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Where is Health Policy After Two Years of Trump?

Two years into the Trump administration, the future of health policy in the United States is as murky as ever.

The Affordable Care Act (ACA) has not been repealed, but President Trump and his administration have taken a number of actions to whittle away at the law. Now we are wondering what comes next in the short and long term. What will the next two years bring? What might come after the Trump administration?

This week, an article in Health Affairs about an Urban Institute brief argued for a new set of incremental changes to the ACA — undoing Trump’s executive actions, further expanding Medicaid, bolstering subsidies, and capping payments to providers in the individual market.

Meanwhile, Republican lawmakers — and Trump — remain critical of the ACA. And Democratic presidential candidates are now pushing various versions of a single-payer “Medicare for All” system that go far beyond the ACA.

It’s a dizzying set of scenarios. But before we start debating where to go, it’s important to take stock of where the Affordable Care Act stands now and how it's playing out in our state.

A new chart and interactive timeline by Emily Cervantes, a CHI research analyst, tracks all the anti-ACA actions that have been taken at the federal level in the last two years and examines how they affect Coloradans.

The chart shows that Colorado has insulated itself from many of the actions the Trump administration has taken against the ACA. For instance, Colorado regulators moved this week to counteract a Trump administration rule regarding short-term health plans that could allow lower-quality insurance policies to be sold under the ACA. In Colorado, short-term policies will have to offer the same essential health benefits as other plans and insurers won't be able to charge more to customers with preexisting health conditions.

But the effects are still unfolding, and the ACA is a weaker law than it was two years ago.

The 2019 Colorado Health Access Survey, which will be released later this year, will help quantify how actions in Washington have affected coverage and access in Colorado. Until then, take a look at CHI’s new timeline and chart to get a better sense of where the ACA stands now, in Colorado and across the country.

Photo: Joyce N. Boghosian, Official White House Photo


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