Healthcare takes center stage in shutdown as Democratic base pressures silent leaders : Peoples Dispatch
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As the shutdown begins, Republicans push deep cuts to Medicaid while Democrats face mounting pressure from their base to finally an even more decisive stand on healthcare

The US government shut down at midnight on October 1 after Congress failed to approve new spending bills, forcing federal agencies nationwide to halt or scale back operations. At the heart of the shutdown is a standoff between Republican and Democratic Party politicians over healthcare. Over the summer, Republican lawmakers passed Donald Trump’s sweeping “Big Beautiful Bill” that makes deep cuts to public healthcare.

Democrats argue that the Republican budget plan would weaken programs like Medicaid, the nation’s largest public health insurance program which covers over 70 million people. Democratic Party lawmakers demanded that protections for these programs be locked into a short-term spending bill, and when Republicans failed to deliver, lawmakers were unable to pass a funding bill to avoid a shutdown.

But as establishment politicians scramble to cut a deal to end the shutdown, the Democratic Party base seems eager for an even fiercer fight.

According to polling by YouGov, the Party’s approval rating has been steadily declining for the past few years, and now stands at 64% disapproval. This summer, a Wall Street Journal poll revealed the lowest approval ratings for Democrats in 35 years. Just 8% of registered voters view the party “very favorably,” while 63% say it is out of touch with everyday concerns.

Amid the government shutdown, Trump shared photos to his social media platform Truth Social of top Democratic leaders Hakeem Jeffries and Chuck Schumer sitting with him around the desk in the Oval Office, alongside prominently featured “Trump 2028” hats – despite the fact that the two-time president cannot legally campaign for a third term.

The administration has made a centerpiece of their attack against Democrats the claim that party leaders are demanding healthcare subsidies for undocumented immigrants. An AI generated “deepfake” video depicting House minority leader Jeffries in a mustache and a sombreros was played on a loop in the White House briefing room, which Jeffries has denounced as racist.

The human cost of healthcare cuts

The healthcare coverage cuts in the “Big Beautiful Bill” carry a high cost for people in the US who rely on the nation’s already gutted public healthcare system. Before the bill even passed, public health researchers from Yale and the University of Pennsylvania warned the Senate that its insurance cuts could cause more than 51,000 deaths.

According to Congressional Budget Office (CBO) estimates, the law cuts a shocking USD 1.1 trillion from Medicaid and Affordable Care Act (ACA) marketplace coverage (which is government-subsidized healthcare delivered through private insurance companies and private providers).

These cuts will lead to roughly 15 million people losing healthcare coverage by 2034, according to analysis by the Center for Policy and Budget Priorities. Health clinics in low income, rural areas which rely on Medicaid funding are already shutting down. According to a fact sheet by the American Hospital Association, the cuts would slash federal Medicaid funding for rural hospitals by USD 50.4 billion over the next decade.

Democratic Party failures on healthcare

But as Democratic Party leaders fight current Republican cuts, there have been longstanding criticisms of the Democratic Party’s unwillingness to secure firmer healthcare protections while they were in power, including a universal right to healthcare.

During his presidency, Biden allowed for the further destruction of the COVID-era social safety net. This included the so-called unwinding of expanded Medicaid coverage, leading to 5.53 million children losing public healthcare coverage.

For proponents of a universal right to healthcare, establishment Democrats have long stood in opposition to coverage for all. The 2024 Democratic Party platform makes zero reference to “universal healthcare,” nor does it even frame healthcare as an issue deserving of its own section. This is despite the fact that polling reveals that a majority of people in the US back robust universal healthcare policies such as Medicare for All.

Walter Smolarek, editor of Liberation News, tells Peoples Dispatch that while the cuts to the Obama-era healthcare reform legislation the Affordable Care Act are central to this shutdown, “it’s important to remember the process that led to the creation of the ACA.” The ACA, which does not provide universal healthcare, was passed when the Democratic Party controlled the presidency, the House of Representatives, and the Senate. While the Democrats “did not need any Republican support to pass healthcare legislation,” they still chose to pass only a watered down version of the popular demand for universal healthcare. “Even the possibility of a ‘public option’ that people could opt in to instead of private insurance was abandoned by the Democrats in Congress,” said Smolarek.

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