Before The Fall: What American Healthcare Lost After Trump Took Over
When the Census Bureau reported on September 15 that the uninsured population remained steady at its all-time low of eight percent of the adult population in 2025, I immediately thought of this visual metaphor to describe the news:
Wile E. Coyote
The picture is of one Wile E. Coyote, whose imminent fall into the canyon of despair always came at the hands of the Acme Manufacturing Co., which, to continue the metaphor, stands for the malfunctioning products of the Trump regime and an obsequious Congress. The GOP’s One Big Ugly Bill didn’t pass until mid-2025. Its destructive impact on the nation’s health insurance rolls didn’t begin until this year.
In other words, today’s news is the final snapshot of the successes of the Biden administration. During its four years in office, the government beefed up subsidies for low- and moderate-income people buying insurance plans on the exchanges, and expanded Medicaid to include many more women, children and low-wage workers.
“These data do not reflect the impact of recent rising inflation or most of the cuts to food assistance and health coverage enacted in the 2025 Republican reconciliation law,” the Center for Budget and Policy Priorities posted on its website. “That law made the largest cuts to SNAP and Medicaid in our nation’s history and failed to extend the premium tax credit enhancements that made the ACA marketplace more affordable and successful in expanding coverage and lowering costs. These cuts are already taking food assistance and health care away from millions of people who need it, driving up poverty and hardship.”
Nearly three million people dropped ACA plans this year because of soaring premiums and the Trump regime’s failure to extend the additional subsidies passed during the Biden years. Nearly four million people have already been thrown off Medicaid.
The Census Bureau also reported wage gains in 2025 outpaced inflation. But again, this largely reflects the temporary waning of inflation during Biden’s last year in office and preceded the White House pursuing its undeclared war against Iran, which has shut Straits of Hormuz and sent food and fuel prices soaring.
While we should use this last “good” year as a benchmark for what is to come, let’s also remember that leaving 27 million Americans without health insurance — an eight percent rate — is an anomaly in the advanced industrial world. So is the fact that 44 million people or one in eight overall live in poverty.
CBPP points out that income inequality after taxes stood last year at its highest point in nearly two decades. That average wage gains outpaced inflation is of little solace to people in the bottom half of the income distribution when those gains are disproportionately distributed to the rich and well-to-do.
Merrill Goozner, the former editor of Modern Healthcare, writes about health care and politics at GoozNews.substack.com, where this column first appeared. Please consider subscribing to support his work.
Reprinted with permission from GoozNews
