Trump executive orders threaten healthcare of millions of Americans

Within his first 48 hours back in office, Trump has signed several executive orders that threaten the healthcare of millions of Americans.

Amid a flurry of executive orders, some of which were signed live on TV on inauguration night, the US president issued several orders that repeal Biden-era directives that had expanded healthcare access and options for lower-income and middle-class Americans.

Those orders are expected to affect the medical insurance coverage for upwards of 20m people in the US.

“The previous administration has embedded deeply unpopular, inflationary, illegal, and radical practices within every agency and office of the Federal Government,” Trump said in the official statement, which referenced several health-related orders.The statement goes on to accuse diversity, equity and inclusion (DEI) policies of having “corrupted” institutions for Americans.

Those people whose coverage is now deemed at risk are the roughly 24 million Americans who have purchased their health insurance via the Affordable Care Act this year. The ACA, also known as Obamacare, helped to expand Medicaid benefits and provides affordable health insurance to millions of people.

Trump’s actions this week will affect all aspects of the ACA, including eligibility requirements, federal subsidies and enrollment deadlines, which determine when Americans can apply for insurance, without repealing the act, which would take action from the US Congress. But the actions are expected to create more barriers and result in healthcare coverage becoming even less accessible.

In a one-page document published by Politico, Trump outlines options for spending cuts. These plans include measures that would reduce the amount of money states have to fund Medicaid and limiting health program eligibility depending on citizenship status. Every option listed involves cutting funding for and access to healthcare coverage.

Some of the Biden-era orders Trump has already repealed include Executive Order 14009, or the Strengthening Medicaid and the Affordable Care Act, which broadened access for Americans and their families, allowing more parents with young children to be eligible for more extensive coverage. Some estimates suggest that this appeal alone could result in a nearly 25% loss of ACA coverage.

Additionally, Trump repealed executive orders aimed at reducing the cost of prescription drugs for people on the government health insurance programs Medicare and Medicaid that chiefly serve older and lower-income Americans.

The Biden administration also previously introduced the American Rescue Plan Act, a subsidy program that lowered the cost of health insurance premiums. This broadened the eligibility requirements, extending them to many more people in the US middle class.

But this program is set to expire at the end of this year. The White House website has been purged of any mention of the plan, and Trump has already repealed EO 14070, which highlighted the positive impacts of the ARP Act on access to coverage, including the enhanced marketplace subsidies that lowered premium costs.

Executive Order 14070 also provided options for states to extend postpartum Medicaid coverage.

A weakened ACA has consequences that reach further than just those Americans who lose their coverage. A lack of federally funded healthcare options means privatized insurers are given more power to control the healthcare industry, leading to the remaining healthcare insurance options likely to increase in cost.

“The consequences of more people going uninsured are really significant, not just at an individual level with more medical debt and less healthy outcomes, but also has ripple effects for providers,” Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University, said.

Commercial insurance has already proved difficult to navigate for millions, as people with insurance have been almost as likely to experience medical debt as those who are uninsured. In fact, people with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts.

“Premiums go up for the people who do have health insurance. For the people without health insurance, it’s financially devastating,” Corlette said. “The result is medical debt, garnished wages and liens on people’s homes because they can’t pay off their bills.”