As the federal shutdown entered a third week, President Trump and Office of Management and Budget Director Russell Vought announced the firing of 4,000 government workers, but warned there were many more terminations to come. Trump, who says he’s now targeting workers in what he labeled “Democratic agencies,” had already laid off some 300,000 federal workers through billionaire Elon Musk’s DOGE program earlier this year. Trump has said that after the shutdown ends, he may block backpay owed to hundreds of thousands of workers, violating legislation he signed into law in 2019.
The impact of the government shutdown is immediately being felt by 750,000 federal employees who have been furloughed or are being forced to work without pay. About 1.3 million active-duty military personnel are also on track to miss their paychecks, unless Congress votes to allocate those funds. The SNAP food and nutrition program and the healthy food program for Women, Infants and Children, or WIC, could run out of funds within days.
Since Oct. 1, Senate Democrats have refused to vote for legislation to reopen the government unless it includes a commitment to extend expiring Affordable Care Act health insurance subsidies, which if not restored, will increase monthly premiums for more than 22 million ACA enrollees by 75 percent to 114 percent. It’s estimated that if rates rise, some 2 million to 4 million Americans will lose their health insurance altogether. Between The Lines’ Scott Harris spoke with Wendell Potter, a former health insurance industry executive turned whistleblower, who links the current federal government shutdown to America’s long failing healthcare system.
WENDELL POTTER: Yeah, and we’ve seen the headlines, or most of us have seen the news reports that many millions of Americans who currently get Medicaid benefits will lose those benefits because of these cuts in future years. What goes largely unreported is the fact that this will affect all of us and in ways that we probably don’t realize. People who don’t have insurance still need to get healthcare. In many cases, they wait until it’s too late or they have an accident and wind up in the emergency room. That’s very costly. Hospitals have to admit people, they have to at least stabilize them, so these people will still get care. It may not be optimal care, but hospitals in particular will wind up with a lot of so-called uncompensated care with people who are not able to pay their bills. They already are seeing big spikes in uncompensated care. People are in health plans with high deductibles and they just simply don’t have the money to pay out of pocket before their coverage will kick in.
So they delay care and often delay and delay and delay until they have a very serious illness or need to go to the hospital. And they still aren’t able to pay their medical bills. This will get even worse as more and more people are back into the ranks of the underinsured, obviously uninsured, and I suspect we’ll see emergency rooms even more crowded than they are now, and we will see that a lot of small hospitals, particularly in rural areas, will be closing.
They’ve already closed in many states. Many rural hospitals have closed because they see and treat a lot of people on Medicaid and Medicare and they’re not getting the compensation they need already. So this will be an additional hit for them. So we can expect to see a lot of hospital closures in the coming years.
But I think that we will see that more and more people will decide that this is so broken. We’ve got to do something significantly different—and let’s look to see what other countries have done that spend half as much as we do, make sure everybody is covered and the quality of care is in many cases better and people are living longer. I think the time is getting closer in which we’re going to have another big debate and I think the insurance industry is going to be standing largely alone.
For more information, visit Center for Health and Democracy at centerforhealthanddemocracy.org.
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