Rural Healthcare Is At Stake In The Shutdown Fight | Crooked Media
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October 15, 2025
What A Day
Rural Healthcare Is At Stake In The Shutdown Fight

In This Episode

A federal judge halted the Trump administration’s efforts to get rid of roughly 4,000 federal workers during the shutdown on Wednesday. And yet while courts try to stop the Trump administration from axing government workers, hundreds of thousands of federal employees are going without paychecks. And the Affordable Care Act subsidies Democrats are fighting for are what stands between millions of Americans and even higher health care prices. To discuss how the shutdown and the subsidies fight are affecting rural Americans, I spoke to Wisconsin Democratic Sen. Tammy Baldwin.
And in headlines, Department of Homeland Security blows a wad of cash on Kristi Noem-inspired propaganda, Trump confirms he’s authorized CIA action in Venezuela. And Operation Summer Heat! No it’s not a new Baywatch spin-off – it’s Trump’s and FBI director Kash Patel’s latest crackdown on crime.
Show Notes:

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TRANSCRIPT

 

Jane Coaston: It’s Thursday, October 16th. I’m Jane Coaston, and this is What a Day, the show that, for once, totally agrees with President Donald Trump. 

 

[clip of President Donald Trump] I want to thank Stephen Miller who’s right back in the audience right there. I’d love to have him. I love watching him on television. I’d love to have him come up and explain his true feelings, but maybe not his truest feelings. That might be going a little bit too far. 

 

Jane Coaston: Donald Trump and Jane Coaston, two people who do not want to hear the truest feelings of White House Deputy Chief of Staff Stephen Miller. [music break] On today’s show, Trump confirms he’s authorized CIA action in Venezuela. And Operation Summer Heat. No, it’s not a new Baywatch spinoff. It’s Trump’s and FBI Director Kash Patel’s latest crackdown on crime. But let’s start with week two of the government shutdown. Active duty military did get paid on Wednesday, but some air traffic controllers are getting partial paychecks, while folks struggling with homelessness are unable to get the paperwork they need for emergency housing in some cities. And Congress is still stuck in a stalemate centered on extending Affordable Care Act tax credits due to expire at the end of the year. On Wednesday, a federal judge halted the Trump administration’s efforts to do its second favorite thing, behind posting memes on official government social media accounts. Firing federal employees. In response to a request from unions representing government workers, a U.S. District judge issued a temporary restraining order to stop Trump from getting rid of roughly 4,000 workers. The judge said that the firings were, quote, “politically motivated,” and pointed to statements like this from Trump last week. 

 

[clip of President Donald Trump] And we’ll be making cuts that will be permanent. And we’re only gonna cut Democrat programs. I hate to tell you, I guess that makes sense. But we’re only cutting Democrat programs. We’ll be cutting some very popular Democrat programs that aren’t popular with Republicans, frankly, because that’s the way it works. They wanted to do this, so we’ll give them a little taste of their own medicine. 

 

Jane Coaston: Yeah, that does sound pretty politically motivated. And yet while courts try to stop the Trump administration from axing government workers, hundreds of thousands of federal employees are going without paychecks. And the ACA subsidies Democrats are fighting for are what stands between millions of Americans and even higher health care prices. So to talk more about how the shutdown and the subsidies fight are affecting rural Americans, I spoke to Wisconsin Democratic Senator Tammy Baldwin. Senator Tammy Baldwin, welcome back to What a Day. 

 

Tammy Baldwin: It is great to join you again. 

 

Jane Coaston: So we are just over two weeks into the government shutdown. How have the conversations you’ve been having with Republican colleagues changed as this shutdown has kept on going and going and going? 

 

Tammy Baldwin: Yeah, well, what I’ll tell you is it’s more common for me to hear from some of my Republican colleagues that they want a solution to this issue of the Affordable Care Act tax credits sunsetting at the end of the year um that they’re hearing from constituents. What hasn’t changed is they’re not being really loud and public about it and and expressing the sort of urgency that we are. I hear from constituents on a daily basis who are so anxious, so worried about what these massive increases in healthcare costs are gonna mean for them and their families, their businesses, their communities. You know, I I can’t believe that some of my Republican colleagues don’t have a stronger sense of urgency. Um. But I will see, you know, I’m seeing cracks in the dam. It was, I think, last week when Marjorie Taylor Greene said that her two adult children got their notices of what their premiums are gonna cost. And she’s like, oh my God, they’re not gonna be able to afford health insurance. We’ve got to do something. Well, I need more of my Republican colleagues uh to speak loudly and with urgency about the need to fix this. We need to reopen the government and we need to lower costs for health care for Americans. 

 

Jane Coaston: I’ve been really struck by how the ACA subsidies issue impacts so many people who live in rural areas and so many people who may have voted for Republicans. And I’m curious about healthcare in rural Wisconsin in particular. What does coverage and access look like for people in those parts of your state? 

 

Tammy Baldwin: So right now it’s devastating between the results of what Donald Trump calls his big beautiful bill and what we call his big ugly bill, but the trillion dollars, nearly trillion dollars in cuts to Medicaid, combined with the the potential for the Affordable Care Act premium tax credits to expire at the end of this year is devastating for rural Wisconsin. I talked to Phil, a farmer in northwestern Wisconsin just earlier today. And he among other things, grows soybeans. The market for soybeans is extremely challenging right now, not in no small part because of Trump’s tariff and policies, but he’s losing money for every acre he plants. And on top of that, he’s in the Affordable Care Act marketplace for his insurance and knows that his insurance prices are gonna go up dramatically next year if Congress doesn’t act. And he does not know how he’s gonna make it or what he’s gonna do about healthcare coverage in this environment. And then yesterday I was in conversation with rural access critical access hospital in also in northwestern Wisconsin, and they have the thinnest of margins. They’ve done the math on how the big ugly bill is going to impact their hospital. It’s probably gonna cut into their margin uh by, you know, cut it 50%. And then they have not yet uh figured out how much additional damage is going to be done if people lose their Affordable Care Act coverage. But certainly a not insignificant number of their patients are on the Affordable Care Act marketplace insurance policies, and therefore they’re gonna come in or not, they’re gonna come in uninsured and sick, therefore the hospital will incur losses, or they’re not gonna come in and uh they won’t have you know paying customers, if you will. The the impact on rural Wisconsin is extremely uh harmful right now. And uh we’ve got to reverse the health care crisis that Donald Trump and Republicans created. 

 

Jane Coaston: Just under 18,000 federal employees live in Wisconsin. And I think that that’s something people kind of forget about the shutdown is that federal employees live pretty much everywhere. And they might be in Madison or Whitewater or anywhere else in Wisconsin. What’s your message to those constituents, some of whom are missing paychecks or at risk of getting laid off entirely because the administration thinks it’s fun to just mess with them. 

 

Tammy Baldwin: Yeah so number one, I want the government to reopen as much as anyone does. And this was so preventable. I voted seven times to reopen the government and bring down healthcare costs for Wisconsinites. And um they are painful. And of course, Donald Trump is choosing to make it even more painful by threatening to not uh do back pay, which by the way, back pay is in the law, a law he signed in 2019 after the last major shutdown. Um. And so it is painful, and I just want to acknowledge that. It is also painful, worrisome, anxiety-provoking for all the people in Wisconsin, well over a quarter million who will get their premium notices in the mail, most likely next week, telling them how much it’s going to cost to keep their health care. And so this is a fight worth having. Wisconsinites are talking to me every day about how worried they are that they’re not going to be able to protect their own health, their family’s health, to keep their small businesses open, to keep their farm going. Uh. These are are are difficult choices, but this is a fight worth having. 

 

Jane Coaston: If Democrats are able to get the ACA subsidies extended and reverse the Medicaid cuts, healthcare is still a massive issue. 

 

Tammy Baldwin: Yes. 

 

Jane Coaston: What do you think Congress needs to address next to make healthcare more affordable and accessible for everyone? 

 

Tammy Baldwin: It’s such a great question. And this is the issue that brought me to run for office in the first place. I wanted to help set policy on healthcare because I’ve seen how many lives have been ruined by a broken system. Um. One of the first things that I think is so important is transparency. And I know that doesn’t sound like a solution to the problem, but you can’t follow the dollars. There are middlemen taking so much money out of the system. And think about in pharmaceuticals. You know, the pharmaceutical company sets the price, and then there’s these mysterious things called PBMs, pharmacy benefit managers, who are setting discounts and uh and rebates and all these things. And we don’t have a way of lifting that veil and seeing where all those dollars are going. So when a pharmaceutical company say doubles the cost of an epi pen from $100 to $200, no one can tell us where the money goes. The same is happening in health insurance. You get a bill, if your insurance pays for it, you probably don’t ask for itemization. But why is it that a procedure that in one place costs $1,000, someplace else costs $14,000? There’s an explanation there. And we’ve got to have transparency to get after the culprits in all of this. 

 

Jane Coaston: You mentioned earlier that you’ve been hearing from your constituents that they support you in this fight. And I think the polling kind of bears that out right now, that Republicans are getting blamed for the shutdown. But if the polling shifts and people start saying, like, hey, Democrats are kind of responsible for this shutdown, do you think that’ll shift your strategy? 

 

Tammy Baldwin: Yeah, this is not about polling, this is not about politics. This is about people. And that’s who I’m fighting for. The people who sent me to Washington, D.C. to be their voice. Not everyone can be here. I have the honor that they sent me here to be their voice, to be the one in the room fighting for their health care, fighting for the affordability of their health care. And so, yeah, this can’t be about polling and it can’t be about politics. But if my Republican colleagues continue to think about this as something that’s about polling and politics, then I want them to think about how their polls will look next year in the midterms when so many of their constituents have been thrown off their health care because they can’t possibly afford it. 

 

Jane Coaston: Senator Baldwin, as always, thank you so much for talking to me. 

 

Tammy Baldwin: Thank you for having me. 

 

Jane Coaston: That was my conversation with Wisconsin Democratic Senator Tammy Baldwin. We’ll get to more of the news in a moment, but if you like the show, make sure to subscribe, leave a five-star review on Apple Podcasts, watch us on YouTube, and share with your friends. More to come after some ads. [music break]

 

[AD BREAK]

 

Jane Coaston: Here’s what else we’re following today. 

 

[sung] Headlines.

 

[clip of President Donald Trump] Historically the summer months have been a time when violent crime soar, as you know, but not under President Trump. Today we’re announcing the results of a sweeping law enforcement effort known as Operation Summer Heat. 

 

Jane Coaston: Trump hit the mic Wednesday to hype up his administration’s latest tough on crime push. Standing side by side at a press conference with FBI Director Kash Patel and Attorney General Pam Bondi, Trump boasted that Operation Summer Heat netted over 8,700 arrests across the country since June. Patel announced with Resting Deer in the Headlights face that in just three months, the FBI and DOJ seized 2200 firearms and took 421 kilograms of fentanyl off the streets, claiming it was, quote, “enough to kill 55 million Americans.” The government offered no evidence for this claim. The president’s crackdown on crime came after he federalized police in Washington but before he attempted to deploy the National Guard in several other Democratic run cities. He said, quote, “I think we can make San Francisco one of our great cities,” and quote, “we have great support in San Francisco.” Only one of those sentences is true. Operation Summer Heat may be wrapping up but stay tuned for next season. When Trump and Patel team up this autumn for Operation Fall Guy. [pause] During that press conference Wednesday, Trump also acknowledged that he authorized the CIA to operate in Venezuela. Citing two reasons:

 

[clip of President Donald Trump] They’ve they’ve allowed thousands and thousands of prisoners, mental institution, people from mental institutions, insane asylums, emptied out into the United States. We’re bringing ’em back. But that’s a really bad and they did it at a level that probably not many, many countries have done it, but not like Venezuela. They were down and dirty. And the other thing of drugs, we have a lot of drugs coming in from Venezuela. And a lot of the Venezuelan drugs come in through the sea, so you get to see that. But we’re gonna stop ’em by land also. 

 

Jane Coaston: Quick thing! Is this going back to his seeking asylum is the same thing as a mental asylum thing? Anyway, all that to say immigration and drugs, but okay. Also, is it weird that the president of the United States is telling the world where he sent our spies? Remember when we were very worried about classified information being shared publicly? Ah. Memories. Trump steered clear of this question about the country’s authoritarian leader, Nicolás Maduro. 

 

[clip of unnamed news reporter] Does the CIA have authority to take out Maduro?

 

[clip of President Donald Trump] Oh, I don’t want to answer a question like that. That’s a ridiculous question for me to be given. Not really a ridiculous question, but wouldn’t it be a ridiculous question for me to answer? But I think Venezuela’s feeling heat. 

 

Jane Coaston: Summer heat, maybe? The revelation about the CIA authorization comes a day after Trump said the US had struck another small boat accused of carrying drugs in the waters off Venezuela, killing six people. It was the fifth deadly strike in the Caribbean as his administration has asserted it’s treating alleged drug traffickers as quote, “unlawful combatants who must be met with military force.” For all of the Trump administration’s cruel and chaotic spending cuts, there is at least one area where they’re more than happy to spend money, Department of Homeland Security propaganda. Just what America wanted, more Kristi Noem. According to a report from the analytics firm Ad Impact, DHS spent at least $51 million this year on ads where Homeland Security Secretary Kristi Noem thanks Trump for quote, “securing our border.” That’s the most money spent on any political ad campaign this year. And don’t worry, DHS is just getting started on this journey to burn cash. The two media companies hired to make these ads could eventually get paid $200 million from their contracts with DHS. But Noem’s efforts to bother as many Americans as possible did hit a roadblock this week. Airports in several major cities are refusing to air the video she made blaming Democrats for the government shutdown. 

 

[clip of Kristi Noem] It is TSA’s top priority to make sure that you have the most pleasant and efficient airport experience as possible while we keep you safe. However, Democrats in Congress refuse to fund the federal government, and because of this, many of our operations are impacted, and most of our TSA employees are working without pay. 

 

Jane Coaston: Look, airports are stressful enough, I don’t need to contemplate puppy murder in Terminal 2. Many of the airports that aren’t airing the Noem ad have cited policies against showing political messaging, because yeah. Fourteen U.S. States in Guam are teaming up to make a kind of miniature centers for disease control and prevention. You might ask, don’t we already have one of those at the federal level? Well, yeah, but this group worries that Health and Human Services Secretary Robert F. Kennedy Jr. has undercut confidence in the CDC’s core work. Shocking, right? That core work typically includes setting vaccine policies, monitoring disease outbreaks, and watching out for pandemics. Like one of those would ever happen again, right? The group announced the Governor’s Public Health Alliance on Wednesday. In a statement, Illinois Democratic Governor J.B. Pritzker said states and territories now have to protect their residents from a CDC that he calls a quote, “misinformation machine.” Technically, the alliance is bipartisan, but I’m 0% surprised that for now it includes states run by Democratic governors on the East Coast and their West Coast counterparts. Colorado’s in the middle, of course, and way west, the territory of Guam. The blue hue of the Alliance isn’t lost in the Trump administration. HHS spokesperson Andrew Nixon told the Washington Post that Alliance Locations supported unpopular COVID mask mandates and school closures, adding, quote, “The same governors who eroded that trust are trying to reinvent public health under the guise of coordination.” Yes, but none of them have been involved in decapitating a whale. So, there’s that. And that’s the news. [music break]

 

[AD BREAK]

 

Jane Coaston: That’s all for today. If you like the show, make sure you subscribe, leave a review, mourn a new study showing that no amount of alcohol is safe to consume and tell your friends to listen. And if you’re into reading and not just about how research published in BMJ Evidence Based Medicine found that even light alcohol consumption can increase the risk of dementia, like me, What a Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Jane Coaston and good news, with Trump’s tariffs, it’s probably cheaper not to drink alcohol anyway. [music break] What a Day is a production of Crooked Media. It’s recorded and mixed by Desmond Taylor. Our associate producers are Emily Fohr and Chris Allport. Our video editor is Joseph Dutra. Our video producer is Johanna Case. We had production help today from Greg Walters, Matt Berg, Sean Allee, Gina Pollack, and Caitlin Plummer. Our senior producer is Erica Morrison, and our senior vice president of News and Politics is Adriene Hill. We had help today from the Associated Press. Our theme music is by Colin Gilliard and Kashaka. Our production staff is proudly unionized with the Writers Guild of America East. [music break]