Tracking Trump’s Sabotage of the ACA

Congressional Republicans have been trying to sabotage the Affordable Care Act (ACA) since it was first enacted. Under the Trump administration, these efforts have accelerated as the president and his allies in Congress actively seek to discredit the law. President Donald Trump has been clear about his goal, saying, “[T]he best thing we can do politically speaking is let Obamacare explode.”

After failing to repeal the ACA altogether, Trump and Congress have repeatedly taken steps to undermine the law. In October 2017, for example, President Trump canceled billions of dollars in payments that help lower people’s deductibles and copays, and in December 2017, Congress passed a tax bill that repealed the individual mandate.

In spite of this sabotage, the ACA marketplace has proven stable. However, efforts to undermine the law are still driving up health care costs; the Center for American Progress has estimated that the average premiums for a 40-year-old marketplace enrollee will be $970 higher in 2019 due to the repeal of the individual mandate and expansion of the availability of short-term junk plans. To help people understand who is undermining the individual insurance market and how they are doing it, the Center for American Progress Action Fund is tracking these sabotage efforts and their effects.

Sabotage is carried out through two principal means: policy changes that hurt the ACA marketplace and threats by policymakers to inflict further damage to the market in order to create uncertainty for insurers and consumers and drive up prices. This tracking page categorizes sabotage actions by their effects on costs, coverage, and enrollment efforts.

We will be updating this page periodically to account for new developments in these sabotage efforts. This list includes final proposals and policies by the Trump administration as well as relevant news reports. This page was last updated on May 30, 2019.
Filter by category
Cost increases
This category describes actions that result in increased costs for enrollees, including premiums and cost sharing.
Coverage losses
This category describes actions that result in individuals with coverage losing their comprehensive insurance.
Undermining enrollment
This category describes actions that make it more difficult for individuals to enroll in coverage.
All categories
Select threats from policymakers about the ACA marketplace