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The Republican Health Care Trap, Episode 78

Speaker of the House Mike Johnson (R-La.) at a press conference with members of the Republican Study Committee on October 28, 2025. (Photo by Nathan Posner/Anadolu via Getty Images) THE REPUBLICANS HAVE A NEW PLAN for ending the government shutdown. They’re going to present an alternative to the Affordable Care Act. And it’s going to […]

Speaker of the House Mike Johnson (R-La.) at a press conference with members of the Republican Study Committee on October 28, 2025. (Photo by Nathan Posner/Anadolu via Getty Images)

THE REPUBLICANS HAVE A NEW PLAN for ending the government shutdown. They’re going to present an alternative to the Affordable Care Act. And it’s going to be great.

That was the message House Speaker Mike Johnson sent at a Monday press conference when he was asked about the core dispute in the nearly month-long shutdown: whether to extend extra subsidies for the Affordable Care Act that are currently set to expire at year’s end

Without those additional subsidies, Democrats warn, premiums will jump for more than 20 million Americans. Republicans say they don’t want to put even more money into what they call a “failed” system—and now, Johnson says, they’re coming up with a replacement.

Fellow Louisiana Republican Steve Scalise, Johnson relayed, “has been working with the chairman of our three committees of jurisdiction . . . grabbing the best ideas that we’ve had for years, to put it on paper and make it work,” But, he added, “we know we’re going to have to arm-wrestle with Democrats over that.”

If this all sounds vaguely familiar, that’s because it is.

Republicans have been trying to repeal the Affordable Care Act law since the day former President Barack Obama signed it—always ignoring the law’s very real accomplishments, while dwelling on flaws both real and imagined.

But every single time, the conversation leads to the same place: What do Republicans propose to do instead? Despite repeated promises that they have a way to provide cheaper, better health care without major coverage losses, they’ve never come up with a proposal that would come close to achieving that.

In fact, the string of empty promises of a supposedly fantastic, about-to-be-revealed GOP health plan has long been a running joke in Washington—one my former colleague Jeffrey Young memorialized with a sardonic “Just In Time!” running gag that stretches back more than a decade.

That’s not to say Republicans have no ideas at all.

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