With two days left in their session, House Republicans prepare to vote on a health care plan.
The roots of Obamacare.
They've gotten so deep that it's no longer possible to just pull it out at the root and start over.
So what is Speaker Mike Johnson planning?
I'm Steve Inskeep with Michelle Martin, and this is Up First from NPR News.
The president's chief of staff, Susie Wiles, offers a behind-the-scenes look at the White House in a Vanity Fair story.
What did she say about the administration and the people in it?
And the Trump administration is fast-tracking new nuclear reactor designs.
Some safety advocates are worried about the government's approach to regulation.
This is not okay, and this is not going to lead to success.
This is how to have an accident.
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Congress has two days to take action on health care subsidies before lawmakers head out of the Capitol for the holiday recess.
The enhanced subsidies for Affordable Care Act marketplace plans will expire at the end of this year.
Millions of Americans can expect their premiums to increase by thousands of dollars and some plan to drop their coverage.
There is no sign of anything that Congress will do about it, although the House plans a vote today.
NPR congressional reporter Sam Greenglass has been tracking this story from Capitol Hill.
He's with us now.
Good morning, Sam.
Hey, Michelle.
So these subsidies, which some 22 million Americans get, have been in place since the pandemic.
Now, we know that without them, premiums could double or triple.
So why are we down to the wire here on addressing this?
Well, Michelle, there is not consensus about how to extend the subsidies.
And among Republicans, there is disagreement about whether to extend them at all.
Now, the deadline to sign up for plans on the Affordable Care Act marketplace has passed now.
And some people have said they'll forego insurance because they can no longer afford the premiums.
The Congressional Budget Office estimates next year 2.2 million people may lose their coverage.
Tell us more about the fault lines here.
Is it strictly along party lines?
No, not exactly.
Democrats want to simply extend the subsidies for three years.
A vote to do that failed in the Senate last week, though it did attract four Republican votes.
Now, Republicans have their own proposals to cut health costs.
Senate Republicans came up with a plan to deposit up to 1500 in health savings accounts for high-deductible ACA plans.
That also failed last week.
Republican leaders in the House are setting up a vote today on their own plan, but neither of these two Republican measures would extend the subsidies.
What do you expect in the House today?
So this House bill is a package of ideas long favored by conservatives to cut health costs, like association health plans and new regulations for pharmacy benefit managers, but they would not do much to prevent the ACA plan premiums from spiking next year.
You know, since the ACA passed 15 years ago, Republicans have tried to repeal and replace it.
House Speaker Mike Johnson says the new aim is reduce and repair.
The roots of Obamacare, the Unaffordable Care Act, have gotten so deep in the system that it's no longer possible to just pull it out at the root and chop it off and start over.
It's too deeply ingrained.
And so now we have to take it step by step to reduce and repair, reduce cost and repair the system.
Johnson says subsidies are just expensive taxpayer handouts to insurance companies.
But there are some moderate Republicans who do want to preserve the subsidies, at least temporarily.
What happened to that effort?
A dozen or so House Republicans have been vocally pushing to extend the subsidies.
Some have for a vote to tack them onto Johnson's bill.
There are also efforts to maneuver around leadership using a tool called a discharge petition, but none have enough support so far.
And some of these Republicans have been fuming this week.
Republican Congressman Mike Lawler slammed GOP leadership for blocking a vote on the subsidies and Democratic leaders for insisting on a three-year extension without reforms to sway Republicans.
It is idiotic and shameful This place is disgraceful.
Everybody wants the upper hand.
Everybody wants the political advantage.
They don't actually want to do the damn work.
So down to the wire here, Sam, any changes likely?
Bipartisan talks are still happening among some rank-and-file senators, but most lawmakers have acknowledged a solution is not going to happen this year, which means premiums for many Americans are going to shoot up on January 1st.
NPR congressional reporter Sam Greenclass.
Sam, thank you.
Thank you.
The White House chief of staff offered some edgy assessments of President Trump and others in the administration.
Susie Wiles gave her opinions, not in some passing remark, but in months' worth of interviews.
The resulting article in Vanity Fair illuminates a woman who rarely made headlines up to now.
She has acted as the president's facilitator.
Since before the inauguration, she's also been ducking out of White House meetings to tell a reporter how Trump's White House works.
NPR White House correspondent Danielle Kurtzleben is here to talk about that fallout.
Good morning, Danielle.
Hey, Michelle.
So what was in this piece that got so much attention?
Well, for one thing, Wiles openly described several conflicts within this White House.
For example, when Elon Musk started gutting USAID.
Wiles says she was aghast and argued with him about how he was doing it.
She also talks about disagreements on tariffs and how she and Vice President J.D.
Vance initially tried to get Trump to back off of announcing that big round of tariffs in April.
But in addition, Wiles is just blunt about people.
She calls Vance a conspiracy theorist whose conversion from anti to pro-Trump was.
Quote sort of political
And she really pointedly criticizes Attorney General Pam Bondi for her initial handling of Jeffrey Epstein disclosures.
Well, that sounds like she really gave her unvarnished take on things.
I mean, I guess some people think that she was being harsh.
Yeah, some people do.
And this really got a lot of attention on social media because of it.
But there's a lot of nuance here, really.
The picture that emerges is that you have all these personalities in that White House, some of whom yeah, aren't described 100 percent glowingly, but that Wiles is this no-nonsense force just herding them all together in the service of Trump's agenda.
And even when it seems here like she might have criticized Trump, the truth is just more complex.
For example, there's a quote that got a lot of attention where she said Trump has an alcoholic personality.
But in context, what she was saying is that Trump has a big, exaggerated personality and that he quote operates with a view that there is nothing he can't do.
Well, that's news to no one.
Yeah, I think we knew that.
Well, so how is the White House responding to this?
Well, Wiles was not happy.
She did a rare social media post calling this a hit piece, saying that she thought the article was trying to quote paint an overwhelmingly chaotic and negative narrative.
And Trump officials have circled the wagons, too.
Trump even did a specific interview on this with the New York Post.
And he backed up Wiles and even agreed with that alcoholic line, saying that yeah, while he doesn't drink, he does have an addictive personality.
Vance also defended Wiles yesterday.
You know why I really love Susie Wiles?
Because Susie is who she is in the president's presence.
She's the same exact person when the president isn't around.
I've never seen Susie Wiles say something to the president and then go and counteract him or subvert his will behind the scenes.
He also blamed the news media.
But again, this was more than a year's worth of interviews, meaning Wiles agreed repeatedly to give Vanity Fair this access.
OK, so quickly, Danielle, the Trump administration at war with the media is not a new thing.
So why is this such a big deal and why the concerted pushback?
Well, first of all, like you said that, it's just rare for Wiles to talk to reporters and be this unfiltered.
Secondly, the drama got attention, as drama does.
But beyond all that, there's the context that the administration has been trying to focus on the economy.
Here we see just how easily that can be derailed, just as Trump himself did earlier this week when he disparaged the slain liberal film director Rob Reiner.
Now tonight, the White House is going to try to get back on course with the primetime address, which is expected to focus on the president's first-year wins.
NPR's Danielle Kurtzleben.
Danielle, thank you.
Thank you.
The Trump administration has ambitious plans for nuclear power.
Yeah, a program unveiled earlier this year is supposed to get nuclear reactors up and running just months from now.
NPR's Jeff Brumfield has been looking at the program and why some are worried about it.
Jeff, good morning.
Thanks so much for joining us.
Good morning, Michelle.
So let's start by talking about this program.
What is it and what does it do?
It's called the Reactor Pilot Program and it's fast-tracking 11 brand-new reactor designs by nuclear startup companies.
The goal here is to have at least three running by the nation's 250th birthday on July 4, 2026.
And to say that's ambitious is like really an understatement.
Nuclear reactors normally take years to build.
The new program is being run by the Energy Department.
And in a meeting in June department officials told company leaders they were ready to do whatever they could to help.
Here's Energy Department lawyer Seth Cohen.
It's whatever.
We need to ensure that the government is not stopping you from reaching criticality on or before July 4th 2026.
Okay.
OK, so what does Attorney Cohen mean by stopping these companies?
Why would the government stop them?
Well, I mean, historically, it's come down to one word, which is safety.
The U.S. has one of the strongest nuclear regulators in the world.
It's called the Nuclear Regulatory Commission.
And some of these companies think that the NRC has been too strict.
They think the Energy Department will be easier to work with.
One company is Valor Atomics.
It's run by a guy named Isaiah Taylor.
And he told me the NRC just isn't the right regulator for these new reactor designs.
The NRC is not built for R&D.
It's built for it.
You need to come to us with a plant that is 100% ready to build all over the United States.
So Valor is part of this energy department program, and Taylor says it's just what they need.
Private nuclear companies can do RD again in real hardware with real neutrons you know real uranium and then get ready for commercialization.
But many safety advocates are really worried about this approach and they're particularly worried that the NRC has no direct oversight.
So why do these safety advocates think the Energy Department is the wrong regulator?
Well, first of all, the Energy Department has just far fewer staff devoted to reactor safety.
It also hasn't really regulated commercial reactors much in the past.
On top of that, its mission is to develop nuclear power.
Alison McFarlane is a former NRC chair under the Obama administration.
She calls that a conflict of interest.
You cannot promote and regulate nuclear.
McFarlane and other critics of the program told me they're very worried that safety was being sacrificed for speed.
This is not okay, and this is not going to lead to success.
This is how to have an accident.
Now just one thing to note these are small test reactors, so if there is an accident it won't be like Chernobyl or anything huge, but it could still hurt workers or the local environment.
Well, that still sounds concerning.
So what does the Energy Department say about that?
It told NPR that it quote upholds the highest standards of safety in our work with the nuclear industry.
It also said NRC staff are working with the department to ensure safety and that it's still shooting for that July 4th deadline.
Four companies of the 11 have already presented their preliminary designs, and approvals could come early next year.
That is NPR's Jeff Brumfield.
Jeff, thank you.
Thank you.
And let me note here that Amazon and Google are financial supporters of NPR.
And that's Up First for Wednesday, December 17th.
I'm Michelle Martin.
And I'm Steve Inskeep.
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Act two, the drink.
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