Tamara Keith and Amy Walter on GOP’s struggle with rising health care costs

Geoff Bennett:

A former key Trump ally plans her departure from Congress, DOGE quietly dissolves, and Washington grapples with rising health care costs yet again.

To discuss that and more, we turn now to our Politics Monday duo. That is Amy Walter of The Cook Political Report With Amy Walter and Tamara Keith of NPR.

It's always great to see you both.

Tamara Keith, National Public Radio:

Good to see you.

Geoff Bennett:

So President Trump today was expected to unveil his plan to deal with spiking Obamacare premiums, but that announcement, our White House and congressional teams are told, was delayed after congressional Republicans pushed back against the president's apparent sudden embrace of these expiring subsidies.

Amy, what does this delay tell us about the internal dynamics of the Republican Party, especially between the White House and Republican congressional leadership?

Amy Walter, The Cook Political Report:

Right.

So the issue of health care is something that Republicans in Congress have long grappled with and not really found an answer to. I went back because I remembered, after John Boehner, the former speaker, was out of office for a little while, in 2017, when the first version of repeal and replace the ACA came up, he was quoted at a conference saying: I have been in Congress for 25 years. I have never seen one time when Congress agreed what a health care proposal should look like.

In other words, even before the replace and repeal failed in 2018, he was predicting it wasn't going to work because Republicans have such a tough time on this issue. So that's number one.

The second is that where the divide really is between a president, who believes that this is a political liability coming up in the midterms, he sees where the polls are, he sees how much support there is for extending these ACA subsidies, and his Republicans in Congress, who ideologically are deeply opposed to everything that the ACA stands for and many of whom voted to repeal it not that long ago when the president was in his first term.

Geoff Bennett:

More than 60 times.

Amy Walter:

Oh, yes, the 60 times, and then they finally got the vote to actually repeal it in 2017 or 2018.

Geoff Bennett:

Right. Right. Yes.

Tamara Keith:

Yes.

Geoff Bennett:

So, Tam, I mean, how does this episode really highlight the tension, to Amy's point, between ideological purity, no Obamacare subsidies, and pragmatism, you have to do something about these premiums spiking?

Amy Walter:

Right.

Tamara Keith:

So what has happened is President Trump has changed the Republican Party, or at least he's changed the Republican electorate.

I was just talking to a political scientist about this today. He has expanded the party. He's expanded the tent. He's brought in a lot of voters who are more working class, who would be more sensitive to these spikes in health care costs.

And he has his finger on the pulse of his base, which is not the same as the traditional Republican Party, or the same as the Tea Party, which wants to make the government smaller. And so, when you have a big tent — and President Trump's presidency has sort of helped paper over this, when you have a big tent, there are divisions.

And what you're seeing right now is, with such a narrow Republican majority in the House and the Senate, those tensions between the Libertarian wing and the populist wing or whatever you want to call it, those tensions make it really hard to get something done. And now you have Marjorie Taylor Greene leaving, which is one fewer vote for Republicans in the House.

Geoff Bennett:

Well, what does it say, Amy, that Republicans have had a decade to come up with some sort of free market solution for health care coverage…

Amy Walter:

Yes. That's the…

Geoff Bennett:

… and yet they haven't been able to settle on one?

Amy Walter:

Well, the one person who was the most successful — Republican who was successful in passing real health care reform was Mitt Romney as governor of Massachusetts…

Geoff Bennett:

Right.

Amy Walter:

… which was the platform on which…

Geoff Bennett:

For Obamacare.

Amy Walter:

Exactly.

And because of that, I think there is the feeling that, well, then we use that platform because it was something that Democrats used. But just sort of building on Tam's point too about the tension within the party, there are 13 Republicans that have stated publicly, we would like to see these ACA extensions go forward.

They all sit in vulnerable districts, districts that are up in 2026 that either Trump narrowly carried or Kamala Harris carried. But most of the people in Congress don't sit in those kinds of districts. But these are the people who will determine who's in the House majority.

Geoff Bennett:

You mentioned Marjorie Taylor Greene. She announced on Friday her resignation from Congress effective January 5. And that announcement came just one week after she criticized President Trump — or, rather, President Trump withdrew his support for her after she criticized him.

But what does her sudden decision to resign tell us about the fault lines within the MAGA era Republican Party?

Tamara Keith:

Well, first, it tells us that being a member of Congress just isn't that great. And you have seen a lot of members of Congress complain about certain — complain any number of things, experiencing threats to their families, and just the general unpleasantness.

There are some ways to see this as a victory for President Trump. She criticized him. She wasn't just — it wasn't just the Epstein files. It was on the economy. It was on Venezuela. It was on other foreign entanglements. She was becoming a critic from inside the party. And that was a problem for him.

And rather than sticking it out and fighting, she said, all right, peace, I'm out. And so, in some ways, that's a win for President Trump. In other ways, it's a sign that these fissures exist and people are already thinking about what the party looks like when he's no longer the leader who sort of blocks the sun and prevents others in the party from defining what the Republican Party really is going forward.

Geoff Bennett:

Could her resignation trigger a ripple effect where you have other far right members, MAGA-aligned folks break away from President Trump?

Amy Walter:

So I think she was a unique figure, in that, look, she came into Congress and instantly went for the shiny object and being in the spotlight.

And you could make the other case that she just got too close to that spotlight and it singed her and now it's over. But you can also say that, going back to Tam's point about what the Trump coalition looks like now, if you look both at polling and at election results that have happened, the elections that have happened since 2025, what you see is a MAGA base, the core Trump base, they still like him a lot.

They're going to stick with him. It's that periphery coalition, the younger voters, the Latino voters, the independents. When you see his numbers among those voters, those were people who they weren't ever assigning themselves the MAGA label. They voted for Donald Trump because they thought he was going to do certain things, especially on the economy, and now they don't see those things happening.

And so he's losing favor with them. That is the bigger threat to the Trump agenda going forward, meaning, what will the Trump coalition look like in 2028? Those are the voters who determine that.

Geoff Bennett:

Well, I mentioned the dissolution of DOGE in the intro. And lucky for us we still have time to talk about it.

So, Tam, so DOGE, the Department of Government Efficiency, is dissolving ahead of schedule. This organization, agency, however you want to describe it, they claim to have cut tens of billions of dollars in spending. They have provided no verifiable accounting. How wide is the accountability gap here?

Tamara Keith:

Yes, they never provided the receipts for all of these cuts that they claimed to make. Many of the cuts that they claimed to make weren't real. Others were extremely inefficient, which led to actually more spending, not less.

And the reality is that DOGE has basically been dead since the summer, since President Trump's falling out with Elon Musk. They have sort of repaired that relationship now. But DOGE was more an idea than it ever was a practical reality.

Geoff Bennett:

What's it say about the feasibility of rapid-fire bureaucratic overhaul in a federal government that's built on bureaucracy?

Amy Walter:

Yes, I think the one thing it was successful in doing though, Geoff, is that it has fundamentally altered the way that agencies work and may be working far, far beyond just the four years of Trump's term.

Geoff Bennett:

Well, we covered a ton of ground on this Monday.

Amy Walter, Tamara Keith, thanks, as always.

Amy Walter:

You're welcome.

Tamara Keith:

You're welcome.