Audrey Morse Gasteier

A Massive Health Care Shock Is Coming And there is little time—and maybe not enough will from Republicans—to avert it.

Republicans could allow the expiration of a Biden-era program that reduced premiums and got record numbers of Americans insured, but that might be risky after running so hard on consumer prices and the cost of living.

Difficult to capture just how much self-destructive policy — undermining long-term energy independence, killing new factory jobs, reversing historic gains in health coverage — Republicans have packed into this one bill

Statement just issued from our bipartisan coalition of State-based Marketplaces, urging the Senate to reject proposals in the reconciliation bill that will result in coverage losses and increased costs for the tens of millions of Americans that depend on ACA Marketplaces for their health care.

Opinion | The One Big Beautiful Bill would tangle Obamacare in red tape Under the legislation now before Congress, millions of people would lose their health insurance.

@anil-blue.bsky.social here you go: wapo.st/40oKti9

Opinion | The One Big Beautiful Bill would tangle Obamacare in red tape Under the legislation now before Congress, millions of people would lose their health insurance.

Thank you to the Washington Post editorial board for shining a bright light on the very real threats to ACA Marketplaces hiding in plain sight in the reconciliation bill. www.washingtonpost.com/opinions/202...

Do You Have Obamacare or Medicaid Coverage? Tell Us About It.

As Republicans weigh steep cuts, Times reporters want to hear from people who rely on the Affordable Care Act or Medicaid for health insurance.

www.nytimes.com/2025/06/05/u...

Do Republicans Realize Whose Health Care They’re Cutting? Their big beautiful bill is polling terribly, yet somehow Senate leaders may have just made it worse.

GOP leadership strategy so far has leaned heavily on speed and obfuscation

Does make me wonder how much lawmakers understand what they’re voting on—or what it’d do to some of their own constituents

My latest for @thebulwark.com www.thebulwark.com/p/do-republi...

Do Republicans Realize Whose Health Care They’re Cutting? Their big beautiful bill is polling terribly, yet somehow Senate leaders may have just made it worse.

@citizencohn.bsky.social: "For now, almost all elected Republicans seem content to keep going with their big beautiful bill. But they should be spooked—and maybe they will be, once they realize what’s truly in there." www.thebulwark.com/p/do-republi...

Yes, They’re Going After Medicare Too A wonky change in Trump’s Big Beautiful Bill would hammer some of the very people Republicans insist they are protecting.

You might have heard Republicans say their bill wouldn’t touch Medicare

That was a lie

My latest for @thebulwark.com www.thebulwark.com/p/yes-they-a...

Trump’s Big Bill Would Be More Regressive Than Any Major Law in Decades Estimates from the Congressional Budget Office, released Thursday, offer a detailed view into the effects on income groups.

“I’ve never seen anything that simultaneously really goes after poor people and then really helps rich people."

www.nytimes.com/interactive/...

Taking Stock Of The Health Coverage Impacts Of The House Reconciliation Bill | Health Affairs Forefront The US uninsured rate has never risen as far, as fast as it will if the House bill and other looming policy changes affecting insurance coverage take effect; the resulting increase would erase almost ...

"...the US uninsured rate has never risen as far, as fast as it will if the House bill and other looming policy changes affecting insurance coverage take effect"

-- @mattafiedler.bsky.social www.healthaffairs.org/content/fore...

Should it matter what the political ideology of the people who depend on ACA Marketplace coverage is? Of course not. That’s an absurd way to think. But, nevertheless, leaving this here.

The State Marketplace Network put together explainer resources on the Marketplace provisions of the reconciliation bill. The link will take you to one on the overall provisions and another is a deep dive on pre-enrollment verification. statemarketplacenetwork.org/state-market...

Yes! And that’s in no small part due to the excellent work of you, @pamherd.bsky.social, @povertyscholar.bsky.social, and many others. Grateful to be able to lean on your work as we sound the alarms on these threats.

Millions Would Lose Their Obamacare Coverage Under Trump’s Bill

“In many ways, it’s sort of repeal by paper cut."

www.nytimes.com/2025/06/05/u...

Millions Would Lose Their Obamacare Coverage Under Trump’s Bill

"'In many ways, it’s sort of repeal by paper cut,' said @amgasteier.bsky.social, the director of the state marketplace in Massachusetts."

Yes. People Will Die. Joni Ernst’s cringey videos were wrong. They also reveal a lot about the GOP’s desperately dishonest sales job.

“They’ve can’t win the political fight on the merits, so they’re lying. Whether they get away with it will depend, in part, on how many people realize what the Republican bill would really do…’People don’t appreciate the scale and scope of what’s at stake here.’”

open.substack.com/pub/thebulwa...

Republicans face new pressure to extend expiring Obamacare tax credits If the money lapses this year, 5 million are expected to lose coverage and others would face premium hikes in 2026. A new coalition is pushing reluctant GOP lawmakers to extend it.

NEW: Republicans face new pressure to extend expiring Obamacare tax credits

Money to limit premiums expires end of 2025. If so, ~5M lose coverage.

Dems pushing to extend; Rs not inclined.

Big coalition is launching 7-figure ad blitz to ramp up pressure.

www.nbcnews.com/politics/con...

They Are, In Fact, Coming After Obamacare Again Plus: Billy Joel and the value of medical research.

The Republican health care bill would focus its anti-fraud efforts on the behavior of applicants rather than agents and brokers. That makes it hard not to suspect they are simply out to slash government health care assistance.

Highlighting for Joni Ernst:

"If you take Sarah Miller’s research on what the Medicaid expansions did, she found that for every 529 people covered, a life was saved. That means that kicking 13.7 million people off of health insurance would lead to 23,000 more deaths a year in America."

Proud to stand with my Senators and Governor and local leaders yesterday to protect health care in Massachusetts.

I wish journalists would stop framing political news as wins or losses for politicians or political parties. It’s an abrogation of our mission. Why do we keep doing this? Is the spending bill a win or loss for the American people? Who does it help? Who does it hurt? Is it sound policy? Fiscally?

The ACA reconciliation policies have gotten scant coverage, even though they drive a quarter of coverage losses (before accounting for enhanced subsidy expiration)

But 18 state-based marketplaces just sent a pretty blistering letter to the House about just how bad those policies are

Sen. Chris Murphy: This budget bill is an absolute disaster. It is going to kick over 10 million people off of their health care. Medicaid covers about a quarter of all Americans in order to pass along a new trillion dollar tax cut for the richest 1%. Nobody in this country is asking for that.

Opinion | How do Republicans plan to cut health coverage? Two basic ways. The House reconciliation plan’s provisions add up to millions more going without insurance.

Opinion | Republicans overall health plan is simple:
The plan saves money mainly by removing millions of people from coverage, while offering no alternative means to insure them
www.washingtonpost.com/opinions/202...

The GOP Medicaid Cuts Are a Big F*cking Deal 7.6 million newly uninsured, and that’s not even the whole story.

Buckle up, the GOP Medicaid cuts are brutal

The tax cuts are being paid for by a 30% higher number of uninsured at the end of the decade and increased immiseration for low-income folks who do manage to get (and successfully jump through more hoops to keep) health insurance and SNAP benefits.

That's what we're doing here.

Not necessarily buying these estimates but...of the changes/cuts CBO has analyzed, almost the largest impact on the uninsured--3.8m--comes from the least discussed change, not extending the enhanced ACA tax credits.

Health Insurance for Millions Is Now on the Chopping Block Republicans’ very quiet, very serious effort to go after Obamacare’s Medicaid expansion.

"'Eliminating the Medicaid expansion would likely precipitate the biggest one-time increase in the number of people uninsured ever.'" ICYMI @citizencohn.bsky.social on the plan to do just that: www.thebulwark.com/p/health-ins...

Concord, MA celebrating its anti-tyranny roots on the 250th anniversary of the shot heard ‘round the world. ❤️✊⚖️🗽🇺🇸 #handsoff #nokings