The “Concept of a Plan” President Trump Proposed to Replace the ACA
Trump has long talked about making the ACA less expensive, but the question is less expensive for whom
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Trump has long talked about making the ACA less expensive, but the question is less expensive for whom
What do new Census Bureau data say about the uninsured? The uninsured rate remained at a near historic low of 8.0 % in 2023, per the Current Population Survey.
This election is a choice in health between aggressive incrementalism and a sharp right-hand turn in federal policy and spending, but ... no one should doubt the capacity of our system and institutions to thwart dramatic change in any direction.
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).
In a new column, President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”
In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."
So far in 2025, ACA Marketplace enrollment has more than tripled since 2020 in at least 6 states: Texas, Mississippi, Georgia, Louisiana, West Virginia, and Tennessee. All of these states were won by President Trump.
Vance’s debate comment likely refers to state reinsurance waivers, largely approved by the Trump Administration. These waivers aimed to lower unsubsidized premiums by offsetting insurer costs for very sick enrollees.
It is worth a refresher on how the ACA protects people with pre-existing conditions. It’s also worth asking whether and how an alternative would do the same.
With Election Day just over a month away, here is a timeline of significant ACA moments.
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