Federal health subsidies are expiring. Now, states are trying to fill the gap

0:00Support for Here and Now Anytime comes from MathWorks, creator of MATLAB and Simulink software for technical computing and model-based design. MathWorks, accelerating the pace of discovery in engineering. Learn more at mathworks.com. WBUR Podcasts, Boston. This is a simple solution. We have something that it's not perfect, but it works. With the new year comes new health care costs for millions of Americans on Obamacare.

0:44It's Wednesday, December 31st, and this is Here and Now Anytime from NPR and WBUR Boston. I'm Shiko Theuri. Today on the show... Five, four, three, two, one. Happy New Year! We did it! Counting down into the new year is a fairly modern tradition. We wind back the clock for a little history lesson. But first, the new year will bring drastically higher health care costs for millions of Americans. That's because federal Obamacare subsidies are expiring today. Congress failed to reach a deal to extend them, and now some states are trying to fill the gap. New Mexico will cover the lapsed subsidies.

1:30It's unclear for how long. But states like Georgia are at a stalemate. Some Democrats there, like state Representative Sam Park, are pushing for the state to make up the difference. He joins Robin Young to explain why. You've called on your state to step in and fill this funding gap. Does the state have enough money to do that? Yes, without a doubt. Currently, Georgia is sitting on a$14 billion surplus. So we have more than adequate funds to cover this and to backfill this gap. And for how long? At least for a few years as needed. but at the very least for the upcoming year, you know, it's estimated that at least for one year it'll cost about$900 million.

2:17I don't think the state could permanently fill this gap, but at the very least it could mitigate harm and hopefully create a transition to ensuring that more folks could get covered. Well, we mentioned New Mexico. That's the only state so far to cover all the ending subsidies. The Speaker of the House, though, Javier Martinez, told Politico that they can carry the cost for a little bit, but at some point we will need Congress to act. How do you feel about Congress right now? Democrats, Republicans couldn't get this done. It's quite frustrating. But of course, this is coming from a state-based perspective in Georgia in which Republicans have had complete control over state government for more than two decades.

3:00And under their leadership, they failed Georgians, particularly when it comes to health care. We have some of the worst health care outcomes because health care access is so challenging. It's, you know, quite frustrating in seeing that after Republicans, you know, have essentially taken over complete control over the federal government in D.C., they've exacerbated matters. They've made things that so much worse, particularly when it comes to health care. So it's quite challenging. As you well know, Republicans would say and have been saying, we've been hearing them in Washington saying these were never supposed to be, you know, they were temporary.

3:37They were for COVID. And we're going to speak with your colleague, Republican State Senator Ben Watson in a minute. And he told Atlanta News First that enhanced credits are from the COVID era, that job loss and costs were up then. Georgia also has a state-based exchange to help low-income residents. Why isn't that enough? The state-based exchange in Georgia has so far failed by, you know, many, many metrics. It has not enrolled the number of folks that it was expecting to enroll, and it's cost taxpayers, you know, five to ten times more, if not even more than that. But, you know, ultimately, I think this is a solution that should and could be solved, especially if we take a step back and recognize that the United States is the only industrialized country without any sort of universal health care program, for them to simply say that this is part of the Affordable Care Act, it was never supposed to exist in perpetuity, all right, if that's the case, what is the solution to ensuring that Georgians, that your fellow neighbors can get access to life-saving health care?

4:43There is no solution coming from the Republican Party while they remain in complete control over government. Well, we're going to find out. We're going to find out. But in the minute that you have served before we speak to your Republican colleague, what what olive branch, what can you what can you offer? You know, you want the you know, some of the 14 billion, what can you offer to get people across the aisle? You know, I myself and my Democratic colleagues, we remain very open to any Republican or any legislator who wants to work on ensuring that we are lowering health care costs and increasing health care access.

5:18Unfortunately, by their actions, Republicans have demonstrated they are wanting to continue to put barriers in front of access to health care or make it more difficult to receive access to health care. So, you know, frankly, if Republican legislators are not willing to come around and do the right thing of simply helping your fellow Georgian or your fellow neighbor, I think it's up to the people to vote in these upcoming midterms to elect people who will do the right thing and ensure that everyone has access to health care. Georgia Democratic State Representative Sam Park. Representative Park, thank you.

5:50Thank you. Coming up next, we get the opposing perspective from a Republican lawmaker in Georgia. Stay with us.

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6:52Before the break, we got into one side of the debate in Georgia over whether to fund subsidies for Obamacare that expire today. As you just heard, Georgia Democrats are pushing for it, but many Georgia Republicans like State Senator Ben Watson are against it. He explains his stance to Robin. There's$14 billion in surplus. Why not use some of that to help people who've come to depend on these subsidies? Well, I mean, I think you said it, and I've said it before. You know, these were the enhanced appropriations that the feds did during the COVID emergency. And we're reverting back to what we had done before.

7:28And, you know, Georgia is very proud of what we have done. I mean, there really is no reason for anybody in the state of Georgia, unless you're an illegal immigrant, not to have health insurance. We have access, which is a waiver for the ACA, which takes care of people from 138 percent up to 400 percent of the federal poverty level. We have a state-based exchange, which is the second largest in the nation. And even the socially progressive liberal folks, I'm surprised that, you know, Representative Parks doesn't feel this way, but he's really in a very small minority. We have had a very successful state-based exchange, and this is where people are on insurance, not Medicaid, which pays about 65 % on the dollar, but we're talking about private insurance, which pays 150 up to 400 % to hospitals and providers.

8:18Everybody wants to be on private insurance, and that's what we have. Well, the New York Times article pointed out all health care is expensive. Obamacare costs on average about$7 ,000, but that's less than employer coverage, which is around$9 ,000. This is on average, Medicaid,$8 ,500. But I want to hear from someone in your state. This is Angela Holmes. She's a diabetic. She told 13 WMAZ News that she relies on insurance for surgeries for insulin, needs coverage to stay independent, pays 20 cents a month, and that could jump to$1 ,300 a month if these subsidies expire. 20 cents a month compared to$1 ,300.

8:57Let's listen. $15 ,000 a year is not something that's going to just simply appear in my bank account. Doctor, she feels she's going to choose between groceries and surgery and medication. Your thoughts? Well, I mean, everyone, I don't know her particular circumstances, and there are situations in which those people in the bottom of the state exchange pay absolutely nothing like she's doing. And there are people who are in the 400 percent of the federal poverty level who are paying significant amounts. I don't know what her income is, but that's what is graded out there. everybody the socially progressive liberals all say that they think it's good to have skin in the game so to speak now her situation certainly may be different and she may be really more disabled than she is really should be on a federal program for disability i can't comment on that i do know that those were emergency enhancements during the covet era we're going back to what we were for We have 1.7 million people in the state of Georgia that are covered on the exchange.

10:04Over half of those are in the lower portion of the federal poverty level. And that's a good thing. That's access. Pathways is below 138 percent. And that's a revolving door. It's a pathway out of poverty. And that's what is being taken care of for the rest of the nation, the model in Georgia. Well, but this is happening tomorrow. You know, these subsidies are dropping tomorrow. We know some Republicans have called for giving people money to put into health savings accounts to save money tax-free for medical expenses. That's not the same as having insurance because – yeah, but hold on. KFF found that those accounts can't be used to pay insurance premiums.

10:43So I just – you have a minute here, sir. I'm not arguing. Listen, the fact is that Governor Kemp, who has led the way when it has come to Medicaid waivers and the expansion, has said that we're not going to subsidize or do what the feds have failed to do. Now, whether they come up with a full 100 % expansion of the enhanced or they come up with a compromise of 25 to 50%, that is not the state's role at that standpoint. Well, you're right. and Congress did not act, but at this point this is going to hit your not just, I guess, with being a doctor maybe you have patients, but also hit your neighbors and friends tomorrow it'll be interesting to see.

11:25I'd like to speak to you again, Republican State Senator Ben Watson Chair of the State's Senate's Health and Human Services Committee and also a doctor so, Dr. Senator, thank you so much We appreciate that. I'd be happy to follow up Thank you

11:46Coming up, for most of the world, the new year always begins with a countdown. We get a quick history lesson on how this tradition began after the break.

12:03Many parts of the world are already in the new year.

12:12Those are folks in New Zealand welcoming 2026 with a countdown, a tradition we've been maintaining around the world for years. And if you're planning to keep up with that tradition tonight, you may be surprised to learn that it's actually relatively new. It actually started after the space race. I'll let Alexis McCrossin explain more. She's a professor of history at Southern Methodist University in Texas, and she spoke to Robin. Happy New Year. Yeah, and it's almost here, but it's only recently that we've counted down. That's amazing. When did it start? To my mind, having gone through all of the audio, it's to usher in 1979.

12:53It's the first time that I hear the Times Square crowd audibly counting down. Wow, not till then. I don't remember that. I mean, it seems like it was always there. Did people just stand there? Well, they shouted and cheered and blew 10 horns and made tons of noise. If you go back and you listen to the audio, either from radio or from the television recordings from the 50s and the 60s, you'll hear this tremendous, it's like a wave of sound. But the crowd isn't counting down in part because they're not exactly sure when midnight is going to arrive. Technologically speaking, how would you know? How would you synchronize 20 ,000 people to do that?

13:42Okay, well, that's the Times Square ball drop. But we understand you have found a countdown. It's from the 1950s on radio. So first, let's just hear it. It's starting to move. There's 10 seconds to go. You can hear the crowd picking up. 58 is on its way. Five, four, three, two, one. The ball is starting to slide down the flagpole, and it's the signal that 58 is here. Okay, so that's an announcer. You know, that's an NBC. That was Ben Grower. It's on NBC on New Year's Eve, as he said, 57 going into 58. So he was doing it, but as we can hear, the crowd isn't. Right. That's an amazing piece of audio, and in part because you noticed that he was trying to count down, but he screwed it up.

14:29Right? Because he goes 5, 4, 3, 2, 1, and then he goes, oh, we're counting down to the new year, and then the new year is here. It was a little early. Well, so countdowns now are, I mean, we have digital clocks. We all can sync, and we all know how to do 10, 9, 8, 7, 6. But talk about how the New Year was or maybe wasn't an important cultural event. Well, if we go back to the 19th century, it was New Year's Day that was the event. It was the holiday. And not for everybody. Many people worked on New Year's Day. It was just another first day of the month. They knew it was the first day of the year, but that wasn't necessarily momentous.

15:14Now, for some people, it was. For the enslaved people in the American South, New Year's Day was momentous, but not in a good way. It was known as Heartbreak Day. And that was because it was hiring day when the kind of annual contract would begin, when enslavers would hire out their extra manpower, if you will. And the children, friends, family would be sent away to their new enslavers. Now, for other Americans, New Year's Day, Americans living in New York City, for example, it was a day of visiting. And it was a very important day to renew acquaintance and reaffirm bonds with friends, family, business associates.

16:01And it was very important to make those New Year's Day visits, much the same way sending those holiday cards is important to many of us. That's a big deal then for New Year's Day. And by the way, we look around the world. In Scotland, there's a first footing. The person who crosses your threshold, the very first person to do that in the new year must bring a gift. And you mentioned enslaved people. African Americans now traditionally eat black-eyed peas, you know, with their greens and cornbread, and that ensures good luck, prosperity, and wealth. What you're telling us, though, about Heartbreak Day is really hitting.

16:37You know, that's history worth remembering. Any thoughts, Professor, you want to leave us with about New Year's Eve or New Year's Day? Well, while New Year's Day was Heartbreak Day, it also became Emancipation Day. On January 1st, 1863, Lincoln signed the Emancipation Proclamation, and it became a day of jubilee, a day of momentous reorientation, of freedom and of liberation. And I think for all of us, that sense of new beginnings, of new starts, of something exciting happening with the new year, with the turn of the calendar, is an inheritance from not just from the Emancipation Proclamation, but from a long-standing tradition going back to the ancient Romans of the new year, bringing something new.

17:32Do-overs. Do-overs, exactly. Professor Alexis McCrossin, author of an upcoming book about the history of New Year's observances in the U.S. Look forward to that. Professor, thank you. Oh, thank you so much. This was fun. And Happy New Year. Happy New Year.

17:56Here and Now Any Time comes from NPR and WBUR Boston. Today's stories were produced by Jill Ryan and Sam Rafelson. Today's editors were Micaela Rodriguez and Michael Scotto. Technical direction from Caleb Green and Matt Reed. Our theme music is by Mike Moschetto, Max Liebman, and Chris Bentley. Our digital producers are Alison Hagen and Grace Griffin. And the executive producer of Here and Now is Alan Price. Thanks so much for sticking with us throughout 2025. We hope you'll continue to do so in 2026. Happy New Year. We'll be back tomorrow.

18:37Thank you.