Is Obamacare doomed without extended subsidies?

没有延长补贴,奥巴马医改是否会注定失败?

The Indicator from Planet Money

2025-10-29

8 分钟
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Health insurance subsidies are at the center of the current government shutdown. Democrats want to extend some expiring Affordable Care Act/Obamacare subsidies. Obamacare has weathered several political storms since its inception, but how will it fair without those subsidies? Today on the show, death spirals and the future of Obamacare. Related episodes: The hidden costs of healthcare churn How doctors helped tank universal healthcare For sponsor-free episodes of The Indicator from Planet Money, subscribe to Planet Money+ via Apple Podcasts or at plus.npr.org. Fact-checking by Sierra Juarez. Music by Drop Electric. Find us: TikTok, Instagram, Facebook, Newsletter.   Learn more about sponsor message choices: podcastchoices.com/adchoices NPR Privacy Policy
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  • NPR.

  • We're about a month into the government shutdown and lawmakers are still at an impasse over health insurance subsidies.

  • Democrats say they won't vote to reopen the government unless Republicans agree to extend subsidies for people who get health insurance through Obamacare,

  • aka the Affordable Care Act.

  • And if these subsidies expire at the end of the year,

  • millions of Americans could see the amount they pay for premiums double or more.

  • That's according to the nonpartisan health policy think tank KFF.

  • And this could just be the start of a cascade of consequences.

  • Theoretically speaking,

  • a big price hike like this could even lead to something called an adverse selection death spiral.

  • How's that for spooky season econ terminology?

  • This is the indicator from Planet Money.

  • I'm Adrian Ma.

  • And I'm Darian Woods.

  • Today on the show,

  • we explain why the specter of a death spiral has haunted Obamacare ever since it began.

  • And we ask if Congress lets these Obamacare subsidies expire, could a death spiral be in its future?

  • I Want It That Way was a Backstreet Boys banger, but was it also a secret economics lesson?

  • If you watch the music video,

  • you can really see an illustration of the concept of comparative advantage.