While the twice-impeached former President Donald Trump has long promised a comprehensive healthcare proposal, he recently admitted he only has “concepts” rather than a fully fleshed-out policy.
According to a report from the campaign of Vice President Kamala Harris and Minnesota Gov. Tim Walz, Trump’s ideas would eliminate the Affordable Care Act’s (ACA) current protections for over 20 million people. The critical elements of the Trump-Vance plan, which aligns with the conservative-backed Project 2025, include:
- Eliminating health insurance for millions: The plan would dismantle the ACA, stripping away protections for those with preexisting conditions and leaving millions without affordable coverage.
- Increasing prescription drug and health insurance costs: Out-of-pocket expenses for medications and premiums would rise significantly, affecting seniors, families, and individuals with chronic illnesses.
- Cutting Medicare and Medicaid would reduce the benefits of seniors and low-income families who depend on these programs, creating a ripple effect across the healthcare system.
- Banning abortion nationwide: A national abortion ban would eliminate access to reproductive health services, compounding the plan’s impact on healthcare for women.
When speaking to reporters this month, Republican vice presidential nominee JD Vance confirmed that his and Trump’s plan would begin by rolling back protections for preexisting conditions and returning to high-risk insurance pools. Experts say this move would drive up healthcare costs for the most vulnerable populations.
Preexisting Conditions at Risk: Huge Cost Increases Expected
A central concern of the Trump-Vance healthcare plan is its treatment of people with preexisting conditions. The Center for American Progress found that repealing the ACA would lead to staggering cost increases for those with health conditions such as asthma, pregnancy, and cancer. Without ACA protections, insurers could charge:
- $4,270 more for asthma,
- $17,060 more for pregnancy,
- $20,450 more for substance abuse disorder,
- $26,180 more for rheumatoid arthritis, and
- $140,510 more for metastatic cancer.
Paul Krugman, a Nobel laureate in economics, noted that Trump’s “concept” for healthcare would “deny healthcare to millions of Americans, particularly those who need it most.” He added that Vance’s understanding of healthcare economics shows “someone completely unaware of the history of healthcare policies.”
Impact on the Economy: Millions of Jobs at Risk
Beyond the immediate impact on health insurance, the Trump-Vance plan could also devastate the broader economy. A joint study by the Commonwealth Fund and the Milken Institute School of Public Health estimated that repealing the ACA would result in losing 3 million jobs. These losses would extend beyond the healthcare industry, affecting small businesses and the labor market nationwide.
The American Hospital Association echoed these concerns, warning that a repeal of the ACA would result in “likely catastrophic effects,” rolling back health coverage for millions of Americans and reducing access to everything from routine checkups to chronic illness treatment.
The Treasury Department also reported that repealing the ACA would have devastating effects on small business owners with preexisting conditions. Approximately 4.2 million entrepreneurs and self-employed workers currently receive health insurance through the ACA.
ACA Subsidies at Risk: A Major Financial Blow
The Trump-Vance plan’s opposition to ACA subsidies could lead to steep increases in health insurance premiums for millions of Americans. The subsidies, which were expanded during the COVID-19 pandemic and extended through the Inflation Reduction Act, have been instrumental in reducing healthcare costs for low- and middle-income Americans. Since 2021, Obamacare enrollment has nearly doubled due to these enhanced tax credits.
The Congressional Budget Office (CBO) estimates that without these subsidies, premiums will increase significantly, particularly for families earning more than $100,000 a year, who could lose access to federal assistance entirely. The CBO projects that a permanent extension of the subsidies would increase the federal deficit by $335 billion over the next decade. However, failing to extend them would result in a return to pre-ACA conditions, where health insurance was unaffordable for millions.
According to an earlier analysis by AARP, a similar plan that Trump put forth during his first year in office would have increased out-of-pocket expenses for some seniors by as much as $16,000 annually.
The Center on Budget and Policy Priorities also highlighted the disproportionate effect of the Trump-Vance plan on minority communities, with the number of uninsured Black households expected to increase by 85% and Hispanic households by 40%.
“Although Donald Trump claims to only have the concept of a healthcare plan, we know exactly what he will do if he’s given another chance,” Harris said in a campaign release. “He will terminate the Affordable Care Act (ACA), rip health insurance away from millions of Americans, and endanger millions of individuals with preexisting conditions. He has tried to do it before.”
Harris continued: “As President, he worked tirelessly to sabotage and defund the ACA through executive action, Congress, and the courts—shifting costs and burdens onto the backs of those least able to carry them. And now, he and running mate JD Vance have said plainly that, if given the opportunity, they’ll double down.”