Are we on the cusp of another big health care debate?
Make Me Smart
Marketplace
4.6 • 5.4K Ratings
🗓️ 18 November 2025
⏱️ 22 minutes
🧾️ Download transcript
Summary
For the Affordable Care Act, it’s been one battle after another. The ongoing fight over the ACA subsidies at the center of the government shutdown are just the latest flash point in the law’s 15-year history. KFF Health News’ Julie Rovner joins Kimberly to break down where things stand with the ACA and whether we’re on the cusp of another national healthcare debate. Plus, the other health policy changes coming under the Trump administration.
Here’s everything we talked about today:
- "The State of the Affordable Care Act" from KFF Health News
- "Oz: Trump administration weighing ACA subsidies extension" from The Hill
- "8 Things to Watch for the 2026 ACA Open Enrollment Period" from KFF
- "Obamacare sticker shock is more shocking in some states than others" from Politico
- "GOP plans to replace Obamacare have failed. Here’s what lawmakers propose now." from Washington Post
We love hearing from you. Leave us a voicemail at 508-U-B-SMART or email [email protected].
Transcript
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| 0:00.0 | Hello everyone. I'm Kimberly Adams. Welcome back to Make Me Smart, where none of us is as smart as all of us. |
| 0:13.7 | We are in the middle of open enrollment season, and millions of Americans who get their health care |
| 0:19.1 | through the Affordable Care Act are still |
| 0:21.3 | facing uncertainty around costs, and the costs that they are seeing look pretty scary for a lot of |
| 0:27.5 | folks. The future of the ACA subsidies were at the heart of the government shutdown, and their |
| 0:33.2 | outcome is still kind of unclear, leaving many people stuck with choosing drastically higher premiums |
| 0:38.8 | or no coverage at all. So we want to talk about what's going on with the Affordable Care Act, |
| 0:44.5 | what options ACA enrollees have right now, and the future of health policy under the Trump |
| 0:50.3 | administration. And here, to make us smart smart about this is someone who has been covering |
| 0:55.2 | this issue for literally decades. Julie Rovner, whose chief Washington correspondent for KFF Health |
| 1:01.0 | News and host of their weekly podcast, What the Health. Welcome to the show, Julie. |
| 1:06.5 | Thank you for having me. You have been covering health policy since long before the Affordable Care Act was even a law. |
| 1:15.4 | What has it been like to watch lawmakers fight over this issue of health care in America |
| 1:21.3 | and what it should look like over and over again? |
| 1:24.4 | It feels like Groundhog Day. |
| 1:26.3 | It really feels like Groundhog Day this year. I've been doing this |
| 1:30.4 | since the late 1980s. Congress struggled to do something small, then decided that you can't |
| 1:36.7 | fix the health system by doing something small. So they tried to do something bigger. That was the |
| 1:41.6 | Clinton Health Reform Plan that didn't work. And so they went back to |
| 1:45.1 | doing things that were small. That was things like the Children's Health Insurance Program. |
| 1:49.6 | Then they decided, again, that that's not really going to fix things. So they wanted to do something |
| 1:53.8 | bigger. And that's where we ended up with the Affordable Care Act. And we've been fighting about |
... |
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