So, about Sunday's Senate CR vote...

I was up to my ears in data crunching over the entire weekend working on my deep dive into the 14 states with Premium Alignment pricing in place for 2026, so I haven't had a chance to chime in on Sunday evening's Continuing Resolution vote in the U.S. Senate until now.

After enough of them held out for 40 days and 14 votes (I think) to prevent the House Republican version of the CR bill from passing & the federal government from re-opening, 7 Democratic Senators and 1 Dem-caucusing Independent finally agreed to vote for a modified Senate version of the bill...none of whom, by what I'm sure is sheer coincidence, are up for re-election next year (2 are retiring; the other 6 aren't up again until either 2028 or 2030, and one of them will likely retire before then anyway).

In terms of "flipping" or "caving" it's really only five of them, however, since three of the eight weren't onboard with letting the government shut down in the first place (Sen. King of Maine, Sen. Fetterman of Pennsylvania and Sen. Cortez Masto of Nevada). The other five were Senators Hassan & Shaheen of New Hampshire, Sen. Rosen of Nevada, Sen. Kaine of Virginia and Sen. Durbin of Illinois.

A few days later (last night, in fact), the Senate version of the CR was kicked back over to the U.S. House, where it also passed narrowly (222 - 209), with 6 Democrats voting for it (one of whom, Jared Golden, is also retiring) and 2 Republicans voting against. Trump signed it into law, and that's that: The federal government is now re-opened...until midnight on January 30th. After that...who knows?

Two months ago, before the shutdown, I implored Senate Democrats not to agree to a CR with just a short-term extension of the enhanced ACA tax credits.

Sunday night, technically speaking, they didn't do that...because 7 of them (plus 1 Dem-caucusing Indy) agreed to a CR without even getting that. All they received on the healthcare front was the promise of a vote to extend the enhanced ACA tax credits sometime in December.

So, on the actual healthcare policy accomplishment front, you could call this a pretty big fail.

So, what was accomplished? Well, generally speaking, I agreed with Josh Marshall's POV back in September before the shutdown and I'm pretty close to his take now that it's over:

There was a legitimate party rebellion after the March debacle. Democratic voters demanded fight. When the time came, Democrats fought. They held out for 40 days, the longest shutdown standoff in history. They put health care at the center of the national political conversation and inflicted a lot of damage on Trump. At 40 days they could no longer hold their caucus together. And we got this.

That’s a sea change in how the party functions in Congress. And that’s a big deal. Many people see it as some kind of epic disaster and are making all the standard threats about not voting or not contributing or whatever. That’s just not what I see. It’s a big change in the direction of the fight we need in the years to come that just didn’t go far enough. Yet.

Put more simply, this was an example of Dems taking baby steps into the Brave New World of American politics. The fact that they were willing to let the government shut down at all, much less hold out for 40 days (the longest federal government shutdown in history) was still impressive in terms of political cohesion, especially over a policy demand which they knew Republicans in the House, Senate and White House are unequivocally opposed to.

If that seems like pretty weak tea, perhaps it is. But as George W. Bush's Defense Secretary Donald Rumsfeld once said, “You go to war with the army you have, not the army you might want or wish to have at a later time.”

Am I disappointed that 8 of them made the decision they did? Yes. Am I impressed that Sen. Schumer was able to keep enough of them in line to prevent this outcome for 40 days? Yes. Should I be? Perhaps not, but again: This is the army that Democrats happen to have at the moment.

None of these 8 Senators are up for election next year themselves, but 13 Senate seats held by Democrats are, along with 22 held by Republicans. So, it's up to Democratic primary voters to look at who's running (incumbents or challengers) and decide which candidates they think will do the best job of fighting for their values. That's what primaries are about, after all.

So...what happens going forward regarding the ACA tax credits?

Well, there's a couple of things happening, neither of which seems terribly promising at the moment:

For starters, there's the promised December Senate bill on extending the enhanced tax credits. It will likely fail to get a majority, much less a filibuster-proof 60 votes. If it does, it will then go to the House, where Speaker Mike Johnson will very likely refuse to bring it to the floor at all...because if he did, it would be a disaster for House Republicans, since dozens of them would be placed in the inenviable position of either voting for it and getting primaried from the right or voting against it and being destroyed in the midterms next November.

Of course, even if it passed the House as well, it could still be vetoed by Trump, although honestly in any scenario where such a bill managed to get both 60 votes in the Senate and pass the House, I suspect he'd just go ahead and sign it after all, because it's not like he really gives a shit about any of this.

Meanwhile, Democratic House Minority Leader Hakeem Jeffries has introduced a discharge petition to force a House vote on a 3-year extension of the enhanced tax credits as is. Assuming all 214 Democratic House members sign on (there's still 2 open House seats, one Dem-leaning district, one GOP-leaning), they'd need to get 4 Republicans to sign it as well. There are 14 GOP House members in vulnerable seats who support a bill with a simple one-year extension, but that doesn't mean that any of them would cross GOP leadership by signing the petition.

So...there it is.

Speaking of discharge petitions, one absolutely positive development from all of this is that with the Senate passing a modified version of the CR bill, it had to be voted on again by the House...and in order to do that, Johnson had to bring the House back into session, and that in turn meant that he had to finally swear in Democratic Rep. Adelita Grijalva, who won her late father's House seat in a special election well over a month ago.

The first thing Grijalva did was, of course, to become the 218th signer of the discharge petition forcing a House floor vote to finally, at long last, release the Epstein files.

So...there that is as well.

Looking at the big picture:

If 8 or more Senate Dems had simply agreed to the original House version of the CR in the first place back in late September, the ACA Tax Credit crisis still would have been a significant story, but it wouldn't have received nearly as much national attention since a) the law itself isn't being repealed and b) not all of the tax credits are set to expire.

Don't get me wrong, it would still have been a major story, especially for the 24 million of us currently enrolled in ACA exchange coverage as well as the health insurance industry itself...but 24 million is still only about 7% of the total U.S. population. Yes, Republicans would still be catching a lot of heat over the issue, just not as much.

Instead, by centering the shutdown battle over the ACA, Democrats have managed to successfully refocus national attention on not just the ACA tax credits themselves but on healthcare policy in general.

The wisest course of action for Congressional Republicans would have been to do exactly what those 14 House GOP members want: Offer a simple one- or two-year extension of the enhanced tax credits, kicking the can down the road until after the midterms. This would have taken the issue completely off the table for now.

That's what I was asking Senate Dems not to accept...but it turned out to be moot, because GOP leadership can't bring themselves to do it, even though it would cost around half as much to extend them for one year ($23.4 billion) as Donald Trump just gave away to Argentina for no particular reason ($40 billion).

Why? Well, as I put it yesterday, they just can't help themselves: It's like cocaine to them. No matter how many times they get hurt by it, they can't seem to stop themselves from doing another line every few years.

This whole episode has placed the ACA and healthcare policy squarely back into the top of the public's mind and has somehow caused Republicans to once again touch the stove, which is why you're suddenly seeing Trump, of all people, posting about "money-sucking insurance companies" while GOP Sen. Bill Cassidy introduces bills to convert ACA tax credits into Health Savings Accounts and GOP House members like Tom Emmer dredge up that oldest, moldiest of ideas, the "High Risk Pool."

As Paul Krugman noted this morning:

Without health insurance, you are at risk of a catastrophic financial blow if you get sick and require hospitalization. Moreover, even if you don’t require hospitalization, you are more likely to avoid getting regular check-ups and preventative care, thereby making it more likely that you will indeed suffer a health crisis and, possibly, death.

Yet the shutdown drama made it clear, once again, that Republicans, from Donald Trump on down, refuse to understand this basic point. Or if they do and say so publicly, like Marjorie Taylor Greene and say so, they become a pariah within the party. But most prefer to behave like the hapless and probably doomed New York Republican Rep. Mark Lawler, and blame Democrats for having forced the issue into the headlines.

But the fact that Republicans have been misrepresenting how health insurance works since Obamacare was first proposed in 2009 is a testament to their cruelty and intentional ignorance. 

...As I explained above, this won’t work for the same reason homeowners need fire insurance: There’s a small risk that you may face extremely high costs, and you need protection in case that happens. In addition, lack of insurance is likely to make you sicker, thus more likely to require higher future health expenses and diminished quality of life.

This clip of then-GOP House Speaker Paul Ryan from March 2017 illustrates this perfectly: He either doesn't have a clue how insurance works or he knows exactly how it works but thinks his supporters are dumb enough not to:

After fifteen years and dozens of attempts to repeal the ACA (which they, and much of the media, still insist on calling "Obamacare"), Congressional Republicans still can't seem to come up with a cohesive alternative:

Republicans, under pressure from Democrats after the government shutdown revived the health care clash, have not coalesced around legislation or even an abstract idea, and are only now starting serious discussions about putting proposals together.

...As the party scrambles to craft an alternative, multiple Republicans are vying for Trump’s endorsement of ideas that could alleviate skyrocketing costs that are just around the corner.

...Johnson, R-La., said House Republicans have also been brainstorming proposals behind the scenes and will “be rolling out some of those ideas,” but he declined to put a timeline on it.

...If Republicans aren’t able to agree on an alternative solution before the end of this year, they’ll have to decide whether to join with Democrats in extending the ACA tax credits, which risks drawing Trump’s ire, or letting them expire, which risks infuriating voters ahead of next year’s midterm elections.

Republican Rep. Jeff Van Drew of New Jersey, who said he talked to Trump at length last week about the importance of health care, warned, “not only is it morally bankrupt, it’s political suicide” for Republicans to let the subsidies expire without an alternative in place.

...“While Republicans have talked for years about replacing the ACA, none of these current ideas are fully fleshed out yet. A tweet is not a health care plan,” said Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research group. “So, it’s hard to tell exactly how these concepts of replacing ACA premium assistance with cash or health accounts would really work in practice.”

“If people could use these Trump health care dollars to buy insurance not regulated by the ACA, it would likely cause the ACA to collapse and upend protections for pre-existing conditions,” Levitt continued.

I'll have a lot more to say about this "HSAs for All" silliness which Trump & Sen. Cassidy are suddenly pitching, but in the meantime, whether you think 8 of them voting for the CR Sunday night was the right thing to do or not, once they did so, shifting the national dialogue back to healthcare policy (where Dems are strongest and Republicans are weakest) and the Epstein Files is probably the best outcome Democrats could've realistically hoped for from that point forward.