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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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  • The Burden of Medical Debt in the United States

    Issue Brief

    This analysis uses government data to examine the burden of medical debt, including variations based on state, age, race and ethnicity, and health status. It estimates that people in the United States owe at least $220 billion in medical debt.

  • 3 Charts: Drug Prices in the United States

    News Release

    This post was updated to clarify that less than 10% of the nation's total health spending is spent on retail prescription drugs and does not include spending on drugs administrated by physicians or in hospitals.Prescription drug costs are a top concern for the American public.

  • What Would Another Trump Presidency Mean for Health Care?

    Perspective

    In a new column in JAMA Health Forum, Larry Levitt, KFF’s executive vice president for health policy, explores what a second Trump presidency might mean for health policy based on his record and remarks, including potentially weakening the Affordable Care Act, reducing federal Medicaid costs, and restricting access to abortion.

  • How Do Facility Fees Contribute To Rising Emergency Department Costs?

    Issue Brief

    With the high costs of emergency department visits of significant importance to consumers and policymakers, this analysis examines claims data from privately insured individuals with large employer health plans, to examine the role that facility fees play in rising cost of emergency care.

  • How Have Costs Associated With Obesity Changed Over Time?

    Issue Brief

    This analysis finds that, among people with large employer health plans, those with an obesity diagnosis on average have higher total and out-of-pocket spending than those without an obesity diagnosis. It also examines the cost of common surgical and pharmacological treatments for obesity.