PNCA Weekly Memo (12/12): Two Paths for the Future of Our Health Care
As we move into 2026, we’re facing a fork in the road on the future of health care. Costs are set to skyrocket, and Democrats and Republicans are taking vastly different approaches to addressing the looming crisis. Let’s take a look at the two paths ahead and where they could lead us.
The Republican Plan- “Happy holidays, brace for next year!”
Trump and Congressional Republicans did two things to health care this summer:
1) They cut roughly a trillion dollars from Medicaid, causing an estimated 15 million people to lose their health coverage.
2) They refused to extend Affordable Care Act (ACA) tax credits, a move that will not only cause health care premiums to spike (NC is looking at an average increase of 28%), but could also push another 4 million people off their insurance.
Maybe even more impressive was how they accomplished all of this while giving away over a trillion dollars in tax breaks to corporations and the ultra-wealthy, and adding roughly 4 trillion dollars to the national debt. It really was a masterclass in screwing over the working class.
So what are they doing to solve the looming health care crisis that they’ve created? Not much. Senate Republicans killed a bill this week that would have extended ACA tax credits for three more years. They proposed an alternative, but it failed because it would do little to lower costs.
With higher premiums kicking in on January 1, the clock is ticking for a solution. Republicans don’t have one. And many of them seem okay with that, willing to sit on their hands and take a “wait and see” approach.
It’s a similar story at the state level, where GOP legislators have failed to pass a budget, leaving Medicaid underfunded by roughly $300 million dollars. North Carolina is the only state in the country that has failed to pass a full state budget. When Gov. Stein called the General Assembly back to finally finish the job, GOP legislators refused to show up. The General Assembly likely won’t resolve the funding crisis this month, and probably won’t be back to work for some time.
The GOP health care strategy appears to be “don’t act, just brace for impact.” Senator Lisa Murkowski, a Republican legislator who broke from her party on a vote to extend the ACA tax credits, agrees.
“We got to do better,” Murkwoski said. “We can’t just say, ‘Happy holidays, brace for next year!’”
Unfortunately, that’s just what they’re doing– sending us down a path of higher costs and less health care.
The Democratic Plan- Act Now, Restore Funding, Lower Costs
Democrats have a different plan– act NOW to restore Medicaid funding and lower insurance premiums.
At the state level, Gov. Stein is doing all he can to keep Medicaid afloat. Medicaid– the program that helps provide affordable health care to 1 in 4 North Carolinians– is facing a $319 million funding gap due to the Republican stalemate over a state budget. No budget means no funding, and that lack of funding forced the state to cut Medicaid reimbursement rates, putting 3 million North Carolinians’ care at risk.
This week, the Stein administration took action to restore that funding, but warned that the well will soon run dry if the NCGA doesn’t act. Gov. Stein is ready to sign a budget that funds Medicaid, but it’s never hit his desk.
At the federal level, Democrats proposed a simple solution to skyrocketing premiums– continue funding the ACA tax credits that have been in place for years. The plan would fund them for 3 years, allowing legislators time to find other solutions that will help our country lower health care costs. Most Republicans voted to kill that legislation, and they failed to offer a viable alternative.
Democrats are ready to act on health care, but they can’t do it without their GOP colleagues. With a minority in Congress and the NCGA, there’s only so much they can do at this time. But they stand ready and willing to pave a path toward lower costs and affordable health coverage.
The Decision Ahead
Inaction will lead to higher costs, less coverage, and worse health outcomes. Action will lead to lower premiums and more access to care. Right now, Republican inaction has us headed down the path to higher costs.
But we still have the opportunity to change course. There’s a big election next year, one where we’ll be able to elect leaders who will fight to lower costs and expand health care access. If the GOP won’t take action, we need to at the ballot box.
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The Weekly Memo is an email from Progress NC Action featuring messaging, talking points, and links of interest for the week ahead.
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