Dear John,
Congressional discussions on extending the Affordable Care Act tax credits, which are set to expire Dec. 31, remain deadlocked as Congress begins its winter recess. Now, millions will see their premiums increase as a result: According to KFF, premium payments will more than double on average—some even quadrupling—for enrollees who were eligible for the tax credits. Without the extension, more and more ACA marketplace enrollees will drop their increasingly costly health insurance plans. This comes at a time when the ACA is more popular than ever—recent polls show that across the political spectrum, three quarters of voters support extending the tax credits.
House Speaker Johnson has promised a vote in January on a Democratic plan to extend the tax credits for three years. But given Republican opposition and Trump’s disinterest, in reality a compromise with Democrats appears dim. “While the enhanced ACA premium tax credits expire at the end of this year, there is no absolute drop-dead date for extending them,” said KFF’s executive vice president for health policy, Larry Levitt. “ACA enrollees would welcome premium relief whenever it comes.”
This is just one of the ways in which Republicans and the Trump Administration are failing when it comes to ensuring the viability of our entire healthcare system. In his latest attack on evidence-based healthcare this week, HHS Secretary Robert F. Kennedy, Jr. announced plans to restrict gender-affirming care for youth, including preventing Medicaid dollars from covering this care, and cutting off federal Medicaid and Medicare funding to hospitals that provide it. Given that virtually every hospital in the country relies on this funding to function, the proposal amounts to a federal ban.
Many of these hospitals are already facing closures, with the hundreds of billions of dollars in cuts to Medicaid under the Republicans’ so-called “Big Beautiful Bill.” Could this latest attack on transgender young people be the Administration’s way of deflecting attention from the disaster unfolding in real time for millions of families in need of healthcare?
However, if the years since the overturn of Roe v. Wade have taught us anything, it’s that restricting vital, life-saving healthcare is deeply unpopular—and it doesn’t always work. Continuing a trend that has persisted since 2022, this year’s #WeCount report from the Society of Family Planning finds that even as some states continue to clamp down on abortion access (including threatening healthcare providers and women with prosecution and prison), the number of abortions is increasing each year. This report finds that telehealth has been a critical lifeline for abortion access—accounting for 27 percent of all abortions performed in the U.S. in the first six months of 2025, a number that has steadily increased since the FDA first authorized telehealth abortion provision in 2021 at the height of the pandemic.
And in their latest gambit to restrict access to abortion pills, anti-abortion forces are trying to mobilize an unlikely force: the Environmental Protection Agency. In 2025, antiabortion policymakers introduced nine bills in seven states using deceptive claims about water pollution to target medication abortion—and now, they are trying to win federal regulations. The fact that there is literally zero evidence to support the claim that medication abortion is impacting U.S. waterways doesn’t seem to matter, nor the claims that expelled tissue from abortion is a risk to the environment. Are they serious? As Candace Gibson and Anna Bernstein with the Guttmacher Institute wrote, “Medical waste tissue from an abortion is identical to that of a miscarriage or even a heavy period.”
And as the hundreds of thousands of long-awaited Epstein files are released, we’ll be reporting on whatever evidence emerges about the cover-up. More than twenty years after the first reports of Epstein’s abuse and his network first surfaced, we know much of the horrific damage that has been done to the victims. But the big unanswered question is: how did so many people look the other way for so long? Whether it’s the powerful men who were abusing women, or the powerful men in the justice system who turned a blind eye, we won’t stop reporting and asking questions till victims and survivors have full accountability.
This holiday season, Ms. is wishing everyone resilience, hope, peace on Earth and goodwill to all people.
Onward,
