge petition but none have enough support so far and some of these republicans have been fuming this week republican congressman mike lawler slammed gop leadership for blocking a vote on the subsidies and democratic leaders for insisting on a three year extension without reforms to sway republicans it is idiotic and shameful this place is disgraceful everybody wants the upper hand everybody wants the political advantage they don't actually want to do the damn.

[C]

Work so down to the wire here sam any changes likely bipartisan talks are.

[B]

Still happening among some rank and file senators but most lawmakers have acknowledged a solution is not going to happen this year which means premiums for many americans are going to shoot up on january.

[C]

First npr congressional report sam greenglass sam.

[B]

Thank you thank you.

[C]

The white house chief of staff offered some edgy assessments of president trump and others in the administration susie wiles gave her opinions not in some passing remark but in months.

[A]

Worth of interviews the resulting article in vanity fair illuminates a woman who rarely made headlines up to now she has acted as the president's facilitator since before the inauguration she's also been ducking out of white house meetings to tell a reporter how trump trump's white house works.

[C]

Npr white house correspondent danielle kurtzleben is here to talk about that fallout good morning danielle hey michelle so what was in this piece that got so much.

[F]

Attention well for one thing wiles openly described several conflicts within this white house for example when elon musk started gutting us aid wiles says she was aghast and argued with him about how he was doing it she also talks about disagreements on tariffs and how she and vice president jd vance initially tried to get trump to back off of announcing that big rally round of tariffs in april but in addition wiles is just blunt about people she calls vance a conspiracy theorist whose conversion from anti to pro trump was quote sort of political and she really pointedly criticizes attorney general pam bondi for her initial handling of jeffrey epstein disclosures well that sounds like.

[C]

She really gave her unvarnished take on things i mean i guess some people think that she was being harsh yeah.

[F]

Some people do and this really got a lot of attention on social media because of it but there's a lot of nuance here really the picture that emerges is that you have all these personalities in that white house some of whom yeah aren't described one hundred percent glowingly but that wiles is this no nonsense force just hurting them all together in the service of trump's agenda and even when it seems here like she might have criticized trump the truth is just more complex for example there's a quote that got a lot of attention where she said trump has an alcoholic personality but in context what she was saying is that trump has a big exaggerated personality and that he quote operates with a view that there is nothing he can't do well that's news to.

[C]

No one yeah i think we knew that well so how is the white house responding to this well wiles was.

[F]

Not happy she did a rare social media post calling this a hit piece saying that she thought the article was trying to quote paint an overwhelmingly chaotic and negative narrative and trump officials have circled the wagons too trump even did a specific interview on this with the new york post and he backed up wiles and even agreed with that alcoholic line saying that yeah while he doesn't drink he does have an addictive personality vance also defended wiles yesterday you know.

[B]

Why i really love susie wiles because susie is who she is in the president's presence she's the same exact person when the president isn't around i've never seen susie wiles say something to the president and then go and counteract him.

[D]

Or subvert his will behind the scenes.

[F]

He also blamed the news media but again this was more than a year's worth of interviews meaning wiles agreed repeatedly to give vanity fair this access okay.

[C]

So quickly danielle the trump administration at war with the media is not a new thing so why is this such a big deal and why the concerted.

[F]

Pushback well first of all like you said that it's just rare for wiles to talk to reporters and be this unfiltered secondly the drama got attention as drama does but beyond all that there's the context that the administration has been trying to focus on the economy here we see just how easily that can be derailed just as trump himself did earlier this week when he disparaged the slain liberal film director rob reiner now tonight the white house is going to try to get back on course with the primetime address which is expected to focus on the president's first year wins.

[C]

Npr'S danielle kurtzler danielle thank you thank.

[E]

You.

[C]

The trump administration has ambitious plans.

[A]

For nuclear power yeah a program unveiled earlier this year is supposed to get nuclear reactors up and running just months.

[C]

From now npr's jeff brumfiel has been looking at the program and why some are worried about it jeff good morning thanks so much for joining us good.

[G]

Morning michelle so let's start by talking.

[C]

About this program what is it and what does it do it's called the.

[G]

Reactor pilot program and it's fast tracking eleven brand new new reactor designs by nuclear startup companies the goal here is to have at least three running by the nation's two hundred fiftieth birthday on july fourth twenty twenty six and to say that's ambitious is like really an understatement nuclear reactors normally take years to build the new program is being run by the energy department and in a meeting in june department officials told company leaders they were ready to do whatever they could to help here's energy department lawyer seth cohen it's whatever we need.

[B]

To ensure that the government is not stopping you from reaching criticality on or before july fourth twenty twenty six okay.

[C]

So what does attorney cohen mean by stopping these companies why would the government.

[G]

Stop them well i mean historically it's come down to one word which is safety the us has one of the strongest nuclear regulators in the world it's called the nuclear regulatory commission and some of these companies think that the nrc has been too strict they think the energy department will be eas one company is valor atomics it's run by a guy named isaiah taylor and he told me the nrc just isn't the right regulator for these new reactor designs the.

[B]

Nrc is not built for r and d it's built for you need to come to us with a plant that is one hundred percent ready to build all over the united states so valor's.

[G]

Part of this energy department program and taylor says it's just what they need.

[B]

Private nuclear companies can do r and d again in real hardware with real neutrons real uranium and then get ready.

[G]

For commercialization but many safety advocates are really worried about this approach and they're particularly worried that the nrc has no.

[C]

Direct oversight so why do these safety advocates think the energy department is the.

[B]

Wrong regulator well first of all the.

[G]

Energy department has just far fewer staff devoted to reactor safety it also hasn't really regulated commercial reactors much in the past on top of that its mission is to develop nuclear power allison mcfarlane is a former nrc chair under the obama administration she calls that a conflict.

[C]

Of interest you cannot promote and regulate.

[G]

Mcfarlane and other critics of the program told me they're very worried that safety was being sacrificed for speed this is.

[C]

Not okay and this is not going to lead to success this is how to have an accident now just one.

[G]

Thing to note these are small test reactors so if there is an accident it won't be like chernobyl or anything huge but it could still hurt workers or the local environment well that still.

[C]

Sounds concerning so what does the energy department say about that it told npr.

[G]

That it quote upholds the highest standards of safety in our work with the nuclear industry it also said nrc staff are working with the department to ensure safety and that it's still shooting for that july fourth deadline for companies of the electricity have already presented their preliminary designs and approvals could come early next.

[C]

Year that is npr's jeff brumfield jeff thank you thank you and let me note here that amazon and google are financial supporters of npr and that's up for us for wednesday december seventeenth i'm.

[A]

Michelle martin and i'm steve inskeep for your next listen consider consider this from npr news up first brings you three big stories of the day consider this drills down on one and you can listen on the npr app or wherever.

[C]

You get your podcasts today's episode of up first was edited by kelsey snell rebecca metzler brett neely lisa thompson and alice wolfley it was produced by ziad butch nia dumas and christopher thomas we get engineering support from stacey abbott our technical director is carly strange our supervising editor is jan johnson join us again tomorrow.

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