The Great Health Insurance Mutiny
Have Americans finally reached their "pain point"?
In extending the Affordable Care Act subsidies, Democrats picked the right issue on which to take a stand, but while the premium sticker shock might win them support right now, it’s not enough. Taking on the health insurance industry - for real this time - as part of a larger crusade for economic fairness may be what finally wins the American voters back over to our side.
The Premiums Are Too Damned High!
Affordable Care Act Subsidies and the Government Shutdown
Democrats should absolutely stand their ground on extending the ACA subsidies before they will vote to reopen the government. In addition to being morally the right thing to do, it is politically the smart thing to do. Open enrollment starts November first, and notices are arriving in inboxes and mailboxes now. Even voters completely unaware of Trump’s trashing of the Constitution, the rule of law, and any remaining semblance of human decency, will face wildly unsustainable increases in their premiums. We will see (or in my case, experience) massive levels of economic distress and moral outrage.
People will mutiny. It’s our job to make sure they overthrow the right leaders. Your assignment is to communicate relentlessly about who is responsible for these ludicrous rate hikes, because far too many Americans do not know.
Say something like this:
“Democrats are fighting to protect the American people from devastating health insurance premium hikes for state exchange plans. Trump and the Republicans would rather shut down the government than even meet with Democrats to discuss it.”
Repeat, repeat, repeat. It won’t have started to penetrate outside the bubble until we are sick of hearing ourselves talk about it.
Why this phrasing matters: 1. Republicans are the ones shutting down the government. 2. Democrats are “fighting” to “protect” the American people. 3. “Devastating premium hikes” is clearer than “subsidy extensions.” 4. “State exchange plans” lets people know that we’re talking about plans they know under names like “Covered California.”
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The Collapse of Obamacare
Losing the subsidies may be the last straw, but extending them is not enough. Health insurance and treatment costs have become impossibly high whether or not you get your plan through a state exchange. The American people have had it with the soaring premiums, deductibles, and out-of-pocket maxes, drug price gouging and shortages, the pre-approvals and the algorithm-driven denials, the shrinking networks, the opaque billing, and the inability to get a human being on the phone. We’re paying more and more and getting less and less.
Premiums are getting high enough to rival the cost of rent or a mortgage, even if you never actually use the healthcare. Buying health insurance in America is like choosing to definitely get screwed every year to avoid the possibility of being screwed later. The math just ain’t mathin’. This is where the “insurance death spiral” kicks in. When the youngest and healthiest drop out, the insured pool gets smaller and sicker. Costs increase, causing more people to drop out and so on.
Conservatives are already attempting to portray “Obamacare” as a failure, but if we just say that having Obamacare is better than not having Obamacare, we will look weak, defensive, and insensitive to the genuine crisis people are experiencing. We need to make it perfectly clear that what is collapsing under its own weight is the for-profit system that Obamacare is trying to prop up.
The system is failing because Obamacare did not go far enough to restrain the private sector’s insatiable drive to exploit the American people and their creativity in finding new ways to do so, including the leveraged buyouts by private equity firms, drug patent abuse, pharmacy benefit monopolies, and the spectacular national heist that is the privatization of more than half the Medicare system. You can get more of the details from Matt Stoller here:
I’m not even including the devastating effects of the Medicare and Medicaid cuts in the Trump-Republican Budget and the impact they are having on rural and inner-city hospitals and nursing homes, and on people with disabilities. That’s just the flat-out bloody-mindedness of this administration. While a tweak here and there would be warranted, government-run Medicare and Medicaid were working just fine.
The Case for Medicare for All
“It’s time to get the greed out of the healthcare system.”
I was recently talking with a campaign team about how to defend Medicare for All against attacks about how to fund it. That’s what Democrats usually do: imagine how our opponents might attack us and then craft a defensive message to inoculate ourselves against it. But that’s like helping our opponents frame the debate from their perspective. The candidate stopped us all and said, “It’s time to get the greed out of the system.”
Adam Murphy (www.murphy4va.com) is a terrific young candidate in Virginia’s 9th congressional district, and a natural at framing issues in terms of our values. Saying “It’s time to get the greed out of the system” also pre-empts their attacks, but does so by using our own framing: that high cost of health care is driven by greed and waste in the private sector. Adam did not hesitate for a moment to take a stand for Medicare for All in the deepest-red district in Virginia because he knows it is the right thing to do and that he can make the case for it. Courage and clarity. That’s why Adam Murphy has a shot to win this race.
If we were to talk to people about what “getting the greed out of the system” looks like, we might describe it like this: “What if we, as a community, decided to pool our resources and when anybody got sick, we just paid for their treatment. We let doctors and patients make the decisions without wasting money on excess paperwork or profit-taking by middlemen.” What we just described is Medicare.
You literally can’t beat real Medicare.
The Center for Medicare and Medicaid Services (CMS)’ “Innovation Center” tried more than fifty experiments to see if people could provide Medicare services at a lower cost, and they all failed. The program was supposed to save $3 billion and it ended up costing $5 billion. Real Medicare has administrative costs around 2%. It is the private for-profit “Medicare Advantage” plans that are taking up to 40% off the top and fraudulently overcharging the American people by billions of dollars a year. Trump is now planning to turn management of real Medicare over to the same corporate middlemen who use 90% error-rate AI systems to deny care and pocket the profits.
If you think standing up for Medicare for All is a politically risky position, think again. Sixty percent of Americans support Medicare for All. The two most popular politicians in America, Bernie Sanders and AOC, are known for supporting it.
In 2020, Elizabeth Warren got an 11-point jump in the polls by making the perfect case for eliminating private health insurance. She said, “Look at the business model of an insurance company. It’s to bring in as many dollars as they can in premiums and to pay out as few dollars as possible for your health care.” She raised the question of what private health insurers are actually contributing to the situation: what do they bring to the table in exchange for the massive cut they take? Warren only lost that support when she later backed down from her strong position in favor of Medicare for All.
Tinkering around the edges is not going to cut it anymore. It’s time to “go big or go home.”
The Coup de Grace
I don’t care what you call it. Medicare for All. Medicare for All Who Want It. Single Payer Healthcare. Public Option. Take an incremental approach if you must. As long as it gets the greed out of the system, I’m all for it. But if you want to hit the game-winning home run, say this:
Every American has the right to keep their body healthy without going broke. Every American should have access to public health services in their own communities and quality local hospitals.
The obscenely high cost of health care in America is caused by the insatiable greed of corporate middlemen who get rich by standing in between you and the healthcare your doctors say you need and using mountains of costly and unnecessary paperwork to hide the fact that they are strip-mining the Medicare trust fund and defrauding the American people.
By finally driving the greed and waste out of the system, we can save enough to not just lower costs for everyone, but to add much-needed coverage for dental, hearing and vision.
EIGHTY-FOUR PERCENT OF AMERICANS (89% of Democrats and 79% of Republicans) favor adding dental, vision, and hearing coverage to Medicare. That would be the kind of bold move that shows we mean it when we say that health care is a human right and a moral obligation: something we owe to each other as fellow Americans.
The Right Fight at the Right Time
The message that helps us beat Trumpism once and for all is not only about prices or the cost of living. It’s about economic fairness and the moral injustice of our broken economic system. For more on this message strategy see:
How to Be a Populist Without Sounding Like a Socialist
People are tired of competing for an ever-shrinking number of slots in the middle class. They just want our economy to be fair. There is a contract inherent in the American dream: you work hard, they pay you enough to raise a family on. But corporate decision makers are not holding up their end of that deal, and people need us to step up and make them.
This health care fight may be the perfect opportunity to take that stand for economic fairness, to show the American people that we are willing to stand up to powerful corporate interests on their behalf. Health insurance executives and their ilk could have settled for bleeding us half the way dry. Their inability to settle for anything less than total exploitation may be the cause of their industry’s eventual demise. It may even be the thing that finally bursts the bubble of fifty years of “free-market” gaslighting, allowing us to finally remember why we created programs like Medicare in the first place.
Conclusion
The private health insurance industry has been given every possible chance to show that they can provide reasonable coverage at a fair price. They have failed. Obamacare was a compromise and the best we were able to get at the time. While the extended subsidies are critical, they probably won’t be enough. The system is broken. If my fellow Americans need to chip in that much for me to afford coverage, I want that money going toward actual health care, not corporate profits.
It’s no longer just about our ability to afford it. The obscene cost increases and the way we are being treated reflect a larger moral crisis where corporate actors see themselves as above society rather than members of it. The time has come to get the greed out of our health care system.
Trump’s assault on our freedom and our government may be our top priority, but to beat him and everything he stands for, we need to address the economic conditions that made his presidency possible in the first place and convince people that we have something better to offer. Taking on the health insurance industry — doing it for real this time — and making it part of a larger crusade for economic fairness, may be what finally wins millions of American voters back over to our side.
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In solidarity, always,
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NOTES
Health insurance sticker shock begins as shutdown battle over subsidies rages, by Paige Winfield Cunningham, Washington Post, October 22, 2025
Why the ACA needs young people — and the looming ‘death spiral’ for health insurance, Selena Simmons-Duffin, NPR, oct. 26, 2025
Back in 2022, nearly 40% of Americans delayed heath care treatment due to cost concerns, according to Gallup research.
According to an Economist/YouGov poll, 59 percent of Americans back the idea of Medicare for All. Only 27 percent of those polled said they did not support the idea. By Chris Walker, Truthout, July 11, 2025
The Truth About the One Big Beautiful Bill Act’s Cuts to Medicaid and Medicare, Mia Ives-Rublee and Kim Musheno, Center for American Progress, July 3, 2025
Thank you keeping us thinking and communicating together.
Bravo. Spot on.