Trump healthcare plan threatens ACA with high-deductible insurance

We all know this saying, “If it sounds too good to be true, it probably is.” That’s how I would describe President Donald Trump’s latest healthcare idea: sending money “directly to the people so that they can purchase their own, much better healthcare.”  

What Republicans are proposing is a bad deal for hardworking Americans, but a good deal for the wealthy. Instead of the government continuing to subsidize Affordable Care Act (ACA) health insurance premiums, this new proposal could push millions into buying high-cost plans that make you pay thousands of dollars before they start paying for your care. Healthcare costs could skyrocket while undermining the entire Obamacare system – putting care at risk for millions of Americans. That doesn’t sound like a good deal to me.  

First things first. People already get money to buy their health insurance, but it’s in the form of a discount code – just like the ones you use when you buy something online. It’s a little different, but it works something like this: the government gives ACA health plans a discount code for everyone who buys ACA coverage. 

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This discount code is then applied – upfront – to people’s health insurance premiums, lowering their premiums and making it easier for people to shop for – and buy – health insurance that works best for both their budget and health care needs. Just like when you’re online shopping. You shop for the thing you want, buy it, and know how much you’re going to pay for it before you actually buy it. Who doesn’t like that? 

But as usual, Republicans are cooking up an idea that will make health insurance more expensive for hard-working Americans – all while helping rich people get a sweet tax deal. Their idea works like this: instead of giving the discount code to health plans, Republicans want to give people money to put into a health savings account. That sounds like a good deal, but it’s not, and here’s why: these savings accounts can only be used with what we call “high deductible health plans” – plans that won’t pay for your doctor visits or other health care until you “hit” your deductible, which can be very expensive. In 2025, the average deductible for a family enrolled in these kinds of plans was nearly $7,000.

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For many of us living on a budget, these plans look good on paper. That’s because they usually have a lower monthly premium. But the problem is, you won’t know how much going to the doctor will cost you. 

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Yes, you can use your health savings account to pay for your healthcare, but what happens when you run out of savings and haven’t hit your expensive deductible? You either don’t go to the doctor and get sicker because you can’t afford it, or you use your grocery money to pay for the doctor visit. How can a family live within their budget under this situation? It’s impossible! 

The only option is for families to go into debt, which is already burdening millions of families. That’s not a viable solution to this crisis, it’s only making the problem worse. 

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And if this wasn’t bad enough – you still have to pay a monthly premium for coverage you can’t afford to use.

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Here’s more salt in the wound: this Republican idea will help rich people get richer. That’s because these health savings dollars aren’t taxed. So rich people get a bigger benefit. Take a married couple making $800,000, they’ll save 37 cents for each dollar that goes into their health savings account, but a married couple making $30,000 only saves 12 cents – that’s one-third what the rich couple get! 

The Affordable Care Act isn’t perfect by any means, but the current system is better than what Republicans are proposing. We need to do more to lower health care costs, but Republicans’ plan won’t make this happen.