Trump and His Shutdown: Why the US Government Isn’t Working Since October 1

The cause of any shutdown in the US is always the same — if Congress fails to pass the budget for the next year on time or at least an interim budget designed specifically to prevent a shutdown. The document must be approved by October 1. In this case, the main sticking point was healthcare spending. Representatives of the Democratic Party insist on increasing it, in particular allocating an additional $1.5 trillion (including for Obamacare and Medicaid programs). Republicans oppose such spending.

The Fight Against Obamacare

Donald Trump is not the first to challenge the program popularly known as Obamacare, introduced during Barack Obama's presidency in 2010. The official name of the program is the Patient Protection and Affordable Care Act, ACA. Its purpose is to provide as many Americans as possible with health insurance, since without it, medical costs in the US are enormous and can amount to tens of thousands of dollars.

Under the ACA, businesses with more than 50 employees are required to provide insurance plans for all their workers. Other Americans are required by law to purchase insurance plans at their own expense, and insurance companies are prohibited from denying coverage based on age or health condition. The program also allowed including parents on their children's insurance plans up to age 26 (previously only up to 18), for those who have not yet obtained their own insurance.

In January 2017, Congress, which at the time, as today, was dominated by Republicans, initiated the repeal of Obamacare. However, the replacement plan proposed by Trump failed to gain enough support even within the Republican Party and was withdrawn from voting.

In addition to Obamacare, the US also has the Medicaid program, which covers health insurance for low-income individuals. It was introduced back in 1965 but was also expanded by Barack Obama in 2010. Both programs remain in place today, and there is currently no talk of their official cancellation. However, the funding for insurance coverage under the Act expires at the end of this year, and Republicans reject Democrats' demands to extend it. In fact, this will lead to a sharp increase in insurance premiums for all residents of the country.

Insurance Is Not a Cure-All

To be fair, having insurance does not automatically guarantee that its holder will receive qualified medical care in the US. Even those with good insurance often face problems with diagnostics when doctors refuse to order necessary tests. The problem lies in the relationship between medical institutions and insurance companies. Medical workers often contact insurers to confirm that the company will indeed cover the costs. If the insurance company decides that the test was not necessary, reimbursement may be problematic.

Sometimes such problems with ordering tests lead to tragic consequences. For example, in 2015, 23-year-old student Anna Ram from the San Fernando Valley, California won a $28.2 million lawsuit. The court found that due to a medical error at a Kaiser Permanente center, the young woman lost a leg, half of her pelvis, and part of her spine. In particular, doctors regularly refused to perform an MRI requested by the patient's family, which prevented timely diagnosis of a malignant tumor. Despite the large compensation, it is clear that it cannot make up for the loss of vital organs, leaving the woman disabled for life.

Overall, the United States is currently the leader in the number of medical lawsuits. According to statistics, there are about 170-200 complaints per million people. The average duration of litigation and compensation in the US is up to five years, and legal costs may include jury trials and high attorney fees, which combined with treatment expenses amount to a considerable sum. Clearly, as funds meant to cover insurance costs run out, the problem will worsen even more.

The Fight Against the Disabled

Meanwhile, for Donald Trump himself, the government shutdown does not seem to be a serious problem. Whereas previously civil servants could be sent on unpaid leave during the government suspension, the US president stated that he will use the break to carry out mass staff cuts. Trump plans to dismiss 750,000 government employees who will not be able to return to work after the shutdown ends.

Another of Trump's initiatives is social security reform. According to The Washington Post, the president's administration is preparing a plan to limit elderly Americans' access to disability benefits under the social security program. Currently, the Social Security Department reviews applications considering age, work experience, and education. Applicants over 50 usually find it easier to get benefits, as age is seen as a factor that makes changing professions difficult.

Authorities are now discussing the possibility of completely removing age as a criterion or raising the threshold to 60 years. Senior Urban Institute fellow and former Office of Management and Budget staffer Jack Smolligan calculated that if new rules reduce the number of benefit recipients by 10%, about 750,000 fewer people will receive payments over the next decade. Another 80,000 widows and children will also be affected, as their spouses or parents lose eligibility for benefits.

In addition, the government plans to repeal a Biden-era rule that expanded eligibility for payments to those living with low-income relatives or neighbors who themselves receive government support. According to the Center on Budget and Policy Priorities, revoking this right will reduce payments for about 400,000 people. How such social policies align with Trump's proclaimed slogan “America First” was not explained by the administration.