For years, Americans have voiced deep frustration with the nation’s health care system. From high costs and surprise medical bills to lack of access and confusing insurance rules, dissatisfaction runs high. In fact, according to a KFF Health Tracking Poll, a significant majority of Americans say the health care system is either “fundamentally flawed” or in need of “major changes.”
While this dissatisfaction spans political lines, recent policy actions and promises by former President Donald Trump—who is running again in 2024—are stirring debate over whether things could get worse under his potential second term.
Why Americans Are So Unhappy With Health Care
America’s health care system is known for being one of the most expensive in the world. Despite this, it delivers worse outcomes than many developed countries. Millions remain uninsured or underinsured, and even those with coverage often face high deductibles and co-pays.
Key reasons for public frustration include:
- High costs: The U.S. spends nearly 18% of its GDP on health care, yet affordability remains out of reach for many.
- Lack of transparency: Patients often don’t know the cost of treatments until they receive a bill.
- Insurance issues: Denials of coverage, in-network limitations, and administrative hurdles frustrate even insured individuals.
The Commonwealth Fund ranks the U.S. last in access, equity, and outcomes among 11 high-income countries.
Trump’s Troubling Health Care Track Record
When Donald Trump served as president from 2017 to 2021, he repeatedly promised to repeal and replace the Affordable Care Act (ACA), also known as Obamacare. However, despite multiple attempts, the ACA remains largely intact today.
Trump did manage to:
- Eliminate the individual mandate through the 2017 Tax Cuts and Jobs Act, removing the requirement that Americans must have health insurance or pay a fine.
- Weaken ACA protections: His administration supported lawsuits aimed at dismantling the ACA entirely.
- Expand short-term health plans: These are often cheaper but provide far less coverage, sometimes denying pre-existing conditions.
Critics argue that these moves destabilized the insurance marketplace and increased uncertainty for consumers.
According to Health Affairs, these short-term plans may have left some Americans more vulnerable during the COVID-19 pandemic due to lack of comprehensive coverage.
What Trump Is Proposing Now
Although Trump has not released a full health care plan for his 2024 campaign, he has made statements suggesting he may attempt to “terminate” the ACA if re-elected. In a late 2023 post on Truth Social, he wrote, “Obamacare sucks,” reigniting speculation about a new push to repeal the law.
Key concerns include:
- ACA rollback threats: Repealing Obamacare could eliminate coverage for over 40 million Americans who benefit from it.
- Pre-existing conditions coverage: Without the ACA, protections for people with pre-existing conditions could vanish.
- Medicaid cuts: Trump’s past budgets included deep cuts to Medicaid, which supports low-income individuals and families.
These proposals have already sparked backlash from both political opponents and some moderates within the Republican Party, who fear a renewed health care fight could hurt them in the polls.
Experts Warn of Dangerous Consequences
Health policy experts say that repealing the ACA without a clear, workable replacement could lead to chaos in the system. Hospitals may be overwhelmed by unpaid care, insurance premiums could spike, and millions might lose access to affordable treatment.
Dr. Ezekiel Emanuel, a former Obama advisor, noted in an interview with Politico, “Every time Trump talks about killing Obamacare, people get nervous—and they should. There’s no alternative that protects as many people.”
Health economists warn that even the threat of repealing the ACA can destabilize markets and make insurers raise premiums in anticipation of uncertainty.
The Public Isn’t Buying It
Recent polling suggests that a majority of Americans support the ACA, even if they want improvements. According to Pew Research Center, 62% of U.S. adults view the ACA favorably.
In contrast, only 26% say they would support its full repeal. These numbers show that despite flaws in the current system, most Americans prefer fixing it over tearing it down.
With health care topping the list of voter concerns in nearly every major poll, Trump’s renewed focus on ACA repeal could become a liability on the campaign trail.
What Could Be Done Instead
Experts say improving U.S. health care doesn’t require starting from scratch. Here are some proposed solutions with bipartisan support:
- Lowering drug prices: The Inflation Reduction Act has started to address this, but further steps are needed.
- Expanding Medicaid in holdout states: Millions remain uninsured in states that refused expansion.
- Improving mental health access: Long wait times and high costs plague this critical area of care.
Other innovative approaches include exploring public options and expanding Medicare coverage to more age groups.
Conclusion: A Ticking Time Bomb?
As Americans head into another contentious election season, health care will remain a hot-button issue. While dissatisfaction with the system is widespread, Trump’s plans—or lack thereof—may raise more questions than answers.
Unless clearer solutions are presented, and unless policymakers from both parties work together, the fear is that the system may deteriorate even further—leaving more Americans without the care they need.
Suggestions (Do-Follow):
- KFF Health Tracking Poll
- The Commonwealth Fund Report
- Health Affairs on Short-Term Plans
- Politico Interview with Ezekiel Emanuel
- Pew Research on ACA
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