“Ex-President Donald Trump’s past electoral triumph and potential re-entry into the White House may lead to significant alterations in the country’s public health insurance schemes. These changes may increase the number of uninsured individuals and introduce new obstacles to abortion and other reproductive health services.
The impact of these changes would be experienced well beyond Washington, D.C., possibly leading to a decay of the Affordable Care Act’s consumer protections. There could be the introduction of work stipulations in Medicaid, funding slashes to the safety net insurance, and challenges posed to federal agencies that protect public health. Moreover, restrictions on abortion might tighten nationwide, with potential efforts to limit the distribution of abortion medications via mail.
With the potential inclusion of vaccine skeptic Robert F. Kennedy Jr. into Trump’s advisory circle, scientifically-backed public health interventions, such as public water supply fluoridation or child vaccination, could face serious challenges.
Trump’s triumph could offer a wider platform to those skeptical or critical of federal health programs and actions. In the worst-case scenario, public health authorities fear an increase in preventable diseases, a decline in public confidence in established science, and the adoption of debunked theories, such as a link between vaccines and autism, as policy.
While Trump has declared that he will not attempt to repeal the Affordable Care Act, his administration would need to decide next year whether to support an extension of enhanced premium subsidies for Obamacare insurance plans.
In terms of policy, details have not progressed much beyond the “plan concepts” Trump mentioned during his debate with Harris. However, Vice President-elect JD Vance indicated that the administration would aim to introduce more competition into ACA marketplaces.
The ACA has gained public support, including provisions such as preexisting condition protections and allowing young adults to remain on family health plans until 26. Supporters of Trump and those who have worked in his administration assert that the ex-president aims to enhance the law in ways that will lower costs.
Potential efforts to weaken the ACA could involve cutting funds for enrollment outreach, allowing consumers to buy more health plans that do not comply with ACA consumer protections, and permitting insurers to charge higher premiums to sicker individuals.
Trump’s circles have already suggested possible leaders for the Department of Health and Human Services, including former Louisiana Governor Bobby Jindal and Seema Verma, who managed the Centers for Medicare & Medicaid Services during the Trump administration.
Trump’s future plans for reproductive health rights remain somewhat unclear. He has stated that decisions about abortion restrictions should be left to the states. Potential moves could include restricting access to abortion medications.
KFF Health News is a national newsroom producing comprehensive journalism about health issues. It is one of the primary operational programs at KFF, an independent source of health policy research, polling, and journalism.”
