States like Missouri and Iowa are choosing to not take up exemption designed to help low-income people keep coverage during hardship
Some conservative states that have rejected hardship exemptions for the new Medicaid requirements may be choosing not to due to political reasons, experts say.
New federal work requirements for Medicaid, slated to come into effect on 1 January, mean that adults enrolled through the Affordable Care Act (ACA) Medicaid expansion will have to work, attend school, volunteer, or take part in another qualifying activity at least 80 hours a month to maintain their coverage.
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Guardian World News
Will Trump’s economy sink Republicans in the US midterm elections? Our reporters answered your questions
The high cost of living has Americans angrier than ever. Guardian reporters answered your questions about the US economy ahead of November
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Send us your questions on Trump’s immigration agenda ahead of the midterms
LucccA asks: Why are labor unions in the US still not as well-organized compared to the rest of the world? I know there was a push against them in the past—does that still have an effect today? Also, why are there so many right-leaning unions in the US?
Michael: A lot of reasons. The US has low union density compared to other wealthy nations, currently at 10.0%, and that has been on a precipitous decline for the past few decades for a variety of reasons that include anti-union and union busting campaigns, outdated labor laws where employers often retaliate for union organizing or delay bargaining for years, as we are seeing with Starbucks, where there is no union contract after nearly five years since the first store won its union election in December 2021.Right to work laws in the US also undermine labor unions and starve them of resources. To the extent that there are right leaning labor unions in the US, they typically are law enforcement unions that consistently endorse and back Republican candidates despite the Republican Party in the US opposing collective bargaining. Some unions like the Teamsters have been making efforts to get Republicans to support legislation and in turn receive endorsements from the union, and this has shown up this election cycle with the Teamsters endorsing Republicans like Congressman Max Miller or Kansas Senator Roger Marshall, who are both facing very competitive re-election battles.
Heather: There’s a bunch of ideas floating around on cutting costs for groceries, healthcare and energy bills. A key thing Democrats are promising if they regain power in Congress is to wrestle back authority on trade and repeal Trump’s tariffs, which would lower what it costs compaines to import. A second is to advance a vote to stop the war in Iran, which could calm fuel prices. If Democrats retake the Senate, expect Elizabeth Warren to become chair of the powerful banking committe, and push forward some curbs on private equity investments. And Democrats have been coalescing around more government funding for childcare, a notable move to the left in recent years. Hakeem Jeffries, who will be House Speaker if Democrats win there, is promising to reinstate ACA tax cuts and roll back Medicaid cuts, but the party is divided on Medicare For All, with DSA candidates making promises on the campaign trail and more centrist Dems being pretty quiet.
Republicans running for Congress have been talking a lot about ways to lower gas prices, especially suspending the fuel tax, and shaving utility bills by making tech companies and other big users pay more. Some have promised to curb Trump’s tariffs, including Michigan’s Mike Rogers, and others are proposing suspending data center building after public backlash.
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In latest blow to Obamacare, Trump is threatening the entire US health system
The Trump administration is removing 760,000 people enrolled in the Affordable Care Act marketplace
The Trump administration is removing 760,000 people enrolled in the Affordable Care Act (ACA) marketplace on allegations of fraud, officials said on Tuesday – adding to previous efforts to chip away at federally subsidized insurance programs and likely causing some of the lowest-income Americans to forego healthcare, experts said.
The US government is also investigating about 420,000 people whom they suspect of fraud, and they are putting a six-month enrollment moratorium on new agents and brokers selling Obamacare policies, officials said at a press conference.
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Reader Q&A: how united are the Democrats ahead of the US midterms? Live now
Who are the Democrats running in the midterms, and where do they stand? Our US political reporters are live now to discuss the state of the Democrats, the party’s moderate and leftwing candidates and key races to watch
Sign up or sign in to post a questionCitizen_Squared writes: After the disaster of the Trump years, the Democrats still do not have a clear message/vision/plan for ending the destruction Maga has done. Talking endlessly about affordability is not a governing vision. The polls may have the Democrats ahead for the House and Senate but thanks to extreme gerrymandering, voter restrictions and a big assist from the corrupt Supreme Court in striking out the Voting Rights Act, don’t be surprised if the gains by the Democrats are limited on election day. If that happens, the party will collapse into civil war.
David: Yes, if Democrats underperform, there are sure to be recriminations and huge pressure on Senate leader Chuck Schumer and House leader Hakeem Jeffries (it’s been notable how many candidates are unwilling to endorse Schumer). But the day after the midterms will also fire the starting gun for the 2028 presidential primary, which will probably galvanising and energising. Candidates will come forward with their visions and that will take up a lot of oxygen.
Shrai: For Democrats, these midterms live in the wake of Kamala Harris’s loss in 2024. The party is still undergoing an identity crisis which these races seem to highlight. We’re seeing battleground states choose insurgent nominees who really buck the party’s establishment (see Abdul El-Sayed in Michigan, Troy Jackson in Maine, Angie Nixon in Florida and several other progressives in House races in New York and Colorado). But there is also a sense that this wave isn’t applicable across the board, particularly in states where we have Democrats running on more centrist platforms (see Roy Cooper in North Carolina, Chris Pappas in New Hampshire and James Talarico in Texas).
If progressive candidates aren’t successful in November it could be the cudgel that the establishment uses to advocate for moderate candidates (particularly looking ahead to 2028). If they win, however, it could be the exact proof-of-concept for the party’s direction forward, and running politicians who are pushing for ideas that might have once been considered radical (thinking about Medicare for All and higher taxes on the ultra-wealthy).
David: Affordability worked for both moderate and progressive Democrats in last year’s elections in New Jersey, New York and Virginia. I have to believe some flavor of that will be central in 2028: an understanding that the elites and the system have failed, that voters are struggling to make ends meet, that they fear their children will be worse off than they are. We’ve gone from an age of aspiration to an age of anxiety. Senator Jon Ossoff of Georgia has been good at tying this to Trump and “the Epstein class”. But how will Democrats fix it? It will also be fascinating to see how Democrats handle the issues of AI/datacenters and Israel.
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‘Our system is in dire straits’: progressive Democrats hold Medicare for All hearing
Congressional Progressive caucus say ‘healthcare should not be a privilege’ as they champions single payer system
The Congressional Progressive caucus (CPC) held a shadow hearing on Medicare for All on Wednesday, led by Pramila Jayapal and Debbie Dingell.
The hearing comes as over half of the House Democratic caucus has co-sponsored Medicare for All legislation, and Senator Andy Kim introduced legislation on Tuesday that would enroll all children into Medicaid until the age of 26, while Republicans passed drastic healthcare cuts in the One Big Beautiful Bill Act, including nearly $1n in cuts to Medicaid and allowing Affordable Care Act subsidies to expire.
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Trump’s $1.8bn ‘anti-weaponization’ fund scrapped, acting attorney general Todd Blanche confirms – as it happened
Blanche confirms fund set up to compensate president’s allies will not go ahead after fierce backlash and court setbacks
In six months, Adam Hamawy has gone from a political nobody to, deemed by most measures, the frontrunner in a crowded race, endorsed by prominent progressive and Democratic figures including Bernie Sanders, Alexandria Ocasio-Cortez, Ilhan Omar and Tammy Duckworth.
His work history has driven him to call for Medicare for All, advocating for sanctions and an arms embargo on Israel, and the abolition of ICE – and to say openly he cannot support the Democratic leaders Hakeem Jeffries and Chuck Schumer.
CALIFORNIA: Vote today for Steve Hilton for Governor. He will work with me and the Federal Government, the money will flow because I have confidence in him (but not any of the others!), and we will MAKE CALIFORNIA GREAT AGAIN. Steve Hilton will NEVER let you down. VOTE NOW!
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US under-45s struggle for insurance approval as colon cancer rates rise
ACA requires firms to cover colonoscopies for over-45s but young people face hurdles to receive appropriate tests
As colon cancer rates are rising among people in their 20s and 30s, some adults in the US who are under 45 and experiencing worrying symptoms are struggling to get insurance coverage for colonoscopies, which can detect colon cancer.
The Affordable Care Act (ACA) requires insurance companies to cover colonoscopies for people over 45 “because it’s been recommended by the US Preventive Services Task Force”, says Caitlin Murphy, a cancer epidemiologist and professor at the University of Chicago. The ACA requires preventive screenings, including pap smears, for example, to be completely covered.
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US health insurance executives testify before Congress about increasing costs of healthcare
CEO of UnitedHealth Group said his company will return profits earned from Affordable Care Act plans to customers
Executives from five of the country’s largest health insurance companies appeared before Congress on Thursday as lawmakers examined why healthcare has become increasingly harder for Americans to afford.
In one effort to address the affordability crisis, the CEO of UnitedHealth Group, Stephen Hemsley, announced that the nation’s largest insurance company will rebate profits made this year from its Affordable Care Act (ACA) plans to customers, while adding it was a relatively small participant in the ACA individual market.
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US House breaks with Trump to revive Affordable Care Act subsidies
Seventeen Republicans join Democrats to pass a three-year extension of tax credits cutting ACA premiums
The US House of Representatives on Thursday passed legislation to re-establish tax credits that lowered premiums for Affordable Care Act (ACA) health plans, after a small group of Republicans broke ranks and joined with Democrats to defy Donald Trump on a key healthcare issue that could sway voters ahead of the November midterm elections.
The chamber voted 230-196 to approve a bill that would extend for three years the credits, which were first created under Joe Biden but expired at the end of last year despite a concerted effort by the Democratic minority to continue them.
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Wyoming supreme court strikes down near-total abortion bans
Justices rule 4-1 that laws, including a ban on abortion pills, violate a state amendment protecting healthcare choices
Abortion will stay legal in Wyoming after the state’s supreme court struck down two near-total abortion bans on Tuesday, ruling that the laws violate the constitution of the profoundly conservative state.
In a 4-1 decision, the justices decided that the two bans – which include the nation’s first exclusive ban on abortion pills – violated a 2012 state constitutional amendment. That amendment affirmed competent adults’ right to make their own healthcare decisions and was originally passed as part of Wyoming’s response to the Affordable Care Act.
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