Bob Sheak and Arlene Sheak, August 1, 2026

Introduction

Trump and his Republican Party not only continue to fail in creating a viable health care system, they are also making the present system even more inadequate. It is but one example of how Trump and his Republican cronies are reducing opportunities generally for the majority of Americans. His Iran War, tariffs, massive deportation, regressive tax cuts, and self-enrichment schemes are examples. All this is happening despite his hollow presidential campaign promises to support policies that would benefit all citizens.

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Trump Is Making America Uninsured Again

Sasha Abramsky offers some evidence of this trend, May 16, 2026

(https://truthout.org/articles/trump-is-making-america-uninsured-again).

Abramsky’ central point is that the Trump’s GOP is heading into the 2026 midterms as the party that is making health coverage out of reach for millions of Americans. Consider some of his ample evidence.

 He writes, “In 2025, the Trump administration successfully pushed Congress to enact nearly $1 trillion in health care cuts over the coming decade, which the Congressional Budget Office analysis estimated would result in 10 million people losing health coverage by 2034. More recently, it has blocked any and all efforts to extend the Affordable Care Act (ACA) tax credit subsidies for people buying insurance on the state exchanges. In demanding that the GOP leadership in Congress prevent at all costs a continuation of the expanded ACA tax credits, Donald Trump intimated that his administration was on the verge of proposing a better and more affordable health care reform to replace the ACA system.

“Nothing of that nature has materialized. Instead, the administration’s health reforms have been shockingly small-bore — a handful of measures to lower the costs of prescription drugs, more incentives for consumers to create health savings accounts, a rollback of regulations on catastrophic coverage plans — thus, making it easier for younger, healthier, patients to buy junk insurance, but doing nothing for those who are older or suffer from chronic conditions.

Abramsky continues. “Over the past months, even these baby steps have stalled out, with the GOP seemingly and inexplicably resigned to the fact that it will be heading into the midterm elections as the party that is putting health coverage out of reach for millions of Americans. Early in the Iran war, Trump was caught saying that the federal government could no longer afford its massive Medicare commitments now that the country was engaged in an expensive overseas conflict, and it would have to roll back responsibility for paying for this bedrock safety net program onto the states.”Bottom of Form

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Evidence that millions of Americans are already losing their health insurance

Journalist Aparna Soni reports that “2.6 million Americans Lost Health Insurance in 2025 After ACA Subsidies Expired, Leading to Real Health Consequences,” July 15, 2026 (https://www.counterpunch.org/2026/07/15/2-6-million-americans-lost-health-insurance-in-2025-after-asa-subsidies-expired-leading-to-health-consequences).

Soni continues. “Millions of Americans who buy their own health insurance coverage through the Affordable Care Act marketplaces faced a stark choice this year: pay more than twice as much to keep the same plan or go without. Many did not keep their coverage.

“Federal data released on June 26, 2026, shows that marketplace enrollment fell from 21.8 million people in February 2025 to 19.2 million in February 2026, a decline of about 2.6 million people, or 12%. That is the steepest single-year decline since the marketplaces opened in 2014. ACA marketplaces (or exchanges) are government-regulated platforms where individuals and small businesses can shop for and purchase compliant private health insurance.

Soni is a health economist who studies how insurance coverage affects people’s health, I see the drop as more than a numbers story. The key question is: What happens to people’s health when coverage becomes too expensive to keep?”

Why enrollment fell

“The drop in enrollment numbers traces back largely to the expiration of the ACA’s enhanced premium tax credits, which lowered enrollees’ monthly payments when they were in effect from 2021 through 2025.”

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Trump also eliminated Medicare Part D Subsidies After Vowing to “Protect” the Program in 2024

Chris Walker reports on this for Truthout, July 29, 2026

(https://truthout.org/articles/trump-to-end-medicare-part-d-subsidies-after-vowing-to-protect-program-in-2024). Walker is a news writer at Truthout, “based in Madison, Wisconsin. Focusing on both national and local topics since the early 2000s, he has produced thousands of articles analyzing the issues of the day and their impact on people.”

Walker provides context.

“Mehmet Oz, [Trump’s appointed] head of the Centers for Medicare & Medicaid Services, justified the change by citing the hollow reason, ‘stabilizing’ markets.’

“On Tuesday [July 28] the Trump administration announced its plans to end a subsidy program for Medicare Part D, which has helped lower prescription drug costs for tens of millions of enrollees in the program for the past two years.”

“The Biden-era program provided subsidies to insurance companies, which in turn lowered the cost of drugs for seniors in Medicare. If repealed, many enrollees in the program could see their prescription costs increase by hundreds of dollars annually.

“The announcement comes at a time,’ Walker writes, ‘when other costs, including for everyday consumer goods, have been increasing, too. The changes to Medicare Part D will go into effect at the end of this year.”

Trump misled the public

Walker reports that the upcoming program cuts Bottom of Form

contradict “promises and commitments to protecting Medicare that President Donald Trump and the Republican Party in general made during the 2024 elections.” During his presidential campaign, for example, Trump said he would ‘always protect’ Medicare,’ strengthen it for future generations, and promised there would be ‘no cuts’ to the program.”

Now millions of Americans struggle to afford medical insurance

Walker cites DNC Rapid Response Director Kendall Witmer who said in a statement “Donald Trump and Republicans are doing everything they can to make healthcare unaffordable for Americans, especially for seniors,” She added:

Trump and Republicans massive healthcare cuts have pushed working families to the brink, Walker writes. Americans must now grapple with skyrocketing insurance premiums, even bigger medical bills, and rising prescription drug costs. They “are taking on record amounts of medical debt just to make ends meet — all while Trump and his family get even richer and his wealthy donors rake in tax cuts.”

Democrats have a different approach

Democrats and those on the Left want a very different approach. For example, “ In an op-ed for Truthout co-written last month by Rep. Ilhan Omar (D-Minnesota) and Lisa Gilbert, co-president of Public Citizen, the pair called for repairing the broken U.S. health system by expanding Medicare eligibility to every person in the country.”

Walker notes that Omar and Gilbert added: “Given the resources of our country, we can no longer justify the status quo. The U.S. spends almost twice per person on health care compared to other wealthy nations and our outcomes are often worse. Millions of Americans remain uninsured or underinsured. This is utterly outrageous, especially in the wealthiest country in the world.

“‘We are sick and tired of our health care system putting profits before people,’ Omar and Gilbert said. ‘We need to create a future in which every single person in the U.S. can get the care they need regardless of their ability to pay.’”

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Hospitals are now facing an increasing number of uninsured patients

Reed Abelson reports on how a report by hospitals document that the healthcare cuts have led to a sharp increase in uninsured patients coming for uninsured care

(https://www.nytimes.com/2026/07/30/business/aca-obamacare-health-insurance.html).

 She writes, “More people who lost coverage after congressional Republicans ended enhanced federal subsidies are now seeking care in emergency rooms and unable to pay bills.”

Abelson continues. “More and more uninsured patients are showing up in hospital emergency rooms and clinics, having lost their coverage under the Affordable Care Act.

“Executives running some of the biggest hospital systems, including large for-profit chains spanning many states, expressed concern over the unexpectedly sharp rise in uninsured patients and the costs associated with treating them.”

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More evidence on how hospitals are facing funding problems and many are closing

Whitney Curry Wimbash reports for The American Prospect on how Trump Funding Cuts are Endangering City and Rural Hospitals Alike

(https://prospect.org/2026/07/15/trump-funding-cuts-endangering-city-rural-hospitals-alike). Here’s some of what she reports.

“A year after Trump ripped $1 trillion out of the American health care system, hundreds of hospitals have closed and millions of people are without health insurance. The majority are in urban areas.”

Winbash continues. “In the year since President Trump stole $1 trillion out of the American health care system to free up funding for mass deportation, tax breaks for his billionaire friends, and, it turns out, illegal wars of aggression, much of the resulting conversation has focused on how the funding cuts would impact rural hospitals and patients. The idea was that most of the harm would hit there, since rural medical providers were already on the brink of collapse across the country.

“But new research from National Nurses United challenges that assumption. Researchers identified 602 financially vulnerable hospitals across 47 states, which together operated with an aggregated deficit of about $10.2 billion. They found that when the full impact of Trump’s One Big Beautiful Bill Act finally hits, the group’s deficit will increase to between $15.4 billion and $17.9 billion. Of this group, 366 are in metropolitan areas, nearly 61 percent, while the rest are in rural or semirural areas,” often financially vulnerable hospitals in cities that tend to serve communities of poor and working-class people.

Trump ended the Affordable Care Act

Winbash continues. “Trump’s Republican Party also refused to extend Biden-era Affordable Care Act enhanced premium tax credits, which caused enrollment for ACA insurance to drop by about 4.2 million people as of February 2026. Insurers that participate in the program jacked prices so high that enrollees faced an average 114 percent increase just to stay with the same plan as the year before; they have proposed a double-digit increase for next year, too, with a median increase of 14 percent for 2027.”

Hospitals are sending patients massive bills just when they can’t afford them and even suing them for payments, Winbash notes.

There’s more bad news.

Winbash continues. “The services hospitals typically cut first are pediatric, maternity, and psychiatric units as well as home health care, all of which typically do not make hospitals as much money as other divisions, Protect our Care’s Director of Policy Programs Vaishu Jawahar told the Prospect. With more cuts on the way, however, more hospitals are converting to emergency-only service centers.”

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The Crisis of Care Work

Robert Kuttner focuses on “the crisis of care work in an article for The American Prospect “(https://prospect.org/2026/07/21/crisis-of-care-work-trump-tps-haitians) .

His contention is that “The end of Temporary Protected Status and Trump’s budget cuts make a bad situation worse.”

Examples of the non-professionals who serve the sick.

Those who serve the sick “come from Haiti, Mexico, the Dominican Republic, Uganda, Jamaica, the Philippines, and dozens of other nations. They serve people who may be aging, frail, sick, disabled, dying; often frightened, sometimes angry and unappreciative.

“They bathe their clients, change adult diapers, supervise medications, and provide companionship in relationships that are intimate as well as professional. Their compassion can be ennobling.

“These are the people Donald Trump hates.

Growing shortage of care workers as funds are cut

“America today faces a worsening shortage of care workers, as the population ages, needs expand, and deportations increase. Too few people are willing to work for low pay in nursing homes, hospice care, home care, and as personal care attendants for people with disabilities. These jobs start at $20 an hour or less, and max out at around $25 for experienced people.

Care workers are both skilled and kind

“Anyone who has personally encountered care workers notices that despite the low pay, they tend to be both skilled and kind. The label, care, is exactly the right term. In my own experience with loved ones reliant on nurses and aides, most care workers are deeply caring.

Government has paid too little for much of care work

Kuttner points out, “Care work is heavily funded by government, except for a minority of affluent clients who can self-pay. Hospice care is financed by Medicare. Long-term nursing home care is mostly reimbursed by Medicaid. Care that supports independent living for people with disabilities is funded by Medicaid or the VA. Home care is underwritten by several agencies.

“All of these sources of public funding are barely adequate to the need, and that severely limits the room for better pay. And all are under further threat from Trump

budget cuts as well as mass deportations.

Unions have pressed for improved benefits for care workers

“In heavily Democratic states, the strategy of the labor movement and other advocates has been to press allies in government to allocate more budget for reimbursements, typically through Medicaid, which in turn can translate into better pay. Unions also organize workers directly. This has had only limited success because of other financial demands on Medicaid.

“SEIU has focused on nursing home workers. In Massachusetts, modest increases in Medicaid funding have created a bit more space to press for higher wages. SEIU’s big health local 1199 has organized certified nursing assistants in about 9 percent of Massachusetts nursing homes. According to Massachusetts SEIU leaders, CNAs in unionized nursing homes start at around $22-$23 an hour. That union premium makes life better for these workers but is far from sufficient to increase worker supply.”

Trump’s war on immigrants cuts care service

Kuttner observes that “TRUMP’S WAR ON IMMIGRANTS has cut deeply into the care workforce. The strategy of using ICE to intimidate immigrant workers into self-deporting, even when they currently have legal work status, is all too effective.”

Trump’s ends Temporary Protect Status adding to the shortage

“Separately,” Kuttner writes, “Trump has been systematically ending a legal immigration system called Temporary Protected Status. When Trump’s second term began, TPS was protecting some 1.3 million people facing various perils in their home countries. However, Trump has already ended TPS for people from Afghanistan, Cameroon, Honduras, Liberia, Nepal, Nicaragua, and for most Venezuelans.

“Ai-jen Poo, the founder of the National Domestic Workers Alliance and the coalition Caring Across Generations, told me, “The end of Haitian TPS will be devastating for hundreds of thousands of families who rely upon Haitian care workers. Providers will close their doors, jobs will be lost—for citizens as well as immigrants. The entire industry was already buckling under the pressures of cuts to Medicaid, and high workforce turnover due to low wages. At a moment when the need for care is surging, particularly on the part of our growing aging population, we should be expanding and strengthening our care workforce, not gutting it with cruel and misguided policy.”

Solutions?

Kuttner sees two long-term solutions. “First, we need massive investment in caregiving work, so that different categories of care are not reliant on a patchwork of chronically inadequate funding. Second, the war on immigrants needs to end.” Both have a chance only when Trump’s presidency ends.

“After Trump finally leaves office, Congress could also resume its efforts to enact comprehensive immigration reform, which was fast-tracked for passage in early 2018 until Trump decided that he’d prefer to use immigration as a political cudgel and persuaded key Republicans to oppose it. Comprehensive immigration reform would regularize the status of long-term undocumented residents who have stayed out of trouble, give legal status to ‘Dreamers’ who were brought to the U.S. as children, and crack down on employers who hire people not entitled to work.”

“Congress should revise the law so that admission of asylum seekers and refugees is mandatory, not optional; and shift judicial review to the independent judiciary established in the Constitution.

“America has plenty of immigrants who want to work in the care economy. We should welcome that workforce and pay them decently.”

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Concluding thoughts

Trump has made the already inadequate U.S. healthcare system far worse than it has been. His supporters, perhaps one-third of the population, have gone along with him as they have Trump’s other priorities. His rich and well-to-do followers like the tax cuts, deregulation, and pro-fossil-fuel energy policy.

He and his administration do all this because they are ideologically opposed to programs and policies that give benefits to ordinary Americans. To top it off, Trump falsely believes in his ability to make the best decisions.

Fortunately for democracy’s future, Trump’s poll rankings are low, Republicans are losing elections, his Iran War is highly unpopular, and he is having trouble getting his candidates confirmed by the Senate. Meanwhile, as this post shows, he is doing a great deal of harm. But there is light at the end of this dark time.