In a move that has significant implications for millions of Americans, President Donald Trump issued a series of decreessome of which target the healthcare market. These changes are expected to affect the registration process and medical insurance coverage for approximately 24 million people.
News week reached out to the Trump transition team via email for comment.
Why it matters
The Affordable Care Act (ACA), also known as Obamacarehas been the cornerstone of health care in the United States since it was signed into law in 2010. About 24 million Americans purchased health insurance through the ACA this year.
Trump’s recent changes will impact key provisions, including application deadlines, eligibility requirements and federal grants. These changes could result in reduced access to affordable health care for millions of Americans.
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What you need to know
On January 20, 2025, President Trump signed a series of decrees. Two sought to roll back several key elements of the Affordable Care Act that were implemented under the Biden administration. This included rescinding President Biden’s 2021 Executive Order 14009, which expanded open enrollment periods for ACA plans, as well as 2022 Executive Order 14070, which sought to reduce ACA premiums.
Executive Order 14009, titled “Strengthening Medicaid and the Affordable Care Act,” includes several key elements designed to increase access to affordable health care and reduce the number of uninsured Americans:
Reversal of Trump administration policies: The order sought to roll back measures that limited provisions of the ACA or made health care less accessible.
Longer registration periods: The order encouraged states to extend enrollment periods and provided additional federal support. As a result, many states have expanded their enrollment windows to ensure broader access to affordable health care.
Restoring Pre-Existing Condition Protections: Reaffirmed protections for people with pre-existing conditions and strengthened non-discrimination policies in health care.
Immediate assessment of the agency’s actions: The order directed various executive departments and agencies to review existing regulations, orders, and policies to ensure they align with the goal of strengthening Medicaid and the ACA.
Executive Order 14070, titled “Continue to Strengthen Americans’ Access to Affordable, Quality Health Coverage,” aimed to maintain and improve Medicaid and the ACA. Key components included:
Enhanced Market Subsidies: The order highlights the positive impact of the American Rescue Plan Act on access to coverage, including improved marketplace subsidies.
Expanded Postpartum Medicaid Coverage: It provides states with the opportunity to expand postpartum Medicaid coverage.
New incentives for Medicaid expansion: The order includes new incentives for states to expand their Medicaid programs.
What people say
President Donald Trump, in the executive order, said: “The previous administration embedded deeply unpopular, inflationary, illegal and sweeping practices within every agency and office of the federal government.” He added: “…the policy of the United States is to restore sanity to the federal government and to unleash the potential of the American citizen. Revocations under this order will be the first of many actions the United States federal government will take. take to repair our institutions and our economy. »
Alex Beene, professor of financial literacy at the University of Tennessee at Martin, said: News week: “While we do not yet know what the actual effects will be, it is fair to say that reversing course from President Biden’s initial executive order will result in fewer Americans purchasing insurance under Affordable Care Act This executive order extended the registration periods for “
“Expanding ACA enrollment periods was important for Americans whose personal and professional situations took an unexpected turn and immediately required additional coverage. This could be someone losing health coverage due to job loss, moving, having a child, or any number of other situations that result in a sudden change in that person’s needs. person. Now, if it’s outside of that enrollment period, the process of finding coverage just becomes more difficult.
Kevin Thompson, founder and CEO of 9i Capital Group, said News week: “Third-party funding has played an important role in increasing participation in the ACA. These funds, along with government subsidies, have helped offset premiums for millions of Americans, leading to the enrollment gains seen in recent years. A reduction in this funding will likely result in lower enrollment. Numbers.”
“The most vulnerable populations will be hit hardest. Non-expansion states, many of which are red states, tend to have higher percentages of their population enrolled in the ACA market. These states will face significant challenges with shorter registration periods and reduced subsidies What was once proclaimed “we won’t touch the fees” is now coming dangerously close to that promise.
What happens next
President Trump’s recent executive orders are just the first steps in his broader agenda to reshape federal policies and assert executive power. He announced plans to launch the “largest criminal deportation program in American history” targeting undocumented immigrants. He also threatened to impose 25 percent tariffs on Canada and Mexico unless they took tougher measures to stop illegal migrants and illicit drugs. Additionally, Trump declared a national energy emergency to boost domestic oil and gas production and end the electric vehicle mandate.