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Undermining Healthcare: Trump And The GOP’s Agenda Against The ACA

The Republican Party, better known as the Grand Old Party or GOP, has a long history in the United States. It’s firmly established as one of the two major US political parties, a prominence that was further highlighted during the Trump administration’s term.

Throughout its existence, the GOP has been characterized by a commitment to principles such as privatization and community welfare support. However, one of the most significant aspects of the GOP’s recent history is in its efforts to undermine the Affordable Care Act (ACA), a hallmark achievement of the Obama administration. 

Is this a matter of political rivalry, as the Democrats always overwhelmingly favored the ACA? Or does the GOP honestly believe that the ACA is flawed? 

In this article, we explore the GOP’s multifaceted battle against the ACA during the Trump administration and beyond, shedding light on their most pivotal moves and the implications of their actions.

The GOP’s Ongoing Battle Against The ACA: 10 Critical Moves Examined

The ACA was passed into law in 2010 under the Obama Administration. It soon earned the moniker Obamacare, and the GOP and Trump administration wasted no time in fighting against this long-overdue health reform. 

1. Repeal Attempts 

Republican lawmakers made multiple attempts to repeal the Affordable Care Act (ACA) through legislation. The most notable of these endeavors was the American Health Care Act (AHCA) in 2017. 

Despite being approved by the House of Representatives during the Trump Administration, it failed to clear the Senate.

The repeal efforts, often referred to as ‘Trumpcare,’ ultimately fell short, which was fortunate for millions of Americans who relied on the ACA for their healthcare coverage. Repealing the ACA would have left many unable to afford the healthcare they needed.

2. Reducing Outreach Funding 

The Trump Administration decided to allocate fewer resources and financial support to efforts to inform and assist individuals in enrolling in ACA-compliant health insurance plans. 

As a result of this funding reduction, the ability to reach and educate potential enrollees about their options significantly diminished, making it harder for people to navigate the enrollment process and leading to a decline in ACA plan sign-ups. 

Many individuals needing this outreach support chose to remain uninsured due to the increased difficulty in accessing and understanding available healthcare coverage.

3. Individual Mandate Undermined: Legal Challenges In The Supreme Court

While the ACA was generally well-received, the individual mandate, which made health insurance compulsory, was unpopular. Non-compliance led to tax penalties.

One of the GOP’s most well-known legal challenges to this is Texas v. United States (2018). In this case, Republican-led states argued that the ACA’s mandate was unconstitutional. They aimed to invalidate the entire ACA. 

The Supreme Court held that Texas (and other plaintiff states) had no authority to ACA mandate’s constitutionality. Undeterred, the GOP decided that if they couldn’t do away with the mandate, they’d weaken it instead. So, they reduced the federal-level tax penalty to $0.

Reducing the federal-level tax penalty to $0 seriously affected insurance markets. It discouraged health insurance sign-ups, leaving many Americans without the safety net of ACA health coverage.

4. Weakened Essential Health Benefits

The GOP’s attempts to redefine Essential Health Benefits (EHBs) threatened a fundamental pillar of the ACA. 

Essential Health Benefits are crucial healthcare services, such as preventive care, maternity and newborn care, and mental health services, that all major medical insurance plans under the ACA must cover. 

The GOP’s efforts to alter these EHB definitions raised concerns that essential services might be reduced making ACA coverage less comprehensive. This would potentially leave individuals with fewer essential health services, ultimately impacting their access to necessary care.

5. Resistance To Medicaid Expansion

Many Americans rely on federal and state-run programs for low-income earners, like Medicaid. The ACA allowed for greater Medicaid access, but several Republican-led states declined to expand it. 

Consequently, a coverage gap has formed for people who don’t qualify for their state’s Medicaid program but can’t afford the ACA plans available. 

6. Focus On Short-Term Health Plans 

The Trump administration expanded the availability of short-term plans as an alternative to the ACA’s health plans. These short-term, limited-duration health plans didn’t have to comply with the ACA’s consumer protections and essential health benefits.

Because it’s not major medical insurance, short-term insurance plans are not subject to ACA requirements. They are generally affordable, but because they don’t have to cover the ten essential health benefits, they’re not a dependable alternative to ACA insurance..

7. Cost-Sharing Reduction Payments Cut

All insurance policies carry unavoidable out-of-pocket expenses. However cost-sharing reductions, or CSRs, were introduced to help lower-income households with their out-of-pocket costs. Subsidies were paid to insurers to absorb the costs of reducing policyholders’ out-of-pocket expenses. 

By eliminating the subsidies that reduced copayments, deductibles, and other out-of-pocket costs, they forced insurers to raise policyholders’ costs again. This made ACA policies unaffordable for the masses.

8. State Waivers And Flexibility 

The GOP favors greater flexibility in defining Essential Health Benefits at the state level. This includes allowing waivers for EHB modifications, which can drastically limit a health insurance plan’s coverage.

By weakening the availability of comprehensive coverage that offers ACA-required essential health benefits, the burden on state-run healthcare systems will inevitably grow. As more and more people can’t access these EHBs from health insurance, they will turn to state-run programs for these services.

9. Sabotage Of Health Insurance Marketplaces

ACA navigators assist individuals in understanding and enrolling in ACA plans. The Trump Administration reduced these navigators’ funding. This effectively challenged ACA education and assistance, making enrollment in ACA plans difficult for the average American.

These actions had a pronounced effect on health insurance marketplaces. It was challenging enough to get people to sign up for health insurance. Without assistance, many individuals decided to forego insurance. 

10. The ACA Risk Corridor

The Risk Corridors program was one of three ACA premium stabilization programs. It was designed to help insurers manage financial risks by offering ACA-compliant coverage. This was, unfortunately, the perfect opportunity for GOP interference.

The GOP undermined the Risk Corridors program through legislation and budget cuts, making insurers reluctant to follow ACA requirements. However, they were required to follow the ACA for major medical insurance, and found themselves in an even riskier situation.

The Future Of Healthcare Reform

The GOP has put considerable effort into unsuccessful Congressional votes and Supreme Court debate. Republicans have stopped trying to repeal the ACA, but this does not indicate wholehearted acceptance. 

The Ongoing Debate  

If the Republican party were again to hold the seat of power, the ACA would probably still be safe. But it could be revised because the GOP still has the same objections.

Amongst other logistical concerns, the GOP feels that:

  • ACA policy premiums are too high for most Americans
  • Cost-sharing is too much of a burden 
  • Income shouldn’t be the main criterion for ACA subsidies 

The GOP also believes that chronically ill people still receive inadequate coverage from many state health exchanges, at the mercy of restrictive networks.

Strengthening The ACA

The ACA is one of the most significant US healthcare reforms of recent years. That’s why Enhance Health is proud to be a broker of ACA insurance, helping people like you find affordable quality health insurance. However, some changes may be made to preserve the foundation laid by the ACA’s reforms. 

Proposals for strengthening the ACA’s legacy include expanding Medicaid in all US states, increasing the availability of subsidies, and bolstering the individual mandate once more.  Are these proposals the answer to strengthening the ACA? Will they ever come to fruition? Time will tell.


Since the ACA’s inception, the GOP has repeatedly attempted to repeal the Act. When this proved difficult, they resorted to reducing funding, scrapping the individual mandate penalty, limiting Medicaid expansion, and more. But the ACA has weathered the storm and remained, for the most part, intact. 

The ACA has opened the door for millions of Americans to access quality, affordable healthcare. As a licensed ACA health insurance broker, Enhance Health is the key to your future health security. Contact us today for help with choosing a health plan that suits your budget and your family’s medical needs.

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