STEVE INSKEEP, HOST:
OK. We've talked about President Trump's political problem. He ran for office in 2024, promising to lower prices. Prices are not lower. People notice. This is an issue. Now another politician has this same challenge. Democrat Abigail Spanberger made affordability a key issue on the campaign when she won Virginia's governor's race last year, and now she's about to be put to the test. Here's Jahd Khalil with VPM News.
JAHD KHALIL, BYLINE: A few days after taking office, Governor Abigail Spanberger told Virginia lawmakers her rough plan for affordability.
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ABIGAIL SPANBERGER: When we talk about affordability, it's important to be clear about what we mean and why it matters.
KHALIL: She's focused on three areas in particular - housing, energy, and maybe her biggest hurdle, health care.
SPANBERGER: No Virginian should have to choose between filling a prescription and paying for groceries.
KHALIL: Health care can be expensive for sure, and this time next year, major federal cuts coming to Medicaid will drive up the price of care for states and individuals. One of Spanberger's biggest health care challenges, though, dates back to 2021. That's when Congress started subsidizing plans bought on the Affordable Care Act marketplace. Just under 400,000 Virginians use those subsidies, according to the state. But the subsidies expired in December, after months of being used as a political pawn. Spanberger put it this way in her speech.
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SPANBERGER: We watched as leaders in Washington sat on their hands and allowed premiums to skyrocket. Virginia families simply cannot afford to wait for Congress to act, so we are going to act first.
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SABRINA CORLETTE: Quite honestly, there's really no realistic way for a state to backfill the loss of federal funding.
KHALIL: Sabrina Corlette is with Georgetown University Center on health insurance reforms. She also used to advise Virginia's health care marketplace. She says states across the country, including Virginia, are feeling totally strapped.
CORLETTE: There just isn't enough money for a state to do that completely.
KHALIL: Corlette says there are a number of reasons why everyone will feel the ripple effects. One, if the newly uninsured end up in the emergency room, hospitals are required to treat them.
CORLETTE: And those costs are ultimately going to be shifted onto the rest of the health care system to people with private or employer-based insurance.
KHALIL: Spanberger says she wants to help certain demographics buy insurance on the marketplace, but hasn't released specifics yet. Regardless of what she proposes, with billions of federal dollars being cut from the health care system, a move to make ACA health care more affordable likely needs a new revenue source. One Democrat in the legislature has floated a tax on the richest Virginians.
That's not a solution Republicans like Virginia State Senator Mark Obenshain are interested in. He says health care subsidies need to be fixed in Washington.
MARK OBENSHAIN: Not by imposing higher tax burdens on the people of the Commonwealth of Virginia - it seems to be the answer to everything. Raise taxes to, you know, fix our health care system, raise taxes to fix the Metro in Northern Virginia. It's not fixing anything. It's exacerbating.
KHALIL: That's why Republicans say they are proposing tax relief mirroring policies in the One Big Beautiful Bill Act. Obenshain sits next to another Republican, State Senator Ryan McDougle, on the Senate floor. McDougle says he wants Democrats to sign on to Republicans' ideas for tax cuts.
RYAN MCDOUGLE: Work with us, make their groceries cheaper, make their energy bills cheaper and make life less expensive so that they have more money in their wallet.
KHALIL: Any changes Spanberger and Virginia Democrats make to push down the cost of living, including health care, likely won't get on the books until mid-summer. That gives voters across the country enough time before the November midterms to determine whether Democrats can figure out affordability. For NPR News, I'm Jahd Khalil in Richmond, Virginia.
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