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Trump Has No Health Plan, He Has the Art of the Health Care Deal

Trump Has No Health Plan, He Has the Art of the Health Care Deal

KFF CEO Dr. Drew Altman analyzes President Trump’s “make a deal” approach to health care. He explains that while the president doesn’t have a health reform plan, or even “concepts of a plan,” or a replacement for the ACA, he does have a distinctive set of tactics that features one-off deals with the health care industry that are more like “health policy by transaction.” He writes that the deals “even do some good,” but “don’t change the long-term incentives of health care companies that participate in the deals,” and a big question is “whether they have staying power.”

Affordable Care Act

Updated Larry QT on ePTCs

There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks

While the Affordable Care Act’s enhanced premium tax credits expired at the end of 2025, there is no absolute drop-dead date for extending them. An extension could happen even after the deadline to sign up for coverage and be made retroactive to January 1. Open enrollment could also be extended to allow people time to change their plans or allow new people to sign up. ACA enrollees would welcome premium relief whenever it comes, explains KFF's Larry Levitt.

ACA Signups Are Down, But Still an Incomplete Picture

Data currently being released represent Open Enrollment ACA Marketplace plan selections, or how many people have signed up for or been automatically renewed into 2026 coverage. These data do not necessarily translate to enrollments. That is because people who have selected a plan or been automatically renewed may not ultimately choose to pay for their coverage, thus “effectuating” their enrollment.

health system tracker
KEY RESOURCES

  • Health Policy 101: Costs and Affordability

    This Health Policy 101 chapter explores trends in health care costs in the U.S. and the factors that contribute to this spending. It also examines how health care spending varies and the impact on affordability and people's overall financial vulnerability.  


  • Americans’ Challenges with Health Care Costs

    This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.

  • National Health Spending Explorer

    This interactive Peterson-KFF Health System Tracker tool allows users to examine five decades worth of data on health expenditures by federal and local governments, private insurers, and individuals.

  • Polling on Prescription Drugs and Their Prices

    This chart collection draws on recent KFF poll findings to provide an in-depth look at the public’s attitudes toward prescription drugs and their prices. Results include Americans’ opinions on drug affordability, pharmaceutical companies, and various potential measures that could lower prices.

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  • Lessons From the Election About Voters and Health

    From Drew Altman

    In this column, KFF president and CEO Drew Altman explores why health costs weigh heavily among voters' economic concerns, even in an election where health was not a flashpoint. The need to reframe health as a pocketbook issue for voters will be central to the competition for the votes of working class Latino voters, two groups very focused on the cost of living.

  • Going It Alone: A Conversation About Growing Old in America

    Event Date:
    Event

    KFF Health News’ Navigating Aging columnist, Judith Graham, spent six months this year talking to older adults who live alone by choice or by circumstance — most commonly, a spouse’s death. They shared their hopes and fears, challenges, and strategies for aging solo. KFF Health News and The John A. Hartford Foundation held a 90-minute interactive, virtual event called “Going It Alone." The event featured frank conversation with five of the people featured in Graham’s series.

  • 2024 Calculadora del Mercado de Seguros Médicos

    Feature

    2024 Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés).

  • 2024 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2024 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

  • 5 Key Facts About Medicaid Coverage for People with Medicare

    Issue Brief

    The recently passed House budget resolution targets cuts to Medicaid of up to $880 billion or more over a decade to help pay for tax cuts. Major cuts to Medicaid may impact coverage for the almost 1 in 5 Medicare beneficiaries (12.2 million) who are also enrolled in Medicaid.

  • A Backlash Against Health Insurers, Redux

    Perspective

    In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.

  • Will the Trump Administration Fast Track the Privatization of Medicare?

    Policy Watch

    The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It's not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications for beneficiaries, health care providers and insurers, and is worthy of serious debate.