Bipartisan Failure on Health Care
Why both parties are willing to risk household coverage—and what it signals for Social Security
I was intrigued by a recent Reuters article on the looming expiration of enhanced ACA premium subsidies and the House Republican health care bill that does not extend them.
What stands out is not just the immediate policy risk, but how clearly this episode illustrates bipartisan failure. Republicans are advancing a framework that cuts or constrains Medicaid while allowing ACA subsidies to lapse. Either move alone increases household exposure to medical risk; taken together, they deliver a double hit. Coverage options shrink at the same time premiums spike, forcing households into plan downgrades, deferred care, or loss of insurance.
Republican reliance on Health Savings Accounts highlights a deeper disconnect from household balance sheets. HSAs can work when paired with moderate high-deductible plans and stable incomes. But tying them to bronze and catastrophic plans—with deductibles that often exceed several months of income—is a bridge too far for many families. In practice, this approach shifts risk onto households without addressing underlying medical costs.
Democrats share responsibility through a different failure. Enhanced ACA subsidies were deliberately made temporary, embedding affordability cliffs into the system. Progressive fixation on Medicare for All crowds out incremental reforms that could permanently strengthen state exchanges, while centrists repeatedly defer durability to coalition politics.
The consequences spill far beyond health care. Rising premiums crowd out retirement saving, increase reliance on debt, and amplify financial stress during job transitions. Health care is the outer failure—and a canary for Social Security. If both parties are willing to play brinkmanship with insurance coverage today, there is little reason to expect restraint when trust fund insolvency forces automatic benefit cuts tomorrow.