Trump Has ANOTHER New Plan to Buy Off Voters Before the Midterms

crown coins winning never sounded so good what would you do if you won big at crown coins casino real people win real prizes every single day hi this is michael from dallas and i won 40k and finally renovated my home visit crown coins.com sign up in seconds enter code crown and get a free lucky wheel bonus you may win up to 10 000 sweeps coins crown coins.com that's c-r-o-w-n coins.com no purchase needed code valid for new users only void were prohibited by law 18 plus terms and conditions apply this is matt rogers from las culturistas with matt rogers and bowen yang this is bowen yang from las culturistas with matt rogers and bowen yang you know when people try a new food and suddenly it's like okay hold on i got a new favorite food that's the reaction a lot of people are having when they first try kewpie mayo yeah it's the one with the red cap and the little baby on the bottle you've probably seen it at the grocery store and this mayo is different most mayonnaise uses whole eggs kewpie only uses egg yolk which gives it this rich umami flavor it's smoother deeper almost buttery once people try it they start putting it on everything egg sandwiches fries burgers chefs use it restaurants use it people who really care about flavor use it put it on just about anything then you'll understand kewpie the original japanese mayonnaise hey everyone i'm katherine rampel economics editor here at the bulwark joined by my colleague and friend and a journalist i much admire jonathan cone he is the best health care reporter in the country uh and he's been around for a long time uh and so whenever i have questions about what the heck is going on in the news about anything related to health care or health policy i am very lucky that i can just ping him and uh like basically at all hours of the day for some reason he will respond and uh share his wisdom today jonathan cone and i are going to be talking about a thing that you wouldn't expect him to have insight on necessarily which is the trump checks so as we have all heard and been widely mocking donald trump has been promising to bribe voters with checks uh either right before or right after the midterm elections and one reason we've been mocking this of course is that he would require congress's help in sending out these five thousand dollar checks that have been promised or so we thought it turns out that in just what the last week the president announced that he would actually be sending out checks unilaterally to some americans through the health care system that's why jonathan cone is here to join me so uh john what exactly is going on who is he sending money to and and why the top line here is basically he's diverting money that is supposed to go to from you know for a specific purpose for maintaining the affordable care act taking it as like his own pot of money and giving it to checks people and what looks like a possibly illegal effort to buy votes that's the sort of top line so let's get into the weeds here so basically um you have people who buy coverage now through healthcare.gov right you don't get it through your employer so you go on the exchanges and it's very important they buy through healthcare.gov for the purposes of this discussion um people if you if you live in one of the states uh that you know runs its own marketplace if you for example um this does not apply to you but if you live in one of those healthcare.gov states which is most states and if you are you're wealthy enough your income is high enough that you make more than four times the poverty line which is uh for a family of four somewhere over a hundred thousand dollars a year um then you in theory are about to get some kind of five hundred dollar check from the united states government i say in theory katherine you know this better than i do trump has a long history of promising to send money to people and then not sending it in fact it goes back you know to his career in the private sector i haven't yet seen actual checks going to people so we don't know about this but you know the white house has announced it um if you ask the department of the treasury if these checks are going out the department of health and the services they say yes this is a real thing so in theory sometime the next week or two you know this group of people it's it's close to a million people overall are going to get five hundred dollar checks in their bank accounts right so this is not coming from a tariff rebate this is not coming from a doge dividend those were the previous pots of money from which donald trump promised that he would be bribing voters this is coming from where like the president says that this was some sort of biden era overcharge or something and then like he's just writing a biden wrong and that's where the money is coming from is that actually true no shockingly it's not true um right the press release that went out said these are refunds for overcharging working families by the biden administration no no no that is not what's going on here when they set up the affordable care act you know they knew they were gonna have to run these websites right and run these marketplaces so people could could buy insurance and you know that requires money right it requires staff time you got to maintain the website and to that late 2013 what a fiasco it was i mean it's actually hard work to to to maintain a website so they congress set aside money um you know for the technical upkeep and also and this is really important they set aside money for outreach for education uh so people would know i know know about the fact that you know there's insurance available and and for people who might have trouble working away through the system i mean health insurance we all know is very complicated um people who have complex conditions trying to figure out what kind of insurance to get what kind of assistance they're eligible for there's money for all of that now the money comes from what they're calling a user fee it's assessed on the insurance companies who sell coverage through the uh you know through through through the marketplaces um you know presumably they build that into their premium so eventually we all pay for it but it's assessed on the insurance companies it builds up you know a fund that then gets spent the law then says it's up to you know each administration each year to decide how you how what level to set that user fee the next year based on how much money you got part last year and what you expect to spend so over the years you know it started off it was about three percent uh during the obama years when when trump got in he lowered it a little bit interestingly when biden got into office he lowered it even more so actually biden actually lowered this insurance fee that that that that that is supposedly this overcharge um at that point trump got back into office trump actually raised it back a little bit but now for next year there's this pot of money sitting there again money that's supposed to go to outreach or or education or enrollment assistance or technical upkeep of the website all things that make the affordable care act work better and by the way lower prices for everybody he's taking that pot of money and saying oh look i found this kitty of money i'm just going to write checks to this particular group of people uh one million people uh and and and you know and use it for that and and to be clear there is as far as i can tell no legal authority for this you know i actually asked i i emailed i emailed the white house i said what is the legal authority for this and i got an answer back that i got details on who these people are i got a one-liner about biden overcharging i literally wrote back i said well thank you but you didn't actually answer my question where's the and i have not heard back since this message is brought to you by talkspace talkspace is the number one rated online therapy bringing you professional 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getting to an office and most insured members have a zero dollar copay as a listener to this podcast you'll get eighty dollars off your first month with talkspace when you go to talkspace.com and enter promo code space 80 that's s p a c e eight zero to match with a licensed therapist today go to talkspace.com and enter promo code space 80 so he's basically taking um one pot of money to then put his name on these checks it's like kind of robbing peter to pay paul it sounds like it almost reminds me a little bit of how trump what was it last year said that he was going to be giving this bonus payment to our service members when really what he did was he took money that i think was supposed to be using for some sort of housing subsidy for those serving in the military and then just converted it into a check for people serving in the military so again it was like rebranding money that was supposed to be spent on this group of people to instead send it to spend it on a different purpose for the same group of people but then he gets credit so it kind of saying, it sounds like it's a worse version of that. that, because not only does it deprive one function of these vital funding resources that are needed for it to happen, but as I hear you speak, it kind of reminds me of this decision that the Trump administration made last year, where it took money from a housing fund for service members and instead sent it out as checks to those same service members for, I think it was $1,776, where Trump could say, aha, I gave these people a check, give me credit, when in fact it was just robbing Peter to pay Paul. Except that it sounds like in this situation, it's actually worse, because by depriving the ACA of this kind of outreach, it sounds like it might further undermine it going forward. Is that right? Can you explain why it's so bad to siphon money away from ACA outreach? Yeah, you're exactly right. I mean, look, the ACA outreach, what does ACA outreach do? And that's one of the functions, right? So if ACA, if you're having the outreach, what you're doing is you're bringing more people into the insurance pool, right? So that accomplishes two things. Number one, you're getting insurance to people who need it. People need health insurance. So you're telling people, hey, you might have thought you couldn't afford insurance. You might have thought it was not available. You have options. Here they are. You can get coverage. So they are better off individually. But as we all know, and Catherine, you know, because you understand insurance pools and risk pools, the more people you get into the system, the healthier it is. And of course, it's not just the education part. It's also things like maintaining the website. It's money to make it user friendly. So this is slowly undermining this program. And people should remember, this is always what Trump constantly says this. He's been saying this since he first ran for president. He hates Obama. He hates Obamacare. He thinks it's a terrible program. He's going to try to destroy it if he can. Now, look, these user fees are not that much money. They're not going to unravel the whole program, obviously. But it is of a piece with a larger campaign to weaken this program and put money into other purposes. And in this case, the money is to promote Donald Trump and his political cause, you know, heading into an election. Right. And just to belabor the point that you just made about the outreach. Presumably, the people who are sick know that they need health insurance. Right. They don't need the government to remind them to purchase health insurance. The people who are getting reached by that outreach are disproportionately probably going to be healthier people for whom it is not necessarily as top of mind or as salient that it's really important for them to enroll in health insurance. So I could imagine a scenario in which by cutting back this outreach funding again by diverting it into a midterm bribe, the administration is basically getting disproportionately sicker people in this health insurance program, which can feed into this economist's fear of a death spiral that like insurance gets more and more and more expensive. The only people who stick with the insurance program are the people who really, really need it, which drives prices even higher because it, again, pushes out the healthier people. So you get into this sort of vicious, vicious cycle, this, again, death spiral that I don't know that like this one action per se is going to lead us down that very dark path where the whole thing unravels. But it's certainly unhelpful. And, you know, this is not just like one cheap bribe that the administration is getting in this moment. It's also like potentially undoing or at least contributing to the subversion of this major program that keeps millions of people insured. In addition to that, as I understand it, Jonathan, there is another set of checks, another set of potential voter bribes that the administration just announced that is going to Medicare recipients. The Trump administration has described this as nearly $100, otherwise known as $90 per recipient. I mean, look, every penny helps. I'm sure for a lot of Americans who are struggling with high prices, but nearly $100, $90 are going out to Medicare recipients. Where is that money coming from and how does that work? Yeah. Yeah. We're like in the Oprah Winfrey stage of this now, right? You get a rebate check, you get a rebate check, you get a rebate check. So this one is going to seniors to help them pay their Medicare Part B premiums. Reminder, if you're on Medicare, there's the hospital insurance program, which is Medicare Part A. There's Medicare Part B, which pays for outpatient. That's what you pay when you go to the doctor. And Medicare B has premiums. They go up every year. This year, actually, they've gone up quite a lot. So this is an almost, I like how you put it, almost, almost $100. It's $90 that will go, that will go to seniors who are for their Part B premiums. Now there's two, as with the ACA, there's a lot like only certain seniors get it. In this case, number one, you can't be getting any assistance from Medicaid. So lots of people who are on Medicare, you know, lots of low-income seniors, because Medicare Part B premiums can be very expensive, the Medicaid program is there and can help them pay for it. So if you're, you know, if you qualify for Medicaid, you get Medicare Part B and then Medicaid basically pays part or all of your premiums. So if you're one of those people, then you don't see this $90. In addition, there are a lot of seniors who, instead of enrolling in Medicare Part A and Part B, they enroll in what's called a Medicare Advantage plan, which is a private insurance plan rather than traditional Medicare. It's actually now the majority of seniors now are on Medicare Advantage. So if you're on Medicare Advantage, you won't get this either. It's only for people who have separate Part B plans and aren't getting assistance from Medicaid already. In that case, then you get this $90 payment. We think, I don't know. This was announced over the weekend. We're going to get this $90 payment. So this one, we're really kind of in the dark here, like what's going on. And so do we know anything about the legality of this particular program? Yeah. So this comes from a, there's a fund inside of Medicare called the Medicare Improvement Fund. I think it dates back to 2008. It's not a, it's not a big program. And over the years, it has, Congress has frequently taken that money and said, oh, that pot of money is sitting there because it doesn't matter. It doesn't matter. It doesn't matter. It doesn't matter. We're going to use it to pay for some other healthcare costs, you know, and then their spending bill, they'll reallocate it. Of course, that's Congress. Congress gets to do that. Congress gets to decide where we spend money. I will say again, based on, you know, tracking this down over the weekend and talking to lawyers, the actual statutory language here is pretty fuzzy. So it's possible this is legal. I, you know, the ACA one looks more clearly to be not, you know, testing the limits of the law, breaking the law. This one, at least based on an initial inspection, looks like it might be okay because the statutory language is so fuzzy. But I, you know, I don't know. And as we discovered and, you know, we discovered that these things, they announced something, they don't put out a lot of information. This is just a meta note here. I mean, we've been both covering policy for a long time. Normally when an administration announces a program, an initiative, there's a whole paper trail there, right? There'll be a memo, there'll be a legal justification. You get none of that, right? I mean, there's a whole paper trail there, right? There'll be a memo, there'll be a There's a truth social tweet, maybe a fact sheet from the White House. You ask questions, they don't answer it. So I, you know, based on what I can tell, this might be legal. It might be illegal. I don't know. But the fact that we're even asking that question is such an indictment of the process and the way these people run the government. And it's just not how it's supposed to work. Yeah. I was going to say that it feels like this administration has been pretty resourceful in trying to find ways to pay off voters in advance of the election. Right. The president has again cited tariff rebates and Doge dividends, and neither of those have been forthcoming, but they have somehow found these other pots of money. But then maybe they're illegal. So who knows? But yes, they are doing what they can to try to helicopter drop some cash onto the voters ahead of the election, branded with Trump's name, with the GOP's name, presumably to help their chances here. I don't know that it's going to be enough to overcome the very real blame that voters have been laying at the feet of the Republican Party for other ways that they have made health care more expensive, like particularly by getting rid of those enhanced premium tax credits last year. I don't think you mentioned this, but I assume that part of the reason why they're sending out these five hundred dollar checks, assuming they actually materialize to the sort of higher income group of ACA marketplace enrollees, is that like those are the people who might have been hurt the most by the end of the enhanced premium tax credits. Right. So it's like sort of trying to pay them off the same people who they hurt. Yeah, absolutely. And, you know, when those enhanced subsidies went away, I mean, prices went up across the board. There's lots of people at lower income levels who are paying more. And for a lot of them, it's a real hard Even though the dollar amount is smaller, you know, it might only be $50. a month. But if you're like, you can't make your rent $50 a month, there's a lot of money for the, but, and they're not getting these rebates. This is only going to the people who are over 400% of the poverty line. Now they are the ones in many cases who saw the crazy high increases because they went from a situation where they were, where basically they're in the amount of money they would pay for insurance was capped because of the subsidies that the extra subsidies now they're not capped. So this is the world where, you know, when we talked about this, you know, we would frequently say there are some people who are paying thousands of dollars more a year. In some cases, even went to five figures. So it's a really big increase. Those are the people getting hit hardest. Of course, by extension, even $500, then, I mean, that will help. I'm always one of those people who says, look, don't, you know, any, like you said before, any little bit helps, but you know, your insurance went up by $5,000 a year, $8,000 a year, $500 isn't gonna, you know, really make up for that. And, and by the way, the, the Medicare premiums, just, you know, since we're talking dollars here, almost a hundred dollars, you know, $90 a month. Well, the average Medicare Part B premium is more than $200 a month. So you're getting, you know, less than half of one month's premium. So that's really not going to make a huge impact. Although, you know what, it shows up in October, shows up in your mailbox, it's got Donald Trump's name all over it. And I assume the hope is that politically this, this redounds to their benefit. Yeah. Yeah. Although as we've discussed, like short-term, it might help. The recipients short-term, it might even help Republicans long-term. Uh, it might completely unravel some of these programs. So, uh, yeah. So people's near-term interests and long-term interests may not be aligned. Okay. Uh, before we go, I want to ask you about this crazy story out of Russia where a plague escaped and maybe killed a researcher. What do we actually know is going on right now? Well, we don't know a ton, right? Because this is in Russia and authorities are not revealing a lot of details. I mean, the sequence here was there was a reported death, an official and a nearby official, not in the city where it happened, uh, said, you know, they had heard it was plague, explain what the plague is. Plague is a bacteria. Um, there's bubonic plague, which is the one transmitted by rats and fleas. Uh, this appeared to be a form, supposedly the rumors were, and some reports suggested pneumonic plague, which is, can be transmitted from human to human. Um, now the, the official word is that they, the Russian authorities have acknowledged that a worker at this laboratory died of some kind of pneumonia symptoms. They have not said it was plague there that we know from various reports that they are, there's big quarantine going on. They seem to be reacting quite aggressively. So the kind of the, the, the pieces that we see and hear suggest it's probably, or could, there's a high probability that it's pneumonic plague, but at this point we don't really know. Um, uh, so we're just sort of watching to see what happens. You know, I, I will say just again, and I am not a doctor, so, you know, I'm getting this from the medical experts I trust. Um, I'm not seeing a huge amount of alarm about this at the moment. I mean, plague does exist in the world. Um, it is very lethal, but it is again, not a doctor, but my understanding, uh, it treatable with antibiotics, especially if you get there in the first 20 years. So, um, I'm not a doctor, but I'm not a doctor. So, um, I'm not a hours. But, you know, it's always a concern. And then in the backdrop of this is, and this is kind of why I think you see people watching with a little anxiety, is that, you know, we know historically Russians going back to the Soviet era have been investing in bioweapons research. You know, the concern would be, is this some kind of engineered pathogen that's more resistant to antibiotics or something like this? Again, no reason to believe that. Again, I am not seeing huge amount of alarm about this, but your ears perk up certainly when you hear plague. Right. And what do you think the broader takeaways are for American policy on all of this? Like, I'm not particularly comforted when I see headlines that are like, oh, yeah, the White House has this under control. They're monitoring it. I don't know how useful or productive that is. I hope it is useful and productive to have the White House monitoring what's going on with the plague. But given how they have handled previous public health risks, it doesn't provide a lot of comfort to me. Yeah. Why wouldn't you feel, have great confidence in this? I mean, I'm imagining the Marco Rubio meme, right? And he's got like a lab coat on now and he's now he's going to be the chief because I saw he gave a statement about this. I mean, look, this administration has just utter disdain for global health in all kinds of forms. And we have watched them pull back. Right. They've pulled us out of the World Health Organization when they killed USAID. One of the programs that they killed was a global, a sort of global surveillance program where we we cooperated with other countries. And I actually remember very specifically hearing about this from Atul Gawande, who I think, you know, a lot of our viewers and readers know he's the doctor journalist who ran global health under USAID. And during the Biden administration, he was very specific about this. He said, look, when we you know, we don't have great insight into what's happening into a lot of countries around the world, especially countries where we don't necessarily have the best relationships. And this global monitoring system like Russia. Yes. And this global monitoring system was basically our early warning system for when an outbreak starts in a part of the world where we don't have great relationships. The World Health Organization, a flawed organization that, you know, definitely needs reform and that the United States government is definitely grounds for things that we would like to see it do better. But at the end of the day, it does serve a vital purpose of bringing countries together to ease communication, to improve the time, being able to respond to crises more quickly. So this outbreak hopefully probably is not something to alarm us. But, you know, you imagine a version of this that was more serious. Imagine it was a new SARS COVID virus, something where we really did need to worry. Not having, you know, being not part of these international organizations, not having that surveillance system means we're getting information later or we're getting information that is incomplete. And when you are trying to protect your citizens, the American public from foreign global biological threats, information and timeliness is everything. So, you know, this to me, the fact that we are so in the dark, I mean, obviously that's on the Russian government for not being, you know, we would like to think that when it comes to these sort of health threats, the Russian government would be more forthcoming. That is a problem. But, you know, in the real world where we're going to have a Russian government, we're going to have a Chinese government, we're going to have regimes abroad that aren't going to want to share information. Every little bit we can do to be part of international cooperation, have as many eyes and ears on the ground as we can, that just seems to so obviously be in our best interest. And instead, we're in the middle of pulling back and destroying that infrastructure. Well, on that note, let's hope that you and I both remain plague free, I wish the same for our audience. Thank you so much for watching and listening today and learning with me alongside Jonathan Cohn, whether or not we should be worried about the fiscal health of our healthcare programs and the literal health of the world population. If you like this, I hope you will consider subscribing, liking and leaving reviews. It really helps us. You can follow us on Bulwark Takes as well as my own separate podcast feed called Receipts with Catherine Rampell. Please check it out. You can find all of the above on YouTube, Apple Podcasts, Spotify, wherever you get your podcasts. Until then, stay healthy. Picture this. 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