During his 2016 campaign, President Donald Trump repeatedly said he was for “insurance for everybody” and promised to “take care of everybody” and to lower costs. Almost four years later, the Trump administration’s record falls far short of these promises: The number of uninsured Americans has swelled, his administration has chipped away at the consumer protections guaranteed by the Affordable Care Act (ACA), costs have risen for Americans with marketplace plans, and the nation is mired in a public health crisis.
The wake of one of the administration’s most destructive health care policies may trail far beyond this term of his presidency. The health care repeal lawsuit that he helped advance to the U.S. Supreme Court could invalidate the entire ACA next spring, ending coverage for more than 20 million Americans, driving up costs for those seeking to buy coverage on their own, and eliminating consumer protections for millions of people with preexisting conditions—all in the midst of the COVID-19 pandemic.
Millions of Americans lost coverage before and during the pandemic
Since President Trump took office, millions of Americans have lost health insurance coverage. The number of uninsured Americans rose by 2.3 million from 2016 to 2019, including 726,000 children, according to the U.S. Census Bureau. Among the 41 states with increases in their numbers of uninsured residents, the largest increases were in Texas (689,000) and Florida (240,000). Many smaller states, such as Michigan (44,000) and Wisconsin (29,000), saw increases in the tens of thousands. Just a handful of states experienced a net gain in coverage, including New York, where the number of uninsured people declined by 176,000. (see Table 1)