Ex-president Donald Trump has spent over eight years promising to replace the Affordable Care Act (ACA) with a more efficient and cost-effective system. However, despite numerous attempts and high-profile promises, Trump has yet to deliver a concrete plan, leaving millions of Americans—including more than two million Ohioans—vulnerable to losing their healthcare coverage.
Since its passage in 2010, the ACA has become a lifeline for millions of Americans, providing coverage for those with pre-existing conditions and expanding Medicaid in states like Ohio. Over 295,000 Ohioans receive coverage through the ACA marketplace, and an additional 808,000 benefit from the Medicaid expansion the law made possible. These figures underscore the critical role the ACA plays in Ohio’s healthcare system.
Years of Empty Promises
Throughout his political career, Trump has attacked the ACA, calling it a “disaster” and vowing to dismantle it. During his presidency, he made numerous attempts to repeal the law, most notably in 2017, when a Republican-controlled Congress narrowly failed to pass a full repeal. Since then, Trump’s administration continued to weaken the ACA by slashing funding for its outreach programs, limiting enrollment periods, and allowing states to impose work requirements for Medicaid recipients.
These efforts have led to a gradual increase in the uninsured population. Between 2016 and 2019, the number of uninsured Americans rose by over 2 million, reversing gains made under the ACA. Despite this, Trump has yet to provide a clear replacement plan.
During a recent debate with Vice President Kamala Harris, Trump once again admitted that he does not have a detailed plan. When asked by ABC moderator Linsey Davis whether he had a healthcare proposal ready, Trump responded, “I have concepts of a plan. I’m not president right now.” He added that any replacement would only happen if something “better and less expensive” could be developed, without offering specifics.
Trump’s inability to articulate a clear plan has left many wondering whether his years-long battle to repeal the ACA was motivated by a desire to improve healthcare or simply to dismantle one of his predecessor’s signature achievements. His failure to provide an alternative has caused widespread concern among healthcare advocates, who argue that a full repeal would have devastating consequences for millions of Americans.
The Consequences of Repeal
For Ohioans, the stakes could not be higher. Should the ACA be repealed, hundreds of thousands of residents could lose their coverage overnight. Those with pre-existing conditions—such as cancer, diabetes, or heart disease—would once again face the possibility of being denied coverage or charged exorbitant rates. The protections offered by the ACA, which prevent insurance companies from discriminating based on medical history, would vanish.
The impact on Medicaid recipients would also be severe. Over 2.6 million Ohioans currently rely on Medicaid, including children, seniors, and people with disabilities. A full repeal of the ACA would slash federal funding for Medicaid, forcing states to either cut services, cap enrollment, or tighten eligibility requirements. This could leave many without access to critical services like mental health care, substance abuse treatment, and preventive care.
Ohio’s rural communities would be hit especially hard. These areas already face significant challenges in accessing healthcare due to hospital closures and physician shortages. Without the ACA’s support, these problems could worsen, as hospitals struggle to cope with an influx of uninsured patients, and individuals are forced to travel long distances to receive care.
Trump’s Campaign of Uncertainty
Throughout his presidency and beyond, Trump has repeatedly made vague claims about providing a “better, cheaper” healthcare system. His administration touted initiatives such as short-term health plans, which offer low-cost, limited coverage options for up to a year. However, these plans have been criticized for failing to provide the comprehensive benefits required by the ACA, such as maternity care, mental health services, and prescription drug coverage.
Despite these efforts, Trump’s critics argue that his focus has always been on undermining the ACA rather than developing a viable alternative. Healthcare experts have pointed out that Trump had ample time to deliver on his promises during his four years in office but failed to do so.
Vice President Kamala Harris, who has been a staunch defender of the ACA, criticized Trump’s lack of action during the debate. She emphasized the importance of expanding access to healthcare, particularly for vulnerable populations such as people of color, older adults, and the LGBTQ community. Harris argued that healthcare is a right, not a privilege, and reiterated her commitment to strengthening the ACA rather than dismantling it.
The Road Ahead
As the 2024 election approaches, healthcare remains a critical issue for voters. Trump’s ongoing refusal to present a detailed plan for replacing the ACA continues to raise concerns about the future of healthcare in the United States. While his campaign promises to reveal a plan “in the not-too-distant future,” many remain skeptical.
In the meantime, millions of Americans face an uncertain future. For Ohioans, the potential loss of affordable healthcare coverage looms large. With no clear alternative from Trump, many worry that his continued attacks on the ACA could result in higher premiums, reduced access to care, and devastating financial consequences for families already struggling with medical bills.
Ex-president Trump’s inability to provide a viable healthcare plan after eight years of rhetoric only underscores the importance of protecting the ACA. As the debate over the future of healthcare intensifies, the stakes for millions of Americans have never been higher.
