Trump's upcoming decision regarding government money for healthcare plans holds significant implications. The Affordable Care Act (ACA) and its associated subsidies have been a hot topic, with potential impacts on millions of Americans.

Trump's Healthcare Choice - A Battle for the Middle Class

Trump's Impact on Healthcare Subsidies

Trump will play a crucial role in deciding the fate of government money for healthcare plans. Letting the ACA subsidies expire could lead to savings for the government but could also result in higher premiums for the middle class. This decision will have a direct impact on the healthcare options available to people and families who rely on these subsidies.

President Joe Biden's enhanced ACA subsidies, which have been providing lower premiums and reduced out-of-pocket costs for Americans on Medicare and Medicaid, are set to expire in 2025. At that point, Trump and a Republican-led Congress will need to decide whether to renew or end these subsidies. The potential consequences of this decision are far-reaching.

Ending the subsidies would save the government money but could restrict healthcare options for those who need them. According to the Congressional Budget Office, nearly 4 million people could drop coverage in 2026 if the subsidies expire. This highlights the importance of this decision and its impact on the lives of millions.

The Affordable Care Act and Its Expansion

The Affordable Care Act, also known as Obamacare, was passed in 2010 and has had a significant impact on healthcare enrollment and access. It requires insurance companies to cover preexisting conditions and has boosted the number of people with federal insurance programs like Medicare and Medicaid.

Biden's expansion of the ACA has increased financial assistance for those already on ACA plans and lifted the income eligibility cap. This has made healthcare more accessible for some middle-class families who were previously priced out. Since 2020, the number of people with ACA marketplace coverage has grown by 88%, from 11.4 million to 21.4 million.

However, the future of these subsidies and the ACA itself remains uncertain. Trump's stance on healthcare and his cost-cutting agenda could lead to significant changes in the healthcare landscape.

The Cost-Cutting Agenda of Trump's Second Term

The US government spent $6.75 trillion in fiscal year 2024, with healthcare being a top expenditure behind Social Security. Medicare costs add another $874 billion. If the enhanced ACA subsidies were to become permanent, it would cost $335 billion over the next 10 years.

Tesla CEO Elon Musk and former GOP presidential candidate Vivek Ramaswamy have been tapped by Trump to lead a new Department of Government Efficiency. They plan to propose cuts for the government's most costly programs, including Medicare and Medicaid. Trump's nominees for the top healthcare positions, such as Robert F. Kennedy Jr. leading the Department of Health and Human Services and Dr. Mehmet Oz leading the Centers for Medicare and Medicaid Services, have not outlined specific plans for affordable healthcare.

In an opinion piece in 2020, Oz said he supports a universal healthcare plan, but this stance may be at odds with the Trump administration's cost-cutting agenda. Any move by Trump to change ACA policies would need congressional approval, and insurers need to submit their plan proposals next summer for the 2026 enrollment period.