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The Indicator from Planet Money

Is Obamacare doomed without extended subsidies?

The Indicator from Planet Money

NPR

Business

4.79.2K Ratings

🗓️ 29 October 2025

⏱️ 9 minutes

🧾️ Download transcript

Summary

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 fare 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.  

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Transcript

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0:00.0

NPR.

0:02.0

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

0:18.0

Democrats say they won't vote to reopen the government unless Republicans

0:22.0

agree to extend subsidies for people who get health insurance through Obamacare, aka the Affordable

0:28.8

Care Act. And if these subsidies expire at the end of the year, millions of Americans could see the

0:34.2

amount they pay for premiums double or more. That's according to the nonpartisan health policy think tank, KFF.

0:40.9

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

0:45.0

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

0:52.8

How's that first spooky season, econ terminology?

0:56.3

This is the indicator from Planet Money.

0:58.4

I'm Adrian Ma.

0:59.8

And I'm Darren Woods.

1:01.0

Today on the show, we explain why the specter of a death spiral has haunted Obamacare

1:06.6

ever since it began.

1:08.4

And we ask if Congress lets these Obamacare subsidies expire,

1:13.0

could a death spiral be in its future?

1:20.4

I want it that way was a Backstreet Boys' banger,

1:23.1

but was it also a secret economics lesson?

1:25.7

If you watch the music video,

1:27.3

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

1:31.5

All right.

1:32.0

In our most recent bonus episode, we compete to see who can pick the most Planet Money song, movie, and more from 1999.

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