grapple

WASHINGTON — The first caller on a telephone town hall with Maryland Rep. Andy Harris, leader of the House’s conservative Freedom Caucus, came ready with a question about the Affordable Care Act. Her cousin’s disabled son is at risk of losing the insurance he gained under that law, the caller said.

“Now she’s looking at two or three times the premium that she’s been paying for the insurance,” said the woman, identified as Lisa from Harford County, Md. “I’d love for you to elucidate what the Republicans’ plan is for health insurance?”

Harris, a seven-term Republican, didn’t have a clear answer. “We think the solution is to try to do something to make sure all the premiums go down,” he said, predicting Congress would “probably negotiate some off-ramp” later.

His uncertainty reflected a familiar Republican dilemma: Fifteen years after the Affordable Care Act was enacted, the party remains united in criticizing the law but divided on how to move forward. That tension has come into sharp focus during the government shutdown as Democrats seize on rising premiums to pressure Republicans into extending expiring subsidies for the law, often referred to as Obamacare.

President Trump and GOP leaders say they’ll consider extending the enhanced tax credits that otherwise expire at year’s end — but only after Democrats vote to reopen the government. In the meantime, people enrolled in the plans are already being notified of hefty premium increases for 2026.

As town halls fill with frustrated voters and no clear Republican plan emerges, the issue appears to be gaining political strength heading into next year’s midterm elections.

“Premiums are going up whether it gets extended or not,” said GOP Sen. Rick Scott. “Premiums are going up because healthcare costs are going up. Because Obamacare is a disaster.”

‘Concepts of a plan’

At the center of the shutdown — now in its fourth week with no end in sight — is a Democratic demand that Affordable Care Act subsidies passed in 2021 be extended.

Trump has long promised an alternative. “The cost of Obamacare is out of control, plus, it’s not good Healthcare,” he wrote on Truth Social in November 2023. “I’m seriously looking at alternatives.”

Pressed on healthcare during a September 2024 presidential debate, Trump said he had “concepts of a plan.”

But nearly 10 months into his presidency, that plan has yet to come. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, told NBC on Wednesday, “I fully believe the president has a plan,” but didn’t go into details.

Republicans say they want a broader overhaul of the healthcare system, though such a plan would be difficult to advance before next year. Party leaders have not outlined how they’ll handle the expiring tax credits, insisting they won’t negotiate on the issue until Democrats agree to end the shutdown.

A September analysis from the nonpartisan Congressional Budget Office estimated that permanently extending the tax credits would increase the deficit by $350 billion from 2026 to 2035. The number of people with health insurance would rise by 3.8 million in 2035 if the credits are kept, CBO projected.

House Speaker Mike Johnson told a news conference Monday that the tax credits are “subsidizing bad policy.” Republicans “have a long list of ideas” to address healthcare costs, he said, and are “grabbing the best ideas that we’ve had for years to put it on paper and make it work.”

“We believe in the private sector and the free market and individual providers,” he added.

A growing political issue

With notices of premium spikes landing in mailboxes now and the open enrollment period for Affordable Care Act health plans beginning Nov. 1, the political pressure has been evident in Republican town halls.

In Idaho, Rep. Russ Fulcher told concerned callers that “government-provided healthcare is the wrong path” and that “private healthcare is the right path.” In Texas, freshman Rep. Brandon Gill responded to a caller facing a sharp premium increase by saying Republicans are focused on cutting waste, fraud and abuse.

Harris echoed a message shared by many in his party during his Maryland town hall, saying costs are “just going back to what it was like before COVID.”

But the number of people who rely on Affordable Care Act health insurance has increased markedly since before the pandemic. More than 24 million people were enrolled in the marketplace plans in 2025, up from about 11 million in 2020, according to an analysis from the health care research nonprofit KFF.

Sara from Middleville, Mich., told Rep. John Moolenaar during his town hall that if health insurance premiums go up by as much as 75%, most people will probably go without healthcare. “So how do you address that?” she asked.

Moolenaar, who represents a district he handily won last year, responded: “We have time to negotiate, figure out a plan going forward and I think that’s something that could occur.”

Some Republicans have shown urgent concern. In a letter sent to Johnson, a group of 13 battleground House Republicans wrote that the party must “immediately turn our focus to the growing crisis of health care affordability” once the shutdown ends.

“While we did not create this crisis, we now have both the responsibility and the opportunity to address it,” the lawmakers wrote.

Some Republicans dismiss projections that ACA premiums will more than double without the subsidies, calling them exaggerated and arguing the law has fueled fraud and abuse that must be curbed.

Many Democrats credited their ability to flip the House in 2018 during Trump’s first term to the GOP’s attempt at repealing Obamacare, and they’re forecasting a similar outcome this time.

About 4 in 10 U.S. adults say they trust the Democrats to do a better job handling healthcare, compared with about one-quarter who trust the Republicans more, a recent AP-NORC poll found. About one-quarter trust neither party, and about 1 in 10 trust both equally, according to the poll.

A looming internal GOP fight

Even as GOP leaders pledge to discuss ending the subsidies when the government opens, it’s clear that many Republican lawmakers are adamantly opposed to an extension.

“At least among Republicans, there’s a growing sense that just maintaining the status quo is very destructive,” said Brian Blase, the president of Paragon Health Institute and a former health policy advisor to Trump during his first term.

Michael Cannon, director of health policy studies at the libertarian Cato Institute, said he’s working with multiple congressional offices on alternatives that would let the subsidies end. For example, he wants to expand the Affordable Care Act exemption given to U.S. territories to all 50 states and reintroduce a first-term Trump policy that gave Americans access to short-term health insurance plans outside the Affordable Care Act marketplace.

Cannon declined to name the lawmakers he’s working with, but said he hopes they act on his ideas “sooner than later.”

David McIntosh, president of the influential conservative group Club For Growth, told reporters Thursday that the group has “urged the Republicans not to extend those COVID-era subsidies.”

“We have a big spending problem,” McIntosh said.

“I think most people are going to say, OK, I had a great deal during COVID,” he said. “But now it’s back to business as usual, and I should be paying for healthcare.”

Cappelletti and Swenson write for the Associated Press. Swenson reported from New York.

In the aftermath of the devastating floods that swept through the Texas Hill Country in Texas in the United States, a tight-knit community is mourning the loss of at least 110 lives to flash flooding – including 27 at Camp Mystic, an all-girls summer camp situated along the Guadalupe River.

Camp Mystic bore the brunt of the floodwaters, but the region is home to several popular sleepaway camps and youth facilities serving families from across Texas, including Hill Country Youth Ranch. Tony Gallucci, who has lived in the area for more than 40 years, works there.

“We’re gonna have some clearing [of debris like fallen trees] to do, we’ve got a log jam and that kind of stuff,” Gallucci said. “We do have one road [in their facilities] that buckled; it’ll have to be repaired.”

The ranch sits uphill from the river, unlike Camp Mystic, where 2.4 metres (8ft) of water filled cabins with sleeping campers in the early morning hours of July 4, and the Guadalupe River rose more than six metres (20ft) in two hours. Among the dead is camp director Dick Eastland, who perished trying to save the girls from the rushing floodwaters.

Flash flooding is a recurring threat in this part of Texas. The Hill Country, including Kerr County where the camp is located, has thin soil and limestone bedrock that limits rain from soaking into the ground, funnelling it quickly into rivers and creeks. Storms fuelled by gulf moisture and clashing air masses often drop several inches of rain in a short span, overwhelming the terrain.

That was the case last week, as deep tropical moisture in the wake of Tropical Storm Barry, which had just struck southern Mexico, fuelled intense rainfall. The Guadalupe River has flooded catastrophically in the past, with notable incidents in 1978, 1987 and in 2002, raising longstanding concerns about the vulnerability of riverside camps. Because this risk is well known, the latest tragedy has renewed scrutiny over what went wrong – and whether it could have been prevented.

A policy problem

Earlier this year, the Department of Government Efficiency (DOGE) cut 600 positions at the National Weather Service (NWS) – the agency tasked with forecasting storms and issuing warnings. As a result, many local offices lack the staff needed to adequately inform the public. In Houston, 30 percent of NWS positions remain vacant.

“Accurate weather forecasting helps avoid fatal disasters. There are consequences to Trump’s brainless attacks on public workers, like meteorologists.” Connecticut Senator Chris Murphy said in a post on X.

However, both the San Antonio and San Angelo NWS field offices, which oversee forecasting for the region that includes Kerr County, were adequately staffed at the time of the flash floods, and the office actually had more staff than usual, with five people on duty instead of the typical two.

Murphy’s office did not respond to Al Jazeera’s request for comment.

The NWS issued a flash flood watch at 12:41am Central Time (05:41 GMT), warning that “excessive runoff may result in flooding of rivers, creeks, streams, and other low-lying and flood-prone locations. Creeks and streams may rise out of their banks”.  As conditions worsened, a flash flood warning was issued at 1:14 am, and a flash flood emergency was declared after 5:30am local time.

Still, Tom Fahy, legislative director for the National Weather Service Employees Organization, told The New York Times that the San Angelo office remains understaffed overall, missing a forecaster, a meteorologist-in-charge, and a senior hydrologist. Fahy did not respond to Al Jazeera’s request for comment.

The recent job cuts by DOGE could hinder the ability of NWS offices nationwide to predict and respond to future severe weather events. There are additional reductions to the NWS included in the tax bill signed into law by President Donald Trump last week.

The legislation rescinds funding for the National Oceanic and Atmospheric Administration (NOAA), which oversees the NWS. Those changes were drafted by the Senate Committee on Commerce, Science, and Transportation, chaired by Texas Senator Ted Cruz.

“Only a shameless and soulless partisan hack would tie the One, Big, Beautiful Bill to the Texas floods. The funds rescinded had nothing to do with weather forecasting, but were instead used for ‘heat awareness’ campaigns, ‘Green Collar jobs,’ creating a climate resilience plan based on an Indian tribe’s ‘traditional knowledge’ of weather, building a new visitor’s center at an aquarium, and ‘citizen science’ around fishing. None of the rescinded funding was obligated for any existing operations or forecasting activity,” Macarena Martinez, communications director for Senator Cruz, said in a statement.

The bill actually includes funding for additional “Weather Observing Systems” but only specifies those to be set up at airports. The legislation also maintains current funding levels for the NWS.

“After getting a 41 percent increase in its budget in the last decade, NOAA now spends roughly $3bn annually on weather forecasting, research, and related infrastructure. Even the Biden administration had proposed to cancel millions in future radar research, in part because much of the project has already been completed and would explain why, after nearly three years, the funds remained unspent. There’s simply more productive ways to be faithful stewards of public money and improve weather forecasts than continuing to overfund every possible NOAA account,” Martinez added.

The Biden administration proposed cuts to NOAA in March 2024. The Trump administration’s fiscal year 2026 proposal would cut funding for climate research, which would cut the development of new weather forecasting technologies that would, contrary to Cruz’s claims, impact weather forecasts.

The White House did not respond to Al Jazeera’s request for comment.

Poor flood infrastructure

Texas has increased funding for flood-related infrastructure projects in recent years, but those efforts have largely been reactionary rather than preventive.

“The loss of life is tragic. While we can’t predict every storm, we do everything we can to prepare. Texas is strong and takes every disaster seriously,” Coalter Baker, head of the Gulf Coast Protection District (GCPD), a state-funded agency responsible for coastal resiliency planning, told Al Jazeera.

The Texas Gulf Coast has experienced some of the most devastating flooding events in US history. After Hurricane Harvey – a storm in August 2017 so intense that the NWS had to add new colours to its rainfall maps – the state created the Texas Infrastructure Fund. Since the fund’s launch, it has allocated roughly $669m in funding, though only one project was located in Kerr County.

“After Tropical Storm Allison in 2001, we invested in flood prevention that still protects us today. Hurricane Ike in 2008 led to the Coastal Texas Project – the largest US Army Corps of Engineers effort ever – to defend our coast and communities. And after Hurricane Harvey in 2017, we created a first-of-its-kind flood infrastructure fund to reduce future risk. We’ll keep working – federal, state, and local – to protect lives, homes, and our economy,” said Baker, who previously served in the Trump administration and worked in the Texas Office of State-Federal Relations alongside Governor Greg Abbott.

But in this part of Texas – more than 480 kilometres (300 miles) inland – flood infrastructure improvements haven’t materialised.  According to a new Houston Chronicle investigation, Kerr County, where the affected camp is located, requested state funding three times to improve its flash flood warning system. The state rejected its requests.

Instead, the state deferred the responsibility to the county. Kerr County Judge Rob Kelly told The New York Times taxpayers would oppose providing local funding because of the cost.

In April, the Upper Guadalupe River Authority (UGRA), a state-funded government agency, granted a more than $72,000 contract to develop a flood warning system despite concerns being raised almost a decade ago. The UGRA did not respond to our request for comment.

This comes as the Texas state house failed to pass a bill this year that would have improved the state’s emergency communication infrastructure. Among those who voted against the bill was Representative Wes Virdell, who represents Kerr County. Virdell did not respond to our request for comment.

Following the recent floods, Texas Lieutenant Governor Dan Patrick said the state will now pay to install a flash flood warning system, despite the state previously denying such requests.

“That’s going to be one of the issues that we begin to address in less than two weeks in the state legislature. We’re going to address every aspect of this storm to make sure that we’re going to have in place the systems that are needed to prevent deadly flooding events like this in the future.” Governor Greg Abbott said in a news conference on Tuesday.

Abbott’s office did not reply to Al Jazeera’s request for further details.

When asked about the current system, Judge Kelly told reporters at a Friday news conference, “We do not have a warning system.”

“This is the most dangerous river valley in the United States, and we deal with floods on a regular basis. When it rains, we get water. We had no reason to believe that this was going to be anything like what’s happened here. None whatsoever.”

Kelly did not respond to Al Jazeera’s request for comment.

Texas did not release its first statewide flood plan until last year.

Washington, DC – For Anson, hearing the news that Chinese student visas were the latest target of US President Donald Trump’s administration was “heartbreaking”.

The Chinese graduate student, who is studying foreign service at Georgetown University, told Al Jazeera that he feels uncertain about the future of students like himself after US Secretary of State Marco Rubio announced the US would begin to “aggressively revoke visas for Chinese students, including those with connections to the Chinese Communist Party or studying in critical fields”.

“There is definitely a degree of uncertainty and anxiety observed amongst us,” Anson said, asking that only his first name be used.

The Trump administration has offered little further clarity on which students would be affected, with some observers seeing the two-sentence announcement, which also vowed to “revise visa criteria to enhance scrutiny” for future visa applicants from China and Hong Kong, as intentionally vague.

While 23-year-old Anson said he understood the US government had concerns about foreign influence and national security when it came to China, he was confused as to why the Trump administration’s new policy was potentially so wide reaching.

Most students from his homeland, he said, were just like the other more than one million students who study every year in the US, a country that is known both for its educational opportunities and for its “inclusivity and broad demographics”.

“It is heartbreaking for many of us to see a country built by immigrants becoming more xenophobic and hostile to the rest of the world,” he said, adding that he and other Chinese students in the US were still trying to decipher the policy shift.

‘Greater and greater suspicion’

It is not the first time the Trump administration has taken aim at Chinese students, with the US Department of Justice in 2018, during Trump’s first term, launching the so-called “China Initiative” with the stated aim of combatting “trade secret theft, hacking, and economic espionage”.

An MIT analysis instead showed the programme focused predominantly on researchers and academics of Chinese descent, in what critics said amounted to “racial profiling and fear mongering”. It was discontinued in February 2022 by the administration of former US President Joe Biden.

Since then, there has only been “greater and greater suspicion in the US, almost on a bipartisan basis, of various aspects of Chinese technology, actions by Beijing around the world, and now these concerns about surveillance and spying within the US”, according to Kyle Chan, a researcher on China at Princeton University.

That included a Republican-led congressional report in September 2024 that claimed hundreds of millions of US tax dollars – funneled through US-China partnerships at universities – helped Beijing develop critical technologies, including those related to semiconductors, artificial intelligence, hypersonic weapons, and nuclear capabilities.

But Chan, while acknowledging “genuine security concerns” exist, said the broad announcement from the Trump administration did not appear to actually address those concerns.

Instead, it has sent “shock waves of fear throughout university campuses across the country”, he said.

That uncertainty has been compounded by Trump’s recent pressure campaigns on US universities, which most recently involved a since-blocked revocation of Harvard University’s ability to enrol international students.

“I think the vagueness is part of the [Trump administration’s] strategy, because it is not about a concrete policy,” Chan told Al Jazeera. “I don’t think it’s really, at the end of the day, about national security and trying to find the few individuals who may pose a genuine risk.”

Instead, he saw the move as aimed at Trump’s political audience, those sitting at an “overlap between people who are very anxious about immigrants in general, and people who are very anxious about China”.

‘Tremendous disruption’

The administration has offered little clarity on the scope of the visa revocations, or how it will define students with “connections to the Chinese Communist Party or studying in critical fields”.

Speaking to reporters on Thursday, State Department spokeswoman Tammy Bruce gave few further specifics, saying only that the department “will continue to use every tool in our tool chest to make sure that we know who it is who wants to come into this country and if they should be allowed to come in”.

“The United States, I further can say here, will not tolerate the CCP’s exploitation of US universities or theft of US research, intellectual property or technologies to grow its military power, conduct intelligence collection or repress voices of opposition,” she said.

Despite the dearth of clarity, the eventual shape of the policy will determine just how “disruptive” it could be, according to Cole McFaul, a research analyst at the Center for Security and Emerging Technology at Georgetown University.

He pointed to “real concerns about research security and about illicit IP [intellectual property] transfer” when it comes to Beijing, noting there have been a handful of documented cases of such activity in recent years.

“My hope is that this is a targeted action based on evidence and an accurate assessment of risk that takes into account the costs and the benefits,” McFaul said.

“My worry is that this will lead to broad-based, large-scale revocations of visas for Chinese students operating in STEM subjects,” he said, referencing the abbreviation for science, technology, engineering and mathematics.

McFaul noted that about 80 percent of the estimated 277,000 Chinese students who study in the US annually are in STEM subjects, in what he described as “an enormously important talent pipeline from China to the United States for the past 40 years”.

A vast majority of Chinese PhDs in STEM subjects – also about 80 percent – tend to stay in the US after their studies, in what McFaul described as another major benefit to the US.

“The question is, what counts as someone who’s working in a critical technology? Are life sciences critical? I would say ‘yes’. Are the physical sciences critical? I’d say ‘yes’. Is computer science critical? Is engineering critical?” McFaul said.

“So there’s a world where the vast majority of Chinese students are disallowed from studying in the United States, which would be an enormous loss and tremendous disruption for the United States science and technology ecosystem,” he said.

‘Generating unnecessary fear’

As the policy remains foggy, Chinese students in the US said they are monitoring the often fickle winds of the Trump administration.

Su, a 23-year-old applied analytics graduate student at Columbia University, said she swiftly changed her plans to travel home to China this summer amid the uncertainty.

“I was afraid if I go back to China, I won’t be able to come back to the US for when classes begin,” said Su, who asked to only use her last name given the “sensitive” situation.

“When Trump announces something, we never know if it’s going to be effective or not,” she told Al Jazeera. “It’s always changing”.

Deng, a graduate student at Georgetown who also asked that his full name not be used, said he broadly agreed that reforms were needed to address issues related to Chinese influence in US academia.

Those included intimidation of political dissidents, the spread of nationalist propaganda, and “oligarchy corruption”, he said.

But, in an email to Al Jazeera, he said the administration’s approach was misguided.

“The current measures not only do not achieve such goals,” he said, “but [are] also generating unnecessary fear even among the Chinese student communities that have long been fully committed to the development and enrichment of US society.”