Wellness Unmasked Weekly Rundown: Government Shutdown Showdown: Immigration, Healthcare, and the Fight Over ACA Subsidies

In this episode. Dr. Nicole Saphier unpacks the latest government shutdown and the heated battle over immigration and healthcare funding. She explains how expiring ACA subsidies and GOP proposals to limit Medicaid for migrants have become flashpoints in the debate. Dr. Saphier also explores the financial strain on hospitals, particularly in rural and underserved areas, and outlines where Republicans and Democrats stand on taxpayer spending and benefits for asylum seekers. Wellness Unmasked is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Tuesday & Friday. 

 

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Episode Transcript

Speaker 1 (00:03):
Welcome to wellness.

Speaker 2 (00:03):
I'm mass I'm doctor Nicole Saftfire and this is your weekly.

Speaker 1 (00:06):
Rundown well Friday, October third.

Speaker 2 (00:08):
And Yes, the federal government has shut down, and it's
really all about immigration and healthcare. Republicans say that the
Democrats want to provide health coverage for illegal immigrants, and
the Democrats say that they're lying that Republicans are distorting facts.
So who's telling the truth, who's not well kind of
a little bit of both. But I figure I will

(00:30):
just break down the facts because by looking at social media,
it seems like a lot of people don't really understand
the nuance of it. And even some of the politicians
who are responsible for the shutdown, I don't even.

Speaker 1 (00:40):
Think they understand what's going on.

Speaker 2 (00:41):
So it all boils down to a couple of really
big things. First of all, the subsidies under the Affordable
Care Act, those are set to us expire. Some of
the expansion subsidies that happened through COVID, they are going
to expire at the end of this year. So the
Democrats are saying we want to con tinue of those
expansion subsidies.

Speaker 1 (01:02):
Republicans aren't saying no to that.

Speaker 2 (01:03):
Actually they're just saying, we just don't need this in
this short cur bill. We'll talk about that later. We
have until the end of the year. So that's one thing.

Speaker 1 (01:12):
The other thing really just goes back to the Big
Beautiful Bill.

Speaker 2 (01:16):
In the Big Beautiful Bill, that Republican bill that got
a lot of media attention was what they did. They
narrowed the Medicaid eligibility when it comes to migrants. So
Medicaid is the government funded health insurance for people who
cannot afford it. So in the Big Beautiful Bill, they
narrowed who is eligible. They said eligibility for Medicaid should

(01:40):
be restricted to those full legal American citizens, those who
have a Green card who are permanent citizens now, and
also some Cubans, Haitians and some Pacific Islanders. But the
big crux of it was that they narrowed the coverage
so that refugees and asylum seekers and though those coming

(02:03):
under the parole programs are no longer eligible.

Speaker 1 (02:06):
So that's about like one point.

Speaker 2 (02:08):
Four million people who would classify under that and would
potentially lose healthcare coverage because they're no longer eligible for Medicaid.
What I find interesting is this that the asylum seekers
or those who were granted asylum were then eligible for Medicaid.
So if you remember during the four years of a

(02:28):
Biden White House, you had a lot and I mean
a lot of people illegally cross the border who were
subsequently granted asylum that automatically made them eligible to receive
Medicaid and other government funded subsidies. So the question is
are they illegal or are they legal. Democrats are saying

(02:50):
they're here legally because they were granted asylum, So technically
that's correct because they're documented now.

Speaker 1 (02:58):
They may have come here legal, but if they.

Speaker 2 (03:01):
Were granted asylum by the Biden administration, they're technically here legally,
so they believe that they should have access to Medicaid
and other tax payer funds. Republicans are saying, well, they
came here illegally and so no asylum or not, they
should not be entitled to some of these programs because

(03:21):
they're trying to deter people from coming here illegally. So
the way to do that is saying, even if you're
granted asylum, you are not going to be eligible for.

Speaker 1 (03:30):
All of these tax payer funded programs. It's actually pretty clear.

Speaker 2 (03:34):
The other thing is the bill also decreased federal reimbursement
to hospitals that provide emergency care to undocumented and illegal migrants.
If someone shows up at the emergency room, they are
going to receive care, not just because they're compassionate and
they have an ethical duty, although they have those as well,

(03:56):
but because.

Speaker 1 (03:56):
They're legally obligated to that's right.

Speaker 2 (03:59):
That law was passed several decades ago, and no one's
talking about undoing that law. So legally, hospitals have to
treat anyone who shows up to the emergency department, documented
or not. So the federal government and the big beautiful bill,
they're saying, well, we're just not going to pay the
hospitals as much for their care because obviously caring for
this patience costs the hospital money and the hospital needs

(04:21):
to be reimbursed for the care. If hospitals are not
reimbursed for the care, the hospitals will go under. So
not just the undocumented don't have anywhere to go, but
other people won't have anywhere to go. And this will
really impact rural hospitals and hospitals that serve the underprivileged areas.
So it's not a good idea to cut funding to

(04:42):
these already struggling hospitals. This is an immigration problem. This
is not a health care problem.

Speaker 1 (04:49):
So what you need to.

Speaker 2 (04:49):
Do is, if you want fewer illegal immigrants going to
the emergency departments, you need to have fewer illegal immigrants
in the country. Well, as we know, the border was
quite wide open under the Biden It's somewhat closed now
under the Trump administration. But still there are a lot
of illegal immigrants here in the country.

Speaker 1 (05:06):
So what to do about them?

Speaker 2 (05:08):
Well, they can't say we're not going to pay for
the hospitals. If the hospitals are providing care for these patients,
as they are legally obligated to do, you have to
pay them because Americans will suffer if these small hospitals close.
So this is a big problem, and this is something
that needs to be discussed because the last thing we
need are even fewer hospitals in underprivileged areas. Thanks for

(05:31):
listening to Wellness Unmasks. I'm doctor Nicole Soffire. This was
your weekly rundown. I know it's all confusing, but at
the end of the days, Republicans and Democrats they are
arguing semantics and it is all about the migrants that
have come here who have gottenn asylum, they're refugees. Should
they be eligible for Medicaid and other taxpayer funded subsidies.

Speaker 1 (05:52):
Well, that's a question. We should put it to the polls.

Speaker 2 (05:55):
Something tells me, since President Trump was elected, that the
people are going to say, no, we want our taxpayer
dollars to be more in our pockets than going to
some of these other people.

Speaker 1 (06:07):
That's my take. Hope you listen next time.

Speaker 2 (06:10):
You can listen to Wellness on Mouse with doctor Nichole
Sapfire on iHeartRadio or wherever you get your podcasts, and
I'll see you next time.