America’s Health Care: Affordability, AI, & Politics 11/21/25

0:00Bring in show music, please. This is Squawk Pod and I'm CNBC producer Cameron Costa. On today's episode, the healthcare standstill on Capitol Hill. Looming over it all, a subsidy cliff approaches for the Affordable Care Act's insurance premiums. House Minority Leader Hakeem Jeffries joins us. Tens of millions of hardworking American taxpayers are going to experience dramatically increased premiums, co-pays and deductibles in some cases. premiums for health insurance will increase by$1 ,000 to$2 ,000 per month. It might not be all doom and gloom, though, for health care. Former Cleveland Clinic CEO Dr.

0:43Toby Cosgrove is looking forward. I think we're actually hitting on an exciting new time in health care, and that's around AI. Those conversations, plus health care leaders, have penned a letter to the FDA, and President Trump will lower tariffs for beef, chocolate and coffee from Argentina. Affordability, obviously, big question. It's Friday, November 21st, 2025, and Squawk Pod begins right now. Stand Becky by in three, two, one. Cue it, please. Good morning, everybody. Welcome to Squawk Box right here on CNBC. We are live from the Nasdaq market site in Times Square. I'm Becky Quick along with Andrew Ross-Sorkin.

1:28Joe is off today. Well, it was quite a session yesterday for those who were watching. We saw a huge swing in the markets yesterday. That reversal with NVIDIA led through to the rest of the market. You did see a swing of more than 1 ,100 points for the Dow over the course of the session. Stocks were down after that reversal by NVIDIA dragged down the tech stocks. It was concerns about AI stock valuations. And then separately, that better than expected jobs report. Dems hopes for a December rate cut by the Fed for the week. The Dow and the S &P 500 each down by about 3 percent. The Nasdaq is down by 3.6 percent.

2:04In fact, the markets are on track for their worst week since April 4th. So going all the way back to when tariffs were the big concern over all of these things. This time, it's a little harder to pin down. NVIDIA had really strong numbers that they reported the day before. But those concerns about the AI valuations certainly dogging the markets. And once you start to see selling, it's hard to stop seeing that selling. A big, big swing of about 4 % at one point for the NASDAQ, just from the highs to the lows. And then Bitcoin, which continues to fall. In fact, we have now seen Bitcoin down for 11 sessions in a row.

2:38That's the first time it's happened in Bitcoin history. If you're looking at this this morning, it's down another 4.3 % to 82 ,781. It's a drop of more than 30 % from where we saw the highs of Bitcoin earlier this year. For the one year, Bitcoin is now down by about 15.8%. And if you look at some of the stocks like MicroStrategy, those shares have been under pressure too. And there's this idea, I don't know if you saw Tom Lee on the Bitcoin front arguing that there are people who are shorting, they're not just shorting Bitcoin, they're shorting MicroStrategy as the sort of - And I should say strategy, I'm sorry, they've changed their name.

3:17It's a strategy, but they're using it as a hedge against Bitcoin. And so he's arguing, actually, that strategy is absorbing even more of the losses because of this sort of hedge that people are using that instrument as a hedge against their own Bitcoin, which is an interesting piece. And Ukraine's president, Vladimir Zelensky, saying he has now agreed to work on a peace plan drafted by the U.S. and Russia and that he expects to talk with President Trump in the coming days. Zelensky's office said that he received draft plans from Washington yesterday. Reports say the proposal includes demands for Ukraine to cede territory in its eastern Donbass region in Russia, to Russia, I should say.

3:53Removal of sanctions from Russia, a halt to war crime investigations, limits on the size of Ukraine's army, and a guarantee that Ukraine will not join NATO. In exchange, Ukraine would receive a guarantee of sovereignty and an explicit security guarantee from the United States. frozen Russian assets would be used in part to rebuild and invest in Ukraine. The question is whether you think that Ukraine is going to be willing to accept all of those elements. Sticking in the international markets, let's take a look at late yesterday. President Trump signing an order to remove the 40 percent tariffs on Brazilian food imports, including beef, coffee, cocoa and fruits.

4:38Those tariffs were added in July to punish Brazil over the prosecution of its former president, Jair Bolsonaro. That order is backdated to November 13th, meaning some duties collected will have to be refunded. Brazil normally supplies a third of the coffee that's used in the United States and has more recently become an important supplier of beef. And if you look at the affordability issues that come with this, it's a big one. You can see coffee futures right now down by about 4 percent on this news. Yesterday, there was media that was kind of circulating with some of this, and they spoke with Stu Leonard.

5:11I think it was the Wall Street Journal, but I could be wrong on that. But they spoke with Stu Leonard, the grocery store company that's pretty regional here. The CEO of the company saying, look, we're not going to lower coffee prices until probably the new year because we've bought enough coffee. Right, they're already at the other prices. We've already stored this up, and we've got enough to get us through the holidays. So there are those questions that come with it, too. Maybe there's a big reversal. Maybe there's some of that that can get paid back. If these are backdated to November 13th, maybe they get back some of the import duties that they had to put on some of these things.

5:45But affordability, obviously, the big question. And watching what it means to consumers. I didn't pay for my coffee this morning, but I don't know. You never do. I never do, but I don't know how much more expensive it is right this moment. A planned$20 billion bailout to Argentina from J.P. Morgan, Bank of America Citigroup is reportedly no longer under serious consideration. The Wall Street Journal said that those banks had been awaiting guidance from the Treasury Department on what guarantees and collateral they could use to shield them from losses. Now, while they were waiting, congressional elections in Argentina in October bolstered Javier Mellier's government and sent the country's bonds and currency rallying.

6:28The report says the banks are now focused on plans to lend Argentina around$5 billion. They're going to do that a little differently through a short-term repurchase or repo facility. Argentina would exchange a portfolio of investments for dollars from the bank to make an upcoming debt payment. The government then on the other end would later borrow billions from the bond market and use those proceeds to pay back the repo facility. Does that make sense? I think so. No. No? No. I'm still thinking it through. It's a little complicated. It's a little complicated. CNBC has learned that healthcare industry leaders have sent a letter to President Trump to the Health and Human Services Secretary Robert F.

7:09Kennedy Jr. and the head of the FDA, Dr. Marty McCary. The leaders who are speaking up here are lodging some frustration with the FDA when it comes to approvals of potentially life-saving therapeutics for rare diseases. The group of letter signatories are made up of biotech leaders, patient advocates, and academics who work in the rare disease space. And they're expressing concern that the level of unpredictability inside the FDA has risen so sharply, it could make biotech less willing to underwrite opportunities in the United States and to look to fund projects in other countries. The group writes to the president, unless consistency is restored, China will seize our biotech leadership and America will lose jobs, investment and the historic momentum you build.

7:54The signees include the heads of foundations and fundraising organizations, the chairman of Ovid Therapeutics and other startups with new and promising therapeutics in the pipeline. They argue in an era of increasing global competition and demand for rare disease therapies, U.S. biotech stakeholders need to share a common understanding of stable, transparent, evidentiary standards to bring medicines to patients quickly and safely. The first Trump administration was known for innovation going back to Operation Warp Speed back in 2020 for COVID. And this group actually starts out saying that these actions that the FDA are taking right now undermine President Trump's legacy of medical innovation that was initiated into the first term.

8:36Things like the right to TRIAC, which demonstrated a strong commitment to the spirit of medical innovation and improving patient access. The FDA has really spoken pretty positively about this. In fact, Dr. Marty McCurry was on with us recently talking about how they are trying to make sure rare disease does have options for some of these things. But this group points out the number of approvals for new orphan drugs for rare disease has dropped pretty steadily from 12 in front of the CBER in 2023 to 3 this past year through November. And for the CDER, it's gone from 28 down to about 18 over the last couple of years.

9:12So they're just pointing to things that they think have made it more difficult in order to see what the FDA is really thinking about, make sure they set up their clinical trials properly. How much of the problem, though, is coming from where Marty is or from RFK? Because he's in a battle. This letter is addressed to all of them. This letter is addressed to all of them. And I don't know. But it is unusual to see an industry speak up like this about basically the regulator that they have to go through. And it's interesting they're doing it collectively, which is the way to do it. There's more than 100 signatories, close to 100 signatories.

9:48I think I counted 96 or 97 on it. But it'll be interesting to see the response from the White House, if any. If any. If any. Cool news, very interesting news. Tees will be next. Coming up next on Squawk Pod, the government shutdown may have ended, but the fight over extending key Obamacare subsidies before the end of the year continues. Democrats are trying to pass an extension to go past the end of President Trump's term, and Republicans aren't fighting. House Minority Leader Hakeem Jeffries explains that strategy. I don't think you want to get a deal done. I think this is something where you'd like to see the rates go higher and allow the Republicans to hang themselves with that.

10:31Is that the answer? That's absolutely a ridiculous assertion. And really, shame on you for saying that.

10:44Hakeem Jeffries explains that strategy. I don't think you want to get a deal done. I think this is something where you'd like to see the rates go higher and allow the Republicans to hang themselves with that. Is that the answer? That's absolutely. That's absolutely a ridiculous assertion. And really, shame on you for saying that.

11:09We're back. This is Squawk Pod. Up in Andrew Q. You're watching Squawk Box on CNBC. I'm Andrew Osorkin, along with Becky Quick. Joe is off on this Friday morning. Discussions remain at a standstill over subsidies for the Affordable Care Act. Yesterday, the Senate left for the Thanksgiving holiday. nothing that's planned at this point. So we are still in wait and see mode. Joining us right now is House Minority Leader Hakeem Jeffries to talk a little bit more about this. And sir, can you lay out without any partisan bent kind of where things stand right now, just so Americans understand what's happening?

11:44Well, the Affordable Care Act tax credits are going to expire on December 31st. And if that happens, tens of millions of hardworking American taxpayers are going to experience dramatically increased premiums, co-pays and deductibles. In some cases, premiums for health insurance will increase by a thousand or two thousand dollars per month. This is for working class Americans, middle class Americans and everyday Americans. Health care will be unaffordable. People will be unable to go see a doctor when they need one. And that's unacceptable in this great country, the wealthiest country in the history of the world.

12:14Over in the Senate, it's my understanding that Leader Thune has recommitted to a vote on an Affordable Care Act extension no later than the second week in December. So there are ongoing discussions that are taking place in the Senate. Meanwhile, unfortunately, in the House, my Republican colleagues have shown zero interest in doing anything related to the ticking time bomb of the Affordable Care Act tax credits expiring. House Democrats have launched a discharge petition to try to compel an up or down vote on a straight three year extension so we can provide working class Americans with the same level of certainty that my Republican colleagues provided their billionaire donors when passing the one big ugly bill.

13:01Minority Leader Jeffries, let's talk about that discharge petition. You need 218 votes in the House in order to pass that. You've got 214 members in the Democratic caucus. So you only need four House Republicans to have to sign on to it to get this passed. But the idea of saying that this is a three-year extension instead of a one or even two-year extension has any potential Republican saying, forget it, this is dead on arrival. That's the opinion of Representative Don Bacon. He's a Republican from Nebraska who has been working with the idea of potentially extending for two years. But three years, they say, is dead on arrival.

13:39So if this is something that you want to satiate, if you want to get done, you are going to need at least some Republicans to come over. Why not start with a one year extension or potentially even a two year extension? Well, Leader Schumer offered a one year extension in the context of trying to end the Trump Republican shutdown. That's different. I'm talking about what you have now. Let's let's not go back to what's done in the past and what has not been extended. If you want to get something that has actually done, you need to do something that will have bipartisanship. You can ask me the question.

14:09You can ask me the question. I'll provide the answer. Answer the question instead of going back. I'll provide the answer. No, no. I'm providing an answer in order to provide context. Republicans have repeatedly refused to take yes for an answer. It was a very reasonable multi-year extension that was offered. It was a one-year straight extension plus a multi-year process through a bipartisan commission to more permanently resolve the Affordable Care Act issue. So having that context is absolutely important, regardless of what you may think. It's important context to make me realize that I don't think you want to get a deal done.

14:44I think this is something where you'd like to see the rates go higher and allow the Republicans to hang themselves with that. Is that the answer? That's absolutely a ridiculous assertion. And really, shame on you for saying that, because we're fighting. It's not a partisan issue for us. In fact, the states that are most impacted as it relates to an Affordable Care Act tax credit expiration are all Republican states. We're talking about West Virginia, Wyoming, Alaska, Mississippi, right? Tennessee. Over and over and over again, we can go through the list. That's why you probably have some Republicans who would sign on if you guys could come up with something that actually looks like a bipartisan deal.

15:25Listen, this is not a partisan fight for us. It's a patriotic fight. We're fighting for every constituent, even if Republicans aren't necessarily fighting for their own constituents. We want to find a bipartisan path forward. And that is what we've repeatedly indicated we want to do. Like we want to sit down and have a reasonable discussion, find common ground to address this issue. Now, Republicans said in the House they were willing to deal with the Affordable Care Act tax credit issue after the government funding agreement was reached. Well, now the government shutdown is over and there's still been no conversations with House Republican leaders.

16:01Mike Johnson never said that. The leader never said that. You do have Republicans, though, who would agree with you on something if it was actually bipartisan in nature. That's what I'm trying to get at. Mike Johnson actually did say that there was always a plan to specifically deal with the expiration of the Affordable Care Act tax credits. In fact, he said that repeatedly. So I'm not sure what you're referencing. Their plan is something that looks more like an HCA, which I'm guessing you would say is dead on arrival, too, if you want to set up these health care plans that are funded instead of going through the ACA.

16:34I'm assuming you would say that's dead on arrival, too, because there have been Republicans who put that forward. Am I wrong in thinking you would not go along with that? What I'm saying is that what's in front of us is the immediate expiration of the Affordable Care Act tax credits. Republicans have had all year to deal with this issue, and they've refused to do it. So they're the ones who are not interested in finding a resolution to a health care crisis that they've created, including passing a bill that enacted the largest cut to Medicaid in American history. And because of their policies, hospitals, nursing homes and community based health centers are closing throughout America, including in rural parts of the country.

17:09Which would why is why it would be nice to see a one year extension so that none of these things happen immediately and give you all time to actually try and work on bipartisan situations. rather than a three-year extension that basically kicks it down until the next administration is here. I think both sides need to come together and find some way of getting around this that's not necessarily saying, okay, we're going to spend$350 billion to extend these tax credits without having any way of trying to get at the real problems of what is causing higher premiums, what is causing this inflationary health care environment to begin with.

17:42Yeah, what's interesting is that Republicans just spent trillions of dollars to provide their billionaire donors with massive tax breaks. And then that same bill cut Medicaid by the largest amount in the history of the country and also ripped$186 billion in nutritional assistance away from hungry children, seniors and veterans, the largest cut to SNAP in American history. But somehow we can't find a dime to extend the Affordable Care Act tax credits, even for a year, because House Republican leaders have rejected a one-year extension. Rejected it. That's their position. not our position. That's their position.

18:17So what I'm hearing, though, is that there is no middle ground. There is no bipartisanship. This is at this point us versus them. And we are not going to agree on anything. No, that's no, that's that's absolutely not the case. We've repeatedly said we will sit down any time, any place with any of our Republican colleagues. We'll even go back to the White House to sit down with President Trump. We've repeatedly offered to do it, but they've refused. Donald Trump spent more time on the golf course during the longest government shutdown in American history than he did talking to Democrats on Capitol Hill who represent half the country.

18:55He has no interest in actually trying to find a bipartisan solution because the Republican approach, which is failing now, the American people know the country is moving in the wrong direction. The cost of living crisis is out of control. But the Republican approach since day one of this presidency has been my way or the highway. Everybody knows it. It's one of the reasons why Republicans were rejected decisively electorally in the elections early this month. Yet as Democrats, we continue to say we want to find a bipartisan path forward, but we need Republicans to operate in good faith in order for that to happen.

19:31Minority Leader, do you think that, what do you think the, do you think you were successful in shutting down the government? Do you think you got what you wanted? We didn't shut the government down. Donald Trump and Republicans control the House, the Senate and the presidency. And in fact, the American people prior to the shutdown, during the shutdown and after the shutdown, know who was responsible for the government shutting down. And in fact, in the midst of it all, Republicans refuse to even sit down and have a conversation about keeping health care affordable for everyday Americans. And so we're going to move past it.

20:05We have a Affordable Care Act tax credit expiration deadline that we need to tackle. We have a whole set of spending agreements that we need to find common ground on in advance of those agreements expiring in terms of the continuing resolution. By the end of January, we just need partnership on the other side of the aisle. You know, what we have right now is that the Republicans are in the midst of an ongoing civil war. I mean, Donald Trump is fighting with Marjorie Taylor Greene. Mike Johnson and John Thune are fighting with each other. Corey Mills and Nancy Mace are fighting with each other.

20:39House Republicans are strongly disagreeing with Senate Republicans. The whole thing on the other side of the aisle is a mess. Meanwhile, as Democrats, we just want to fight for working class Americans. Minority Leader Jeffries, I'm curious, later today, the mayor-elect of New York, Mondami, is going to be meeting with the president at the White House. Unclear whether we'll see it all publicly or not. I'm curious, have you spoken to him about what this meeting is going to be, how he should approach it, and if you have or even haven't, what you're advising him. Well, he and I had an opportunity to talk yesterday.

21:11I congratulated him on the announcement that Police Commissioner Jessica Tisch was going to remain at the helm of the NYPD. I think that's a great thing for the city of New York, for every single community, and it reinforces the mayor elect's commitment to public safety for all New Yorkers. I think at the meeting, as he's publicly indicated, the two topics that will be discussed will be the affordability crisis that exists in the United States of America. The cost of living is way too high. That, in fact, is the case in New York City and across the country, and public safety and how to move forward.

21:50And hopefully, President Trump is going to approach the meeting with a respect for the city that allowed his family and himself to achieve significant levels of success. Minority Leader Jeffries, thank you for your time today. We do hope to see something accomplished with this. So we'll continue to watch. Thank you. Thank you. Next on Squawk Pod, how Capitol Hill's health care standstill plays out in hospitals with former Cleveland Clinic CEO and heart surgeon Dr. Toby Cosgrove. We're tackling costs and the future of America's health. Three things that are really driving the cost up. One is inflation.

22:31Two is more older people. And three, there's more things we can do for people.

22:40You're listening to Squawk Pod with Becky Quick and Andrew Ross Sorkin. Here's Becky. The Affordable Care Act's enhanced premium tax credits expire at the end of the year, but Congress has not yet come up with a bipartisan solution for that deadline. Joining us right now is former CEO of the Cleveland Clinic, Dr. Toby Cosgrove, a heart surgeon as well. And Toby, thanks for coming in today. Pleasure. Nice to be with you, Becky. All right. Let's just talk about where things stand. What is the situation with the health care system at this point? What's going to happen with higher premiums? What do you think potential solutions are?

23:12We've got a big problem that's coming up right now. And the problem is that inflation has really driven up the cost of almost everything. There are three things that are really driving the cost up. One is inflation. Two is more older people. And three, there's more things we can do for people. And health care is the biggest... By the way, more things we can do for people, that's a good problem to have. That's a great problem to have. And health care is getting more and more sophisticated all the time and more things we can do. What we're seeing now is the premiums are going up enormously, 26 % across for people.