Brian Lerer on WNYC.

So the government shutdown ended without Democrats getting the key provision they were fighting for extending the Obamacare tax credits.

With open enrollment for 2026 underway, people who get their health insurance through the Affordable

Care Act are seeing how much their monthly premiums will rise without the extended subsidies

being continued, in some cases, doubling or tripling.

Our next guest argues that the argument over subsidies is far too small.

In fact, the infighting highlights just how dysfunctional the American healthcare hybrid

of public and private health insurance is.

He is Hayden Rookley, senior Fellow at the Brown University School of Public Health.

Hello, Brownies.

His scholarship focuses on corporate consolidation in health care,

Medicare and Medicaid financing, and labor and workforce issues in the health sector.

He recently wrote a post on Caitlin Jedalina's Your Local Epidemiologist

Substack. Some of you know Caitlin Jetolina. We have her on the show periodically with her writings under

your local epidemiologist. Hayden Rooklay wrote on that. An article titled Five Ways,

Our Health Care System has become utterly insane. Hayden, thanks for sharing this with us. Welcome to WNYC.

Thanks so much for having me.

True or false, did Obamacare increase the cost of health care and why, even though it's

called the Affordable Care Act?

I'll go neutral on that question. The answer here is that the Affordable Care Act significantly

expanded coverage for folks and has been vital, for example, for the 20 million people who

are on the ACA exchanges, but part of what we discussed

...