Podcast Summary: What A Day

Episode: Dems Throw Down For Health Care

Host: Jane Coaston
Date: September 30, 2025
Podcast: Crooked Media – What A Day

Overview

This episode dives into the intensifying political battle over healthcare subsidies tied to the Affordable Care Act (ACA) as the U.S. faces a looming government shutdown. Host Jane Coaston interviews Julie Rovner, chief Washington correspondent for KFF and host of the "What the Health" podcast, for an in-depth look at health policy negotiations, the implications of expiring subsidies, partisan grandstanding, and the real-life impacts on millions of Americans. The episode also touches on breaking news, including Trump’s latest moves, a deadly church attack in Michigan, major business deals, and Super Bowl halftime show controversy.

Main Theme

The core issue: Enhanced ACA health care subsidies are about to expire, risking massive premium increases for millions. Political gridlock may lead to a government shutdown, with both parties blaming the other—and real people caught in the middle.

Key Discussion Points & Insights

1. Looming Government Shutdown Over Health Care ([00:02]–[02:51])

• Jane Coaston's introduction frames the brewing crisis, criticizing corporate payments to Trump and laying out the potential for a government shutdown as leaders fail to agree, with health care subsidies at the center of the impasse.
• Critical quote:
  • Hakeem Jeffries warns:

    “Notices are going to go out to tens of millions of Americans making clear that their health care is about to become dramatically more expensive… actually cause medical bankruptcy for many or some to have to forego necessary health care.” ([00:59])

• GOP leaders, including VP J.D. Vance, downplay the importance of the subsidies and argue it isn’t worth shutting down the government:
  • J.D. Vance:

    “You don’t shut the government down. You don’t use your policy disagreements as leverage to not pay our troops to not have essential services… disagreeing about a particular tax provision is no excuse.” ([01:54])

• Jane’s fact check:
  Reminds listeners shutdowns happen specifically because of policy disputes, citing the 2018 and 2013 shutdowns.

2. Deep Dive: The ACA Subsidy Fight – Interview with Julie Rovner ([02:51]–[11:55])

a. What are Enhanced ACA Subsidies? ([02:52]–[04:44])

• Julie Rovner explains:
  • Original ACA (2010) included tax credits (premium subsidies), but insurance stayed expensive.
  • In 2021 (pandemic), Congress beefed up these credits, making premiums lower or free for low-income people (~$30,000/year income).
  • Enrollment doubled, but the enhancements expire end of 2025.
  • Democrats thought they’d have time to extend them; now, both options (Dem control or GOP deal) are failing.
  • Impact:

    “People are going to discover their premiums are going to double or… triple. That will be not boring.” ([04:44])

b. Direct Impact if Subsidies Expire ([04:44]–[05:43])

• 90% of 24 million enrolled get these tax credits.
• Even those not subsidized face 18% premium hikes due to other health care cost pressures.
• Anecdote:
  • Many could see premiums rise from $1,000/year to $3,000–$4,000/year.

c. GOP Inaction and Political Calculus ([05:43]–[07:08])

• ACA enrollment, and thus the impact, is largest in Republican-leaning and swing states (Texas, Florida, Georgia).
• Julie on Republican motives:

  “Half of them would still like to see the Affordable Care Act like it in the beginning… wanted to repeal it in 2017 and couldn’t quite do it… perfectly happy to see these additional tax credits completely go away.” ([06:06])

• Prediction: GOP voters will be hit hard, which could bring political backlash.

d. Accusations About Subsidies for Undocumented Immigrants ([07:08]–[08:19])

• GOP leaders claim Democrats want to support undocumented immigrants with subsidies.
• Julie’s response:

  “No... there will be nobody who is undocumented... and in fact, there will be a number… who will no longer be able to use the Affordable Care Act to buy their health insurance.” ([07:39])

e. Trump’s Stance & Shutdown Blame Game ([08:19]–[09:36])

• Trump accuses Dems of holding government ‘hostage’ seeking “$1 trillion for illegal aliens”—which is false.
• Both parties think they can ‘win’ the shutdown, but Julie notes:

  “…the side that’s sort of forcing it… doesn’t usually get anything… walk away with their tail between their legs.” ([09:20])

f. Logistical Crunch – Is It Already Too Late? ([09:36]–[10:50])

• Open enrollment starts in November; insurers need pricing info now.
• Some states/insurers prepped for either scenario, but if action isn’t taken within weeks, consumers will see higher premiums during “window shopping,” and may drop coverage before a fix can arrive.

g. What Shuts Down in a Health Program Shutdown? ([10:50]–[11:50])

• Mandatory programs (Medicare/Medicaid) don’t halt, but the people running them may be furloughed.
• Many other health programs – especially discretionary ones – would stop or lose critical staff; no payments until shutdown ends.

3. Notable Quotes & Memorable Moments

• On ACA subsidies expiring:
  • Jane: “Having to pay way more for health care is notably one of the less boring things that can happen.” ([04:44])
• On GOP inaction:
  • Julie: “I have been asking this question every week for the last six months. Why aren’t Republicans paying attention…?” ([06:06])
• On the shutdown blame game:
  • Julie: “The side… forcing it… doesn’t usually get anything. They… walk away with their tail between their legs.” ([09:20])
• On missing the policy window:
  • Julie: “A lot of them… will have gone to the website, seen what it might cost them and said, okay, no health insurance for me next year.” ([10:43])

Additional News Roundup

Israeli-Palestinian Crisis: Trump’s “Board of Peace” Plan ([14:14]–[16:27])

• Trump, in a joint press conference with Israeli Prime Minister Netanyahu, announces a proposed peace plan for Gaza; if Hamas refuses, says Netanyahu:
  • “This can be done the easy way or…it will be done.” ([16:00])

Michigan Church Shooting: Calls for Calm ([16:27]–[18:20])

• Gov. Gretchen Whitmer urges against speculation post-LDS church attack:
  • “Speculation is unhelpful and it can be downright dangerous…” ([17:14])
• Contrast with WH Press Secretary Caroline Levitt and Fox News, who immediately frame it as Christian persecution, despite FBI urging caution.

Business & Culture Headlines

• Electronic Arts (EA) to be acquired by investors including Saudi Arabia’s fund and Jared Kushner, marking the largest private equity buyout ever ($55B). ([18:20])
• Bad Bunny named the 2026 Super Bowl halftime show headliner. Some call him controversial for activism and not performing in the US due to “fucking ice could be outside.” ([19:46])

Timestamps for Key Segments

• Introduction & ACA Standoff Background: [00:02]–[02:51]
• Interview with Julie Rovner:
  • ACA Subsidy Overview: [02:52]–[04:44]
  • Impact on People: [04:44]–[05:43]
  • GOP Politics: [05:43]–[07:08]
  • Immigration Accusations: [07:08]–[08:19]
  • Trump’s Role & Blame Game: [08:19]–[09:36]
  • Enrollment Timing Crunch: [09:36]–[10:50]
  • Health Program Effects in Shutdown: [10:50]–[11:50]
  • Interview wrap-up: [11:50]–[11:55]
• Israel-Gaza Peace Plan: [14:14]–[16:27]
• Michigan Church Attack & Political Reactions: [16:27]–[18:20]
• EA Buyout & Bad Bunny Controversy: [18:20]–[19:46]

Tone & Takeaways

Jane Coaston’s tone remains conversational, witty, sometimes sardonic, but always well-informed. She blends policy analysis with humor (e.g., “Having to pay way more for health care is notably one of the less boring things that can happen.” [04:44]) and isn’t shy in critiquing both political grandstanding and the media’s rush to narrative.

The episode’s heart: Americans face serious health coverage cliff, but DC is mired in blame, misinformation, and gamesmanship. The beneficiaries of health subsidies—many in GOP strongholds—stand to lose most.

Memorable closing quip:
Jane, joking about Trump’s proposed movie tariffs:

“Does anyone have any idea how Trump would put a 100% tariff on foreign films? No, of course not. Because it’s stupid.” ([END])

For more: Listen to the full episode or check out the “What the Health” podcast for deeper dives on national health policy.