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Meidas Health: Top Affordable Care Act Leader Debunks Trump’s Lies
Leading healthcare policy expert, Jessica Schubel, debunks Trump’s plan to replace real insurance with empty promises in this new episode of Meidas Health
As healthcare policy once again becomes a flashpoint under Trump, the latest episode of Meidas Health offered a clear, fact-based counter to the disinformation emanating from the White House and its allies on Capitol Hill. In the episode, Meidas Health host Dr. Vin Gupta interviewed Jessica Schubel, one of the country’s most experienced healthcare policy leaders, at a moment of growing legislative and public health uncertainty.
Schubel, who served in senior roles in both the Obama and Biden administrations and was most recently Special Assistant for Healthcare to former President Joe Biden, joined the show to unpack what she described as a looming crisis for millions of Americans who rely on Affordable Care Act marketplace coverage. Schubel didn’t mince words. Absent congressional action, families will face higher premiums, less comprehensive coverage, and an increased risk of medical debt beginning January 1, she told Dr. Gutpa.
The conversation unfolded against a backdrop of broader public health concerns, from a measles outbreak in South Carolina to environmental rollbacks affecting exposure to carcinogens like formaldehyde. But the heart of the episode focused on the fate of enhanced ACA subsidies, the premium tax credits enacted under the Biden administration that currently help more than 20 million Americans afford health insurance.
“These subsidies help lower the cost for over 20 million Americans who buy their coverage off of the ACA marketplaces,” Schubel explained. Without them, she warned, premiums are expected to spike sharply, prompting millions to either downgrade their coverage or drop insurance altogether.
Dr. Gupta, speaking from his experience as a critical care physician, emphasized the real-world consequences of those choices. Delayed care, he noted, often leads to more severe illness and costly emergency interventions. Schubel agreed, predicting a cascade of harm if Congress fails to act. “I’ll just be direct and blunt,” she said. “Americans are going to be sicker and they’re going to be poorer.”
Much of the discussion centered on a Republican proposal backed by the Trump White House that would shift support away from subsidies and toward health savings accounts tied to high-deductible insurance plans. Trump’s pitch is to send Americans checks instead of sustaining what Republicans deride as “Obamacare subsidies.” It’s insane for so many reasons.
Schubel dismantled Trump’s idea step by step. She likened the current subsidies to a discount code applied upfront when purchasing insurance, allowing families to compare plans based on both monthly premiums and out-of-pocket costs. The Republican alternative, she said, replaces that certainty with risk. Under high-deductible plans, patients must often pay thousands of dollars out of pocket before insurance coverage begins.
“It sounds great on paper,” Schubel said, referring to proposals to deposit $1,000 to $1,500 into health savings accounts. “But there’s a catch, and it’s a trap.” With average deductibles hovering around $7,000, she noted, families would still be responsible for the vast majority of their healthcare costs—money that would inevitably come out of grocery budgets, rent payments, or utility bills.
The episode also highlighted who benefits most from health savings accounts. According to analyses cited during the discussion, HSAs function as tax shelters that disproportionately advantage higher-income households with enough disposable income to invest and let funds grow tax-free. Lower- and middle-income families, by contrast, are far more likely to need those dollars immediately for basic care.
Dr. Gupta underscored how this dynamic plays out in patients’ lives, citing cases of individuals with chronic conditions like diabetes rationing medication after being pushed into high-deductible plans. “People are cutting corners and not utilizing the care that they need to keep themselves healthy,” Schubel said.
Beyond individual hardship, the conversation made clear that the consequences would ripple across the healthcare system. Uninsured patients still receive emergency care, Schubel noted, with hospitals absorbing the costs and passing them along through higher premiums to everyone else, including those with employer-sponsored insurance and Medicare.
The episode closed with a sober assessment of the political impasse. Two Senate bills, one Republican, one Democratic, each passed with slim majorities but failed to clear the 60-vote threshold required to advance. Schubel named Senators Lisa Murkowski, Susan Collins, and Josh Hawley as the only Republicans who voted with Democrats to extend the subsidies, a coalition that still fell short.
Despite the setback, Schubel expressed cautious hope that mounting public pressure ahead of the midterms could force a change in course. Democrats, she said, remain committed to extending the subsidies while working on longer-term reforms to lower healthcare costs overall.
It’s easy to just write off Trump’s comments as crazy, or his ideas as dangerous. But on a topic of this importance, it’s vital we speak to experts who explain exactly why that is the case. We need to ground the debate in data, lived experience, and plain language so we can appropriate debunk the disinformation coming from this White House.
Meidas Health continues to reinforce its role within the MeidasTouch Network as a corrective to official disinformation and as a reminder that healthcare decisions made in Washington carry life-and-death consequences for families across the country. Catch new episodes on the Meidas+ Substack and the MeidasTouch Podcast feed.
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