Trump Administration ACA Plans: Cheaper, But Skimpier

Bob Herman covers health insurance, government programs, hospitals, physicians, and other providers — reporting on how money influences those businesses and shapes what we all pay for care. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.

Tara Bannow covers hospitals, providers, and insurers. You can reach Tara on Signal at tarabannow.70.

Trump health officials are proposing changes that would water down the options for people who buy their own health insurance through Affordable Care Act marketplaces.

The proposals, released this week and which would go into effect in 2027, prioritize making ACA premiums as low as possible — by expanding bare-bones coverage, allowing insurers to skip creating networks of hospitals and doctors, and repealing standardized plan options.

The goals and tradeoffs of these policies, which have longstanding conservative roots, are clear, health policy experts told STAT. Premiums would be cheaper for skinnier plans, attracting healthier people who don’t anticipate needing a lot of care. But those with health problems, and those who unexpectedly need care, could face financially ruinous consequences if they choose those plans.