Ratcheting up the Chaos
Allison Silberberg's Plain Talk
Ratcheting up the Chaos
By Allison Silberberg
October 17, 2025
We are now in the third week of the government shutdown. The madness continues. It does seem more and more like a mad King is in charge of our country.
As I wrote last week, the government shutdown comes down to where our priorities are and where our dollars are going, specifically with regard to health care. The Congress is supposed to have the power of the purse, but President Trump is taking over Congress’ domain with the help of the Republican majority in the Senate and the House. Health care is the reason the Democrats are not agreeing to Republican demands about ending the shutdown.
One of the most alarming actions thus far is how Trump is dismantling our nation’s health care system in a diabolical, dangerous, and destructive way. If you think this won’t affect you and your loved ones, that is not accurate.
Here is why we all should care strongly about the state of our health care system.
First, health care is critical for everyone. The health care system in our country is not perfect, but whatever we do have as a system is at serious risk due to Trump and the Republicans in Congress.
This morning, a friend had a medical emergency out of nowhere and was rushed into surgery. Thank goodness, he had insurance and access to immediate medical care so his life could be saved.
But what if this medical emergency had happened in a rural area of our country where health care is not easily accessible? The few hospitals that do exist in rural areas are closing or are on the verge of closing because of provisions in Trump’s so-called Big, Beautiful Bill (BBB). Many didn’t hear much about such consequences when the BBB was being debated and passed. That rural hospital issue is only one of the health-related effects of the BBB legislation.
The people of our country should be outraged and frightened.
At first, the BBB meant that Medicaid would take a big hit. That was horrible enough, as it would affect our nation’s most vulnerable. But wait, there is more. It’s not just the BBB causing chaos.
For many years, Trump and the Republicans have had a dream to kill the Affordable Care Act (ACA), also known as Obamacare. Even though the ACA is very popular, successful, and has helped over 20 million Americans get and keep health insurance, the ACA is about to take a nosedive because of Trump.
The premium subsidies for the ACA, which make the ACA affordable for millions of Americans, are due to expire at the end of this year unless the subsidies are extended by Congress.
Without this extension of the premium subsidies, millions of Americans will see their premiums skyrocket unless the Democrats convince the Republicans to provide the money for an extension of the subsidies. Thus far, Trump and the Republicans in Congress have said no.
If the Republicans get their way, millions of Americans will be forced to drop their health care coverage, and that in turn will make everyone’s premiums go up even more. Americans are already getting squeezed with expensive food prices and housing, as well as significant increases in homeowners and car insurance policies.
Further, as Americans lose their health insurance, emergency rooms will become even more chaotic and crowded. (Have you seen “The Pitt” on television? Their ER is packed!) The ER staffs will be overwhelmed because even more Americans will go to an ER for basic health care. They will have no choice. But someone with a stroke or heart attack, which is time sensitive, won’t be seen as quickly at an ER. As a result, they will suffer even more and will be more likely to succumb or have terrible long-term effects, costing them and their families and society far more. The situation is a death spiral.
Separate from the shutdown but hanging over all of us is the fact that even Medicare could be next on the chopping block. Unbeknownst to most Americans, Congress has a trigger whereby government funding for Medicare would need to be slashed if the deficit hits a certain threshold. So Medicare is at serious risk right now because the BBB has increased the deficit way too much. This is an automatic trigger that no one seems to be discussing. But Trump and the Republicans, especially Office of Management and Budget Director Russell Vought, know about this trigger.
We all pay into Medicare and EARN it as a benefit. It is not a gift, as some Republicans have alleged. Most Americans over 65 depend upon it. With Trump’s BBB, we have a serious disaster in the making for ALL Americans if Medicare is also cut due to the trigger.
About a dozen years ago, our nation was seriously contemplating some form of health insurance for all and ended up with the ACA law. Now, instead of maintaining what we have, Trump has put Medicaid and the ACA at risk, and Medicare for those 65 and older could take a direct hit as well. What a huge step backward for our health care system.
The Republicans are literally dismantling our health care system, putting us all at risk, and the Democrats are standing up to save our health care system. That is what this shutdown is really all about. And this is at the same time that the CDC and FDA and NIH staffs are being slashed, and important medical research that can cure diseases and save lives has lost federal funding.
The U.S. has been the world leader in medical research, and now our leading scientists are going to other countries to continue their research. Is this how we make America great again?
The budget should not be hashed out at the mercy of our health care. Leave our health care system alone. If it needs improving, then let’s work together to make it stronger for all Americans.
“No Kings Day” will be TOMORROW, Saturday, October 18th, in communities all over our country. Over 5 million Americans participated in the first “No Kings Day” over the summer. Tomorrow, there again will be “No Kings Day” rallies in all 50 states. This will be a national day of peaceful protest.
This week, Speaker Mike Johnson (R-Louisiana) stated that all who participate in this rally tomorrow are part of a “Hate America” movement, calling all protesters a bunch of Marxists and even terrorists.
Nothing could be further from the truth. I’m not a Marxist nor a terrorist. I’m an American. I love our beloved country, and I am committed to our Constitution, democracy, and the rule of law. That is why I and countless others will be at a “No Kings Day” rally.
We care deeply about our democracy, and we care deeply about our health care system. We demand that our elected representatives in Congress take back the powers that the Constitution guarantees them, including the power of the purse. We must restore the balance of power our founders set forth to ensure that America has a President, not a King.
And so I would ask Speaker Johnson, is every protester now a terrorist? Is that what you believe? Have you read the Bill of Rights about our freedom of speech? It is our right and responsibility to speak out.
#Trump #ChaosInAmerica #Democracy #Constitution #NoKingsDay
Allison Silberberg is a writer and public affairs/public policy consultant. She served as mayor of Alexandria, Virginia, 2016-2019. Her work includes working on staff on Capitol Hill for Senator Lloyd M. Bentsen (D-TX). She is the author of “Visionaries In Our Midst: Ordinary People who are Changing our World,” which hit #1 on Amazon’s List for Philanthropy & Charity. Her writing has appeared in The Washington Post, The Dallas Morning News, on PBS.org. To learn more, please visit: www.allisonsilberberg.com