President-elect Donald Trump’s return to the White House and likely Republican control of Congress pose big risks to people’s ability to access and afford health coverage in Medicaid and the marketplaces. While Republicans have moved away from talking about their plans for changing health coverage in the U.S. as “repeal,” Trump’s first term and Republicans’ recently released policy agendas suggest they may pursue policies that would have much the same result: higher costs for people, reduced access to care for vulnerable groups, and more people who are uninsured.
It’s not clear what will unfold, but there are reasons to be alarmed. Trump spent his first term as President trying to repeal the Affordable Care Act (ACA) through legislation, rule changes, and the courts. (The ACA vastly increased health coverage by expanding Medicaid and providing financial help for people who lack other affordable coverage, such as through an employer, via private health plans that meet federal benefit standards and consumer protections.)