Policy expert explains why Trump’s attack on key programs is 'outright dangerous'

22 July

U.S. President Donald Trump looks on, on the day of his meeting with Philippine President Ferdinand Marcos Jr., at the White House in Washington, D.C., U.S., July 22, 2025. REUTERS/Kent Nishimura

Six months into Donald Trump's second presidency, GOP lawmakers have yet to push a bill that directly overturns the Affordable Care Act of 2010 (ACA), also known as Obamacare. But according to Trump's critics in the health care field, his "big, beautiful bill" will inflict severe damage not only on Medicaid, but also, on the ACA.

In an article published on July 22, Yaver details the ways in which Trump's policies will "make health insurance prohibitively expensive for millions" of Americans in the months ahead.

One of those critics is Miranda Yaver, assistant professor of health policy and management at the University of Pittsburgh.

"The second Trump Administration has drastically destabilized America's public health bureaucracy, and the president has signed off on historic cuts to Medicaid and the broader safety net," Yaver explains. "What has drawn less public scrutiny is Republicans' decision to let enhanced subsidies for Americans who buy health insurance through the Affordable Care Act expire. This withdrawal of governmental assistance to purchase insurance will most likely result in younger, healthier people's dropping out of the health insurance market, leaving enrollees to be, on average, older and sicker — and therefore more expensive to insure."

Yaver continues, "To offset these sicker individuals' higher medical costs, for-profit health insurers' main tool is to increase the premiums they charge for everyone. Researchers at the Kaiser Family Foundation find that premiums for plans on the ACA's marketplace will increase an average of 75 percent in 2026, with at least 12 states seeing premiums more than double."

Yaver notes that when then-President Barack Obama signed the ACA into law in 2010, "nearly 50 million" Americans or "roughly 16 percent of the population" lacked health insurance" — a number that was down to "26 million Americans" in 2023.

"Through the American Rescue Plan of 2021 and the Inflation Reduction Act of 2022," Yaver observes, "the Biden Administration implemented and extended enhanced subsidies, which reduced the cost of premiums by an average of 44 percent. It is perhaps unsurprising, then, that a record 24.3 million people enrolled in ACA marketplace plans for the 2025 plan year. However, those enhanced subsidies expire at the end of 2025…. A sharp increase in the cost of health insurance in a country with already expensive health care comes with severe consequences."

Yaver continues, "Health coverage through the ACA is associated with being connected to a usual source of health care, such as a primary care physician, and being able to obtain treatments that range from preventive to lifesaving. Rendering health insurance prohibitively expensive can lead people to forgo care they need — at best a problematic outcome, at worst outright dangerous."

Miranda Yaver's full op-ed for MSNBC is available at this link.

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