Background

Health Reform Under Trump >> Background (last updated 1.7.17)

Key Events Timeline

Note that further details and documentation for each listed event are provided elsewhere in this document.

International Initiatives

Federal Initiatives

6.22.16: House Speaker Paul Ryan releases “Better Way” plan to repeal and replace ACA.
11.8.16: Trump elected president in a surprise victory over Hillary Clinton; he wins electoral vote 306-232, while she receives roughly 2.4 million more popular votes.
11.11.16: After meeting with President Obama, Trump reasserts commitment to repeal and replacement of ACA but signals willingness to to retain provisions to prohibit insurers from denying coverage to those with pre-existing conditions and allowing young adults to age 26 to remain on their parents’ health plans.
11.29.16. Rep. Tom Price named by Trump transition team to head Department of Health and Human Services.
12.6.16. Urban Institute releases comprehensive report showing impact of partial ACA repeal through reconciliation.
12.9.16. A new coalition, Protecting Our Care, is launched to oppose ACA repeal, bringing together organizations that helped pass the ACA.
12.13.16. Outgoing CEA releases report: The Economic Record of the Obama Administration: Reforming the Health Care System summarizing impacts of ACA.
12.13.16. Brookings Institution releases comprehensive report showing the potential impact of ACA repeal before a replacement plan can be enacted.

 

State Initiatives

Medical Care System

Health Insurance System

In 2015, private health insurance coverage continued to be more prevalent than public coverage, at 67.2 percent and 37.1 percent, respectively. Of the subtypes of health insurance, employer-based insurance covered 55.7 percent of the population for some or all of the calendar year, followed by Medicaid (19.6 percent), Medicare (16.3 percent), direct-purchase (16.3 percent), and military coverage (4.7 percent).

The individual (or “non-group”) insurance market has changed substantially under the Affordable Care Act (ACA). Starting in 2014, the health law put in place new rules for what types of plans can be sold, required insurance companies to guarantee access to everyone regardless of health status, and limited the factors insurers could use in setting premiums. The law also created new Health Insurance Marketplaces, where low- and moderate- income consumers without access to other affordable coverage could obtain federal tax credits to help them pay their premiums.

However, by 2016, several problems were clearly evident in the ACA marketplaces, including rising premiums (these averaged 22% across all states), a shrinking number of plan choices as several large insurers elected to abandon or substantially reduce their participation in the ACA marketplaces and the failure of 20 out of 24 CO-OPs (not-profit health plans created expressly to offer ACA marketplace coverage).