Former President Donald Trump is promising to make the Affordable Care Act (ACA) “much better, stronger, and far less expensive” if he wins the presidential election in November. He denies wanting to terminate the ACA and states his intention to improve it. This has rekindled the debate on the future of Obamacare, with President Joe Biden arguing that Trump wants to take away health care coverage from millions of Americans.
During his administration, Trump made various changes to the ACA, but most were minor and did not significantly alter the law. His efforts were limited by Congress and the popularity of key ACA provisions like protections for people with preexisting conditions and allowing children to stay on their parents’ plans. Despite this, there were noticeable impacts, such as a decline in sign-ups followed by a rise amidst the COVID-19 pandemic, and insurers returning to the exchanges.
The Trump administration’s actions to weaken Obamacare included cutting the open enrollment period, reducing the advertising budget, and funding for enrollment assistance. Additionally, federal payments that helped reduce deductibles for low-income participants were eliminated, leading insurers to raise premiums. Trump also promoted alternative policies with lower premiums but fewer benefits and protections, such as short-term plans and association health plans.
Trump’s efforts to undermine the ACA included eliminating the individual mandate, supporting a court challenge to the law’s constitutionality, and allowing states to impose work requirements for Medicaid enrollees. His administration also implemented stricter rules for income verification and special enrollments, which some experts criticized as undermining the law. Despite these actions, the ACA remains in place, as the Supreme Court dismissed the challenge to its constitutionality.
Trump has made promises to improve the ACA if re-elected, but he has not outlined specific plans to achieve this goal. However, with the Biden administration reversing many of his actions and the ACA becoming more popular since Trump’s tenure, it may be challenging for him to make significant changes to the law. The current administration states that a record of 45 million people now have coverage through the ACA exchanges or Medicaid expansion, highlighting the law’s importance and popularity.
