Paul Sanchez
During Donald Trump's presidency, the number of Americans without health insurance increased significantly. While the number of uninsured people declined during the Obama administration, this trend reversed under Trump, with estimates of the increase ranging from 2 million to over 3 million. This rise in uninsured rates was particularly notable among younger adults, racial minorities, and low-income individuals. Trump's policies and actions towards the Affordable Care Act (Obamacare), including shortened enrollment periods, funding cuts, and the effective repeal of the individual mandate, are considered significant contributors to the decrease in insured Americans.
| Characteristics | Values |
|---|---|
| Number of Americans without health insurance | Increased by 2 million, 2.3 million, or 3 million, depending on the source |
| Number of states with more uninsured people | 39 |
| Number of uninsured people in swing states | Increase of 440,000 |
| Number of uninsured people in swing states under Biden | Decrease of 580,000 |
| Number of Americans expected to be uninsured by 2034 | 16 million |
| Number of Americans without insurance in 2018 | 30 million |
| Number of Americans who lost insurance in Trump's first 3 years | 2 million |
| Number of deaths due to loss of health coverage | 3,399 to 25,180 |
| Number of Americans who gained health insurance through the ACA | 20 million |
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What You'll Learn
- The number of uninsured Americans rose by 2-3.2 million during Trump's presidency
- Trump's policies worked against Obama's Affordable Care Act
- Trump cut advertising budgets for the ACA by 90%
- Trump's tax cut legislation will increase the cost of certain doctor visits
- Trump's policies strained family budgets with medical bills
The number of uninsured Americans rose by 2-3.2 million during Trump's presidency
During Donald Trump's presidency, the number of uninsured Americans rose by between 2 million and 3.2 million. This increase in uninsured Americans reverses a consistent series of drops in the uninsured rate since the Affordable Care Act (ACA), also known as Obamacare, began taking full effect in January 2014.
Trump's administration worked against the ACA, attempting to dismantle it through various means. For example, Trump lowered the advertising budget for the ACA by 90%, slashed funding for enrollment assistance, and effectively killed the individual mandate. The open enrollment period was also significantly limited under Trump, making it more difficult for Americans to apply for coverage through the ACA's insurance marketplace.
The rise in the uninsured rate under Trump was most pronounced among younger adults, Blacks, Hispanics, and low-income people. This increase in uninsured Americans led to thousands of excess deaths.
Trump's policies and actions related to healthcare and insurance had both positive and negative impacts on Americans. On the one hand, Trump took action to lower drug prices, improve access to telehealth in rural and underserved communities, and increase Medicare payments to rural hospitals. On the other hand, his efforts to undermine the ACA and reduce federal rules and programs designed to protect patients from high healthcare costs contributed to the rise in uninsured Americans and increased financial strain on families.
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Trump's policies worked against Obama's Affordable Care Act
During his presidency, Donald Trump actively worked against the Affordable Care Act, also known as Obamacare. Trump's predecessor, Barack Obama, introduced the Affordable Care Act in 2010, and it provided health insurance coverage to an estimated 20 million people. However, Trump was a vocal critic of the Act, calling it "one of the greatest threats our country faces". He made repealing and replacing Obamacare a key part of his election campaign, promising that his plan would be "cheaper, better, and provide insurance for everybody".
Trump's efforts to dismantle Obamacare included slashing Medicaid, which provided health insurance coverage to millions of low-income adults. The Congressional Budget Office estimated that the proposed bill would cut $880 billion from Medicaid over a decade, resulting in 53 million Americans losing their health insurance. Additionally, Trump eliminated the Obamacare individual mandate, which required most Americans to have some form of health insurance or pay a tax penalty. This effectively removed the financial incentive for healthier people to purchase insurance, leading to a rise in uninsured rates, particularly among younger adults, blacks, Hispanics, and low-income individuals.
Trump also worked to reduce regulations and taxes associated with Obamacare. He eliminated costly taxes, such as the health insurance tax, the medical device tax, and the "Cadillac tax". He also provided states with more flexibility and relief from certain Obamacare regulations, including reinsurance waivers to help lower premiums. These actions were intended to lower costs and provide Americans with more choices and better care. However, critics argued that Trump's policies were based on the "free-lunch fallacy", promising lower costs while providing more benefits, which proved challenging to implement in practice.
The impact of Trump's policies was significant. Between 2016 and 2019, the number of Americans without health insurance increased by about 2.3 million, reversing the consistent decline observed during the Obama administration. This loss of health coverage was estimated to have led to thousands of preventable deaths. Furthermore, Trump's actions contributed to a looming healthcare crisis, with concerns about rising healthcare costs and significant cuts to Medicaid. Ultimately, Trump's attempts to replace Obamacare with his own plan, dubbed "Trumpcare", failed due to a lack of support and the complexity of overhauling healthcare for 320 million people.
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Trump cut advertising budgets for the ACA by 90%
During his presidency, Donald Trump cut advertising budgets for the Affordable Care Act (ACA), also known as Obamacare, by 90%. This reduction in funding for promotional activities aimed at enrolling eligible Americans in health law programs was part of a series of efforts to undercut the ACA.
The Trump administration's decision to cut the ACA's advertising budget resulted in a decrease from $100 million to $10 million. This reduction in spending on advertising and outreach activities was justified by officials citing "diminishing returns" and the belief that most Americans were already aware of the ACA. They argued that a substantial increase in promotional funding under the Obama administration did not lead to a significant rise in Obamacare sign-ups.
However, advocates of the health law expressed concerns that these budget cuts would negatively impact potential enrollees' ability to learn about the benefits of the ACA. They argued that promotional funds were necessary for reaching difficult-to-reach populations, who are crucial for the law's success. Additionally, other decisions made by the Trump administration, such as reducing the open enrollment period, could further depress enrollment.
The consequences of these actions were significant. Between 2016 and 2019, the number of Americans without health insurance increased by about 2.3 million, with an estimated total increase of over 3 million during Trump's presidency. This loss of health coverage led to thousands of preventable deaths. The rise in uninsured rates was particularly notable among younger adults, racial and ethnic minorities, and low-income individuals.
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Trump's tax cut legislation will increase the cost of certain doctor visits
During his presidency, Donald Trump passed sweeping tax-cut legislation that extended and made permanent the tax cuts enacted during his first term in 2017. While these tax cuts disproportionately benefit high earners, they also reduce spending on safety-net programs that aid low-income households. The Congressional Budget Office (CBO) estimates that lower-income Americans will see their resources fall by $1,200 annually.
The legislation, dubbed the "One Big Beautiful Bill", includes provisions that benefit wealthy Americans, such as expanding the estate tax exemption and extending a tax cut for the highest income bracket. Additionally, it seeks to offset the cost of tax cuts with significant cuts to Medicaid and SNAP (the Supplemental Nutrition Assistance Program, formerly known as food stamps). These cuts could deal a blow to low-income earners, especially those who rely on these programs.
The CBO also reported that the federal budget deficits caused by Trump's tax and spending law could lead to automatic cuts to Medicare if Congress does not intervene. Medicare, the federal health insurance program for Americans over 65, could face up to $491 billion in cuts from 2027 to 2034. While Trump and Republicans pledged not to cut Medicare, the estimated $3.4 trillion added to the federal deficit over the next decade puts Medicare programs at risk.
The impact of Trump's tax cuts on the cost of doctor visits is complex and varies across different income groups. While high-income earners benefit from the tax cuts, low-income households may face reduced access to safety-net programs like Medicaid and SNAP, which could increase their out-of-pocket costs for healthcare, including doctor visits. Therefore, it is reasonable to conclude that Trump's tax cut legislation could increase the cost of certain doctor visits, particularly for low-income individuals who rely on safety-net programs for their healthcare needs.
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Trump's policies strained family budgets with medical bills
During his presidential campaign, Donald Trump pledged to "make America affordable again" and "expand access to new Affordable Healthcare". However, Trump's policies have had the opposite effect, with millions of Americans losing health insurance and facing higher medical bills.
Between 2016 and 2019, the number of Americans without health insurance increased by about 2.3 million, and this loss of coverage led to thousands of deaths. This trend continued, with an estimated 3.2 million more uninsured people in 2017, and a further 3 million in 2018. The rise in uninsured rates was most significant among younger adults, racial minorities, and low-income communities.
Trump's budget proposals included substantial cuts to health and housing assistance for low- and moderate-income families. The budget embraced the ACA repeal bill, cutting funding for health coverage programs and eliminating the ACA's expansion of Medicaid to low-income adults. The Trump administration also proposed cuts to SNAP benefits, affecting unemployed, elderly, disabled, and low-income working families with children. These cuts to federal health spending, amounting to over $1 trillion over the next decade, will result in millions more uninsured people and increased medical debt for those who cannot afford the rising costs.
Trump's efforts to undercut the Obamacare law, which had led to a consistent series of drops in the uninsured rate, have had detrimental consequences for Americans' health coverage and financial well-being. The repeal of the individual mandate, which required most Americans to have insurance or pay a fine, is expected to result in 13 million more uninsured people in the next decade. The reduction in protections from medical debt will strain family budgets, hinder their ability to access loans, and negatively impact their credit scores.
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Frequently asked questions
Yes. The number of insured Americans decreased by about 2 to 3.2 million in the first year of Donald Trump's presidency.
By the last quarter of 2017, the uninsured rate stood at 12.2% of adults, an increase of 1.3 percentage points since the last quarter of 2016.
The loss of health coverage led to at least 3,399 deaths and possibly as many as 25,180.
There were a series of efforts to undercut the Obamacare law, including shortened enrollment periods, cuts in advertising and navigator funding, and reductions in payments to hospitals.
Trump relaxed his policies on Medicaid during the pandemic and agreed to extend Medicaid coverage until the pandemic was no longer a health emergency. However, this policy ended in March 2023.
