the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
Nov 10, 2025
As the federal budget shutdown approaches six weeks in length, Trump and the Democrats continue to claim the fight is about health care.
The Democrats say they are holding out to protect subsidies that make Obamacare affordable for many people. Trump says he wants to “fix” healthcare, by which he means to eliminate Obamacare altogether, while saying nothing about how he would replace it.
Access to health care is certainly a problem in this country. Even with Obamacare in place, there are 24 million people who remain uninsured. In addition, the U.S. continues to spend nearly twice as much per person on health care on average compared to other high-income countries yet ranks low down the list of such countries in measures of health, such as life expectancy.
It’s certainly true that the Obamacare subsidies have made it more affordable for some people. They reduced monthly premiums to $0 for the poorest participants. For others with incomes up to four times the poverty level, who don’t have health insurance from their employer, it capped the cost of Obamacare plans at 8.5% of their yearly income.
The Democrats, though, could have avoided the current showdown by making the subsidies permanent before now. They controlled the presidency and had majorities in both houses of Congress when they first passed the subsidies in 2021, and again when they extended them in 2022. Instead, they deliberately set them to expire in 2025, knowing they could be in the minority now.
Subsidies or no subsidies, extending them does nothing for those with employer-provided health insurance, the premiums for which are expected to increase by 9%, according to multiple surveys.
In the end, none of the politicians are about to address the real problem with American health care: profits. The seven biggest health insurers made 500 billion dollars in profits under Obamacare from 2014 to 2024, according to Wendell Potter, a former health industry executive turned consumer advocate. These big insurers even found a way to skirt restrictions on their profits contained in Obamacare by buying up health care delivery companies and paying them more than they pay to providers they don’t control!
Pharmaceutical companies have also taken in huge amounts under Obamacare, with their revenues increasing between 2010 and 2021 from 245 billion to over 1.1 trillion dollars and their profits increasing by over 300% in that time. And that’s not to mention all the other players who continue to reap huge profits off of health care in this country.
So, the Democrats winning and simply extending Obamacare subsidies will not “fix” the health care system in the U.S., no more than Trump’s imaginary plans to eliminate it altogether and replace it with who knows what.
In the richest country of the world, everyone should be able to expect to have access to health care but getting it will require a fight by the working class and the poor against those who profit off of the current capitalist health care system.