President Donald Trump proposed that federal healthcare funds bypass insurers and be directed straight to individuals in a Nov. 8 post on Truth Social.
“I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE, and have money left over. In other words, take from the BIG, BAD Insurance Companies, give it to the people, and terminate, per Dollar spent, the worst Healthcare anywhere in the World, ObamaCare,” he wrote.
President Trump’s comments come amid the longest government shutdown in U.S. history, spurred by disagreement over whether to extend the enhanced ACA subsidies, which are set to expire at the end of the year.
The enhanced subsidies expanded marketplace eligibility to households with an annual income over 400% of the federal poverty limit, capping out-of-pocket premiums for a benchmark plan at 8.5% of income. Since the introduction of the credits, marketplace enrollment has more than doubled from 11.4 million in 2020 to 24.3 million in 2025. Over 75% of adults want to keep the tax credits, according to a recent poll, but many voters favor ending the shutdown without that guarantee.
On Nov. 10, the Senate advanced a spending package that could potentially reopen the government. The spending would allow the Senate to vote in December on legislation extending the enhanced subsidies.
Before his second term, President Trump had stated that he plans to improve the 2010 healthcare law, not terminate it, and make it “FAR LESS EXPENSIVE.” Moreover, Republicans hinted at enacting major reforms. However, the overall ACA structure and benefits have not changed, and there has not been a successful repeal or total overhaul.
“Health plans are doing everything in their power to shield Americans from the high and rising costs of medical care. Data show that in 2024 health plans’ profit margin was 0.8%, and that in 2023 health plan profits represented about 0.5% of national health expenditures. Health plans are the only part of the health care system whose profits and administrative costs are capped under federal law,” AHIP President and CEO Mike Tuffin said the same day.
