Anyone talking about Haley Stevens?

No, no, they're not.

You know, the campaign, you know, Abdul said one thing about him, I think, gets a little lost in the press coverage, in part because so much of what you see nationally are people asking him questions.

When he gives his speeches, he is relentlessly focused on the affordability issues, the kitchen table.

You know, he's got that slogan, right? You know, money out of politics, money in your pocket, Medicare for all.

That's what he was talking about.

He was talking about the momentum they feel like they have going in.

Or are they talking about kitchen table issues and being able to afford groceries?

OK, Jonathan, how do you explain this huge jump in health care costs across the board? Who's going to feel it the most? I don't think people realize this is coming.

Yeah, now, well, a lot of people don't realize it's coming.

People who are looking, they're about to see their check for new insurance options through the ACA are certainly going to see it coming.

You know, within the ACA market itself, it's about 20 million people.

We are seeing partly the effects of an exodus from that market, people leaving because of course, everybody remembers Donald Trump and the Republicans did not extend those extra subsidies that were making coverage there more affordable.

And because of that, we're seeing people leave, a lot of healthy people leaving the pool and that drives premiums up.

But that's not the only story here.

What would that look like, Jonathan? What would their plan be? How long would it realistically take for anyone to get any relief here?

So we will charge you like a fee, a fee for doing that.

Yes, exactly.

Exactly.

So over time, you know, the cost of running has started to come down, as you would expect, because, you know, there's a startup cost.

Now you're past the startup cost.

And, you know, year to year, we saw with the first Trump administration, the Biden administration, they lowered that cost.

fee going forward.

You found him quite pragmatic.

So we will charge you like a fee, a fee for doing that.

Yes, exactly.

Exactly.

So over time, you know, the cost of running has started to come down, as you would expect, because, you know, there's a startup cost.

Now you're past the startup cost.

And, you know, year to year, we saw with the first Trump administration, the Biden administration, they lowered that cost.

fee going forward.

Yeah.

So we will charge you like a fee, a fee for doing that.

Yes, exactly.

Exactly.

So over time, you know, the cost of running has started to come down, as you would expect, because, you know, there's a startup cost.

Now you're past the startup cost.

And, you know, year to year, we saw with the first Trump administration, the Biden administration, they lowered that cost.

fee going forward.

You found him quite pragmatic.

Jonathan, you've been writing about this.

Yeah, I mean, that is an amazing ad to run.

It's especially amazing when you consider there are also ads running in Detroit targeting the black community, saying that El-Sayed is not there for black voters and does not care for black voters and does not care about them and expects black voters to vote for him because black voters traditionally vote Democratic.

So we have two sets of ads running simultaneously online.

One that's saying, you know, the Democrats, they're anti-white.

We have another set simultaneously saying the Democrats are anti-black.

I think there's a message here, which is that this is what desperation looks like.

So, Jonathan, how do you think that the voters of Michigan will hear that answer?

I mean, you know, I think the voters of Michigan are not happy about these tariffs.

And Mike Rogers knows that.

Right.

Because he went from supporting them, saying they were masterful and saying Canadians were we should be having this trade war with Canada because they've been a poor trading partner to now.

He's sort of walked that back.

Now he's got an ad out where he's sitting in a bar with a hockey game on, you know, a bat.

red strings yeah

Jonathan, are these $500 checks really a refund as Trump describes it?

No, they're- they're not at all a refund.

Look, when they created the Affordable Care Act, you know, 15, 16 years ago, they understood they were creating a new insurance market, and it was gonna take money to run this market, right? You have to, you have to create a website, and you have to maintain it, and you need to hire staff to work with insurance companies, watch out for fraud.

You need to do outreach and education.

That last part's really important, right? Because you wanna make sure everybody who's eligible for this coverage and this financial assistance knows about it.

And of course, if you bring more people into the system, it works better, works more smoothly, actually brings premiums down for everybody.

So to pay for that, the- the law sort of assesses a small fee on insurers, start out at about 3%, uh, of premiums.

It may be nonsense and- and not an accurate [laughs] e- explanation of what's unfolded over the last few years, but do you see evidence out there that there's at least a- a- a significant, um, portion of voters who are moved by something like this, who, you know, they can easily conceptualize what they would do with $500, with $5,000, while it might be harder to, say, conceptualize what an 8 to 10% hike, uh, in the cost of your employer health care plan is going to look like for you in 2027?

on

the show.

Yeah, 30,000 foot view.

I mean, what an interesting race we have here, right? So, you know, the magnification of the Michigan...

I feel like, you know, Michigan has been in so many ways this microcosm of what we're seeing happen nationally, politically, and I don't need to tell the two of you about this, obviously, but the sort of change in the Republican Party here.

I mean, I'm old enough, I've lived here long enough to remember when the Republicans were a more moderate party.

You know, I'm a student of history, right? I think a lot about Going back to, like, the Romney era of, you know, the sort of moderate Republicans here.

Well, what's your take on that issue in this race? Is it an issue? Is it being overblown in terms of its effect here? What do you think?

And this one got particularly personal, perhaps unsurprisingly last night.

It did.

It got incredibly personal, and it got personal I think because, you know, this is the issue landscape, uh, that you see in Michigan right now on, you know, Trump is deeply unpopular.

Trump's policies are deeply unpopular.

Mike Rogers will not win if this is a referendum on the issues, if it's a referendum on Trump.

So he has to change the subject and try to kinda build up all these associations of, you know, people who are related to El-Sayed, who may have worked for an organization that later was investigated because some money went, you know, to some groups overseas.

I mean, there was one particular moment I thought was so telling.

That is a huge change in less than two years.

So Jonathan, this $500, where is it coming from?

Yeah, so look, when they created the Affordable Care Act, you know, they knew they were creating these new insurance market.

It was gonna take money to run them, right? You have to set up and maintain a website.

You gotta pay staff to work with the insurance companies and watch for fraud.

You wanna do enrollment outreach and, and counseling, right? This is the new offering.

You wanna make sure people know there's insurance available.

They can get financial assistance.

Is it a bribe?

Is it a winning message? Do Republicans have the ability to get back on board with this?

Well, Republicans are desperate to, if they can't turn this into a winning issue, then make it not such a losing issue for them.

But it's a tough call, you know, because they have a record to defend.

In the last year, what did we see Republicans do? Well, they enacted a trillion dollar in cuts to Medicaid, largest cuts to Medicaid ever.

They had a chance to extend those extra Affordable Care Act subsidies.

They've refused to do so.

As a result, health insurance for 20 million people got more expensive.

What about Donald Trump giving out $500 checks as an Obamacare dividend?

Yep

... hard work to, to, to, to maintain a website.

So they...

Congress set aside money, um, you know, for the technical upkeep, and also, and this is really important, they set aside money for outreach, for education, uh, so people would know, you know, know about the fact that, you know, there's insurance available.

And, and for people who might have trouble working their way through the system, I mean, health insurance, we all know, is very complicated.

Um, people who have complex conditions trying to figure out what kind of insurance to get, what kind of assistance they're eligible for, there's money for all of that.

Now, the money comes from what they're calling a user fee.

What do we actually know is going on right now?

Jonathan, did you come away convinced that she would be independent?

No, I came away convinced that she would not be independent.

Look, she's a doctor.

She knows the science.

And yes, when asked in a congressional hearing, is it safe and pressed, right, by Cassidy and Sanders, they have to really press them to get the answer out of her.

She says, yes, it is safe.

No, it is not lethal.

What are your thoughts on the administration's handling of this outbreak at this stage? And if there is any chance of what's happening being brought back from the brink?

Why did he get them, Roger Marshall?

Well, he got loud boos in Kansas, and, you know, if you had someone making an address about that here in Michigan, you'd get even louder boos.

Look, I mean, there's a time and a place, you know, you can make the case for tariffs to protect a specific industry.

You're the victim of un- unfair trade practices.

That is not what we're seeing here.

These, these tariffs that Trump has imposed, they are arbitrary.

Um, they, they seem to, uh...

Uh, the woman saying that what is the one cost that surprised her? She said beef, now it is a luxury.

What sort of world are they trying to live in?

I don't know.

I mean, it is a, a bit dystopian when you think about it in the sense that if indeed any of this were to escape, and I... and, you know, what you were talking about in one of the prior segments is, you know, we, we need the equivalent of a SALT treaty, you know, to contain the risks, the very real risks that this could get out of control, whether it's the grid, whether it's the water supply, whether it's launch, you know, uh, if an agent swarm launches a drone swarm that's military in nature.

You can have a, a, an enormous event take place in the world.

Why did he get them, Roger Marshall?

Well, he got loud boos in Kansas, and, you know, if you had someone making an address about that here in Michigan, you'd get even louder boos.

Look, I mean, there's a time and a place.

You know, you can make the case for tariffs to protect a specific industry.

Did this stand out to you?

It did.

I mean, first of all, terrific story from Sarah.

We've all covered health pods.

We've seen hospital chains engage in this very aggressive debt collection before.

You don't hear a lot of doctors doing it or doctor offices doing it.

And look, I don't know how much, you know, Senator Marshall knew about this at the time.

But is an 18% interest rate on outstanding debts, is that within the realm of normal?

Jonathan, what has this led to?

Yeah.

Well, you know, that is the one kind of spending cuts that Republicans get very excited about, which is money helping people to pay for food or healthcare.

Um, and we are now in the process of seeing a massive retrenchment on health insurance.

Remember, during the Obama years, during the Biden years, they passed the Affordable Care Act.

Um, Biden strengthened the Affordable Care Act.

We saw mil- tens of millions of people get healthcare.

Medically speaking, though, is it a big number?

Uh, you've been paying very close attention to Michigan, but does it help Mike Rogers when you have the president comparing part of his state, a very crucial part of his state, to the Third World?

Um, well, I don't think it does.

Um, and I think more important, I think what, what Peter was just, uh, was saying is so important, which is that, um, you know, they're attacking him as communist or a socialist or whatever label they're gonna throw at him, um, because on the actual issues that El-Sayed's gonna try to raise, they're in trouble.

Um, you know, Abdul El-Sayed, he's gonna talk about healthcare.

He's gonna say, "I was a doc- you know, I'm a doctor.

I was public health director.

I got people healthcare.

Uh, if the general election were held today, who do you think would win?

Wow, I mean, uh, you know, the, if you believe the polls that are out right now that we have, the polling now says that, you know, Mike Rogers would win that race.

Now the asterisk there is that [laughs] the polls also said, uh, Abdul El-Sayed was gonna win by double digits, and they were quite wrong.

You know, I think we can't know based on the polling yet because we have not seen two things.

Number one, we've not seen Abdul El-Sayed under scrutiny, under attack from a Republican attack.

We're starting it already.

I mean, literally 20 minutes after he was declared the winner, the Republicans were up with an ad, the one you quoted, cited, um, attacking him as a communist.

El-Sayed will be weak, will perform weak, uh, with Jewish voters, uh, in Michigan? They are an important constituency.

Is the Medicare for All messaging resonating within the Democratic base, what you're seeing from voters there, and could it actually transcend party affiliation?

Yeah, so there's absolutely no question that the Medicare for All message has gained in popularity.

People talk about it.

The really important asterisk on this, I think, is that when, you know, Abdul El-Sayed, he's a very good advocate for this.

I mean, he's a doctor.

He's an epidemiologist.

He wrote a book on this subject.

There it is.

Jonathan Cohn runs the Democrat-eccentrist group Third Way.

Hasan Piker is unknown to most Americans who determine elections.

Swing independent voters had never heard of Hasan Piker.

The ones who have wouldn't like him.

He's known and popular among a very small subset of young people who are super online and very radicalized.

Fine, have at it.

That's how he makes a living.

Why did you think it was important to do that?

Why did that happen?

When we started the race, I think a lot of people nationally thought, you know, they looked at the profile, and they thought, "Okay, you have El-Sayed, you know..." Or I, I'm gonna say real quick, I'm gonna call them all by their first names 'cause we call them all by their first names here.

They're all pretty young candidates.

It's Abdul, Mallory, and Haley.

Um, not meant as a term of disrespect, just I sort of fall into that habit.

Um, I think a lot of people who, um, watching this nationally, you looked at the profile, and Mallory just sort of seemed like the obvious perfect compromise between these two extremes, right? So you have this progressive who can really inspire people, but a little, you know, maybe too extreme for the electorate.

You have this, this classic Michigan workhorse who can get stuff done, but really not a great communicator, not someone who's gonna inspire a lot of people.

Okay.

Yeah.

We had this whole debate.

I mean, the Affordable Care Act, when it came into, you know, when we, when it was enacted, helped millions to get coverage and helped some people save money, but the coverage was still really expensive.

So then Biden and the Democrats came in, added some money to the program.

It made insurance cheaper.

Millions signed up, and people who already had insurance were able to get better coverage to reduce their copays, reduce their deductibles.

And then we had this debate: Should we keep the money going? Trump administration didn't wanna do it.

What about the way that we may hear Republicans defend when they are pressed, whether it's at town halls or just by constituents or by reporters, on what the impact of this legislation ultimately has been? They might say, "Okay, well, the drop in Obamacare enrollment is in part because of a crackdown on fraud." Is there truth to that?

But also, you know, this is in real time, yes, saying things about COVID or saying things both in his diary but also publicly that turned out not to be true, because, I think anyway, this was a fast-evolving situation, and they were simply doing the best they could as they went.

Yeah.

Jonathan, I couldn't agree more.

I mean, I think we've been a little memory-holing what it was like in those early months of the pandemic.

It was chaos.

Nobody knew what was going on.

Health providers were overwhelmed.