The GOP’s lies are a smokescreen to gut your health care

The talking points are false, but the consequences are real.

By Jeff Nesbit

As President Donald Trump negotiates with congressional leaders on a budget deal to avoid a government shutdown, the health and financial security of millions of American families hangs precariously in the balance.

Though the specter of a government shutdown dominates headlines, a much more immediate crisis is brewing. And GOP leaders are lying through their teeth about it while trying to shift blame on the looming government shutdown to Democrats (who don’t control any of the three branches of the federal government).

On Nov. 1, open enrollment for the Affordable Care Act (ACA) begins, but this year will be different. Because Republicans in Congress have so far refused to extend the enhanced premium tax credits that have made insurance affordable, a tidal wave of sticker shock is about to hit the country.

The numbers are staggering. More than 20 million working people who buy their own insurance are projected to see their share of premiums skyrocket by 75 percent on average next year, with many seeing their costs double.

This is not an accident; it is a manufactured crisis. And instead of working to solve it, the GOP is deploying a cynical and familiar playbook: recycling a series of debunked lies to justify the very chaos they created. They are calling working Americans “fraudsters“ in an effort to bury families in red tape and terminate their health care.

First, they claim that the enhanced tax credits are a handout to the wealthy. The facts, drawn from non-partisan analysis, tell a different story.

The Joint Committee on Taxation (JCT) found that 95% of these tax credit dollars go to households earning under $200,000. The GOP’s fiction about enrollees making $600,000 benefiting from the credits has been thoroughly disproved; the JCT confirmed no one making over $500,000 receives them at all.

So, who are the real beneficiaries? They are families making up to just above 400 percent of the Federal Poverty Level—about $128,600 for a family of four.

Without these credits, these working families would be forced to spend up to 30 percent of their income just to remain insured. And nearly half of all ACA enrollees have incomes below $31,300 for an individual. This is not a subsidy for the rich; it is a lifeline for the middle and working class.

Next, Republicans are trying to conjure a phantom menace of widespread “fraud and waste“. But their assertions are baseless. The Centers for Medicare and Medicaid Services found about 1 percent in improper payments, but that is mostly related to paperwork errors, not ineligibility.

In fact, the “flawed third-party analysis“ the GOP relies on is so questionable that a federal judge suggested its methodology may be unsound. The real fraud identified within the ACA marketplace has been driven by brokers and other third parties, not by consumers.

If Republicans were serious about fighting fraud, they would join Democrats who have already introduced legislation to crack down on these bad actors. They aren’t, though, because this was never about fraud; it’s about finding an excuse to take health care from working people.

Perhaps the most cynical lie is the attempt to paint the 24 million people who rely on the ACA as “illegal immigrants and fraudsters.”

Let’s be perfectly clear: Undocumented immigrants are not eligible to purchase coverage on the ACA marketplace, nor are they eligible for Medicare or Medicaid. This is a vicious and knowing falsehood designed to distract from the reality of who is truly under attack.

The very people who would be most harmed are the GOP’s own constituents. Since 2020, about 90 percent of new ACA enrollments came from states Trump won in 2024.

More than a quarter of American farmers and nearly half of the ACA’s enrollees work or own America’s small business, and many use these tax credits. These are not fraudsters; they are the backbone of our economy.

Finally, conservatives are taking aim at zero-dollar premium plans, arguing that low-income people need more “skin in the game.”

Eliminating these plans would be catastrophic. It would cause millions of working Americans to drop their coverage, leading to a surge in uncompensated or delayed care that raises costs for everyone across the entire health insurance market.

Zero-dollar benefits are a standard tool to encourage access to care, used widely in programs like Medicare Advantage and for preventive services. In an economy in which families are struggling to afford housing, food, and childcare, forcing them to choose between a new premium and a household essential is a recipe for a public health disaster.

The talking points are lies, but the consequences are real.

As the president and congressional leaders meet, they face a deliberate choice. They can act now to prevent the chaos they have unleashed on the American health care system, or they can stand by these falsehoods and consciously inflict a massive tax hike and devastating premium increases on millions of working families—and increasing health care costs across the board.

Make no mistake, if nothing is done, more than 20 million people will see their premiums spike or lose their health coverage altogether. This is not a policy debate. It is a political decision to sacrifice the well-being of the American people for partisan gain.

Jeff Nesbit was the public affairs chief for five Cabinet departments or agencies under four presidents.

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