For years, Donald has promised that a healthcare plan better than the Affordable Care Act was just around the corner. Instead, we have gotten concepts of a plan, but no actual plan. Donald finally did release something on January 15th, 2026, when he announced what he called the Great Healthcare Plan. But that was actually a framework that he asked Congress to enact, not a comprehensive replacement for the Affordable Care Act. It does not specify how much direct assistance Americans would receive or who would qualify.
The United States spends more money on healthcare than any other developed nation, and still it does not guarantee coverage to everyone. But on the right, Americans going without healthcare is not a radical idea. Making sure everyone has access to healthcare is the radical idea. Radical and, to Republicans, unacceptable.
On August 10th, Sean Hannity attacked Michigan Democratic Senate nominee and physician Abdul El Sayed for supporting Medicare for All.
This is what Sean Hannity said:
El Sayed, who refers to himself as a medical doctor, never practiced medicine in his life, also hates America’s healthcare system. He’d like to replace that with the single payer system like they have in Canada. By the way, why do all those Canadians come to America for healthcare, yet they pay for it out of pocket?
He calls himself a medical doctor because he has an advanced degree in medicine and therefore is, in fact, a medical doctor. That fact has either escaped Hannity’s notice, or Republicans simply do not care what Americans want. As many as 90% of Democrats support Medicare for All, as do as many as 64% of Americans overall. Oh, well. Republicans do not, which is to say, the Republicans in power do not.
On July 4th, 2025, Donald signed his big abominable bill into law. This legislation made the largest federal reductions to Medicaid in the program’s history. CBO estimates its Medicaid provisions will reduce federal spending by nearly $900 billion through 2034, leaving 7.5 million more people uninsured that year. This came after Donald repeatedly promised he was not going to cut Medicaid.
So how do you cut hundreds of billions of dollars for Medicaid without simply announcing that millions of Americans are losing Medicaid? Well, you simply change the rules for staying enrolled.
Beginning no later than January 1st, 2027, by the way, after the results of the midterm election are in, many adults covered through Medicaid expansion will have to demonstrate that they are working, volunteering, participating in job training or education, or otherwise meeting the law’s requirements for at least 80 hours a month. On June 1st, 2026, the Trump regime announced a federal framework for putting those requirements into place. Dr. Mehmet Oz, a former TV host who now runs the Centers for Medicare and Medicaid Services, called it a path to prosperity.
By the way, many people who get Medicare or Medicaid do work, so there’s that.
I think it is safe to say we have a pretty good idea where all of this is heading. On July 23rd, 2026, the Congressional Budget Office released its latest projections. It expects the number of uninsured Americans to grow from about 30 million this year to 37 million by 2036, largely because of the Medicaid, CHIP, and Affordable Care Act provisions enacted in 2025.
Avik Roy, a longtime healthcare policy expert, spoke on C SPAN’s Washington Journal about what the Trump regime’s new Medicaid work and reporting requirements will actually mean for people trying to keep their coverage.
When he was asked how the work requirements would affect the pool of people receiving Medicaid benefits, this is what he said:
Yeah, I mean, it’s going to significantly shrink the pool of people that get benefits through Medicaid. We’re already seeing that happening. And I think the critical point here is that the majority of people who get Medicaid already work.
Medicaid is only part of the story. The enhanced ACA premium tax credits were allowed to expire by the Republican majority on December 31st, 2025. By February, marketplace enrollment had fallen by nearly three million people, while average monthly premium payments for those who remained enrolled rose 58%, from $113 to $178.
But losing health insurance does not make people stop getting sick. It changes where they go when they do get sick.
The Trump regime points to the $50 billion Rural Health Transformation Program included in the big abominable bill as evidence that it is protecting rural healthcare. But here is the scale of what that money is up against. KFF estimates the same law will reduce federal Medicaid spending in rural areas by about $137 billion over 10 years. The Rural Health Fund provides $50 billion over just five years, and the two things are not interchangeable. Much of the new fund is intended for things like technology, workforce development, and restructuring rural healthcare systems, not simply replacing the Medicaid revenue hospitals are losing.
As of May 2026, 720 rural hospitals, which is roughly one third of the rural hospitals in the country, were considered at risk of closing because of existing financial problems. More than 40% were losing money providing patient care, and Medicaid is especially important outside America’s cities. It covers 16.1 million people in rural communities, where hospitals often operate on extremely thin margins and may be the only hospital for miles.
The $50 billion fund is now beginning to reach states, but there are already questions about how quickly that money is getting where it needs to go. West Virginia received nearly $200 million for the program’s first year, but as of August 11th, only $38.8 million of that money had been obligated, prompting state lawmakers to question officials about delays, contracting, and oversight.
About one in seven Americans lives in a rural community where patients already face longer travel distances and shortages of doctors and other healthcare providers. Roughly half of rural hospitals consistently operated at a loss on patient services from 2017 through 2022, before Donald’s latest Medicaid reductions were enacted.
On February 13th, 2025, the Senate confirmed Robert Kennedy as Donald’s Secretary of Health and Human Services. Within weeks, Kennedy was confronting one of the most basic tenets imaginable for a public health secretary: measles.
As of August 6th, the Centers for Disease Control had confirmed 2,465 measles cases in the United States in 2026, already surpassing the 2,289 cases reported during the entirety of 2025 and making this the highest annual measles case count since 1992. Ninety four percent of this year’s cases have been associated with outbreaks, with 38 outbreaks reported so far.
The historical context makes those numbers even more striking. Measles was declared eliminated in the United States in 2000, meaning that the disease was no longer continuously spreading within the country. Since Kennedy was made Secretary of Health and Human Services, two unvaccinated children in Texas died and one from New Mexico from an easily preventable childhood disease.
While measles was making a comeback in the United States, Kennedy went on Fox and offered this assessment of which children should die from the disease.
Robert Kennedy: We need to know how to treat them. And one of the failures of CDC in the past is they weren’t telling doctors. No kid should die of measles in this country. Even in 1963, before the introduction of the vaccine, there were 400 deaths a year and there were up to two million measles cases.
Well, that’s an interesting way of putting it. Only very, very sick children should die from measles, says the anti vaccine sociopath.
No. No child anywhere should die from measles, certainly not in a country that had eradicated that disease because of a safe, effective vaccine that was readily available to anybody who wanted it.
Kennedy also promoted vitamin A in connection with measles treatments, but here is the thing: actual doctors warn that excessive doses of vitamin A can cause toxicity. The problem for us, besides the fact that Robert Kennedy is in charge of Health and Human Services, is that apparently people listen to him because of the authority that comes with that position.
So anybody not vaccinating their children because Kennedy told them not to is also listening to the snake oil salesman when it comes to his alternative treatments that could also get their children killed.
Your voice is an important part of the conversation. Thanks for joining us.
Why doesn’t the richest, most powerful nation on Earth have the greatest healthcare system on Earth? Why doesn’t the richest, most powerful nation on Earth have the greatest educational system on Earth? It ought to be a gigantic embarrassment, but of course, the people responsible for this, the conservatives and regressives who make up the Republican party, are incapable of being embarrassed and shamed. For proof, just look at who leads their party, the most corrupt, addlebrained liar to ever be President.
We have money to bomb other countries. We have money to kidnap leaders from other countries. We have money to build a fighting ring on the grounds of the White House. And a ballroom. We have money to ruin the reflecting pool . We have money to fly the President and his entourage to NJ and FL for golf on the weekend. We have money to cover the oval office in tacky gold paint. We have money to pay Mitch McConnell, who voted against paid leave, to pay him while he was out for three months, and his staff as well. But somehow, we keep getting told we have no money for Social Security or Medicare or Medicaid. Congress is bought and paid for by large corporations. The rest of us beg for scraps and are supposed to be grateful. We are the only first world country on the planet where people can go broke because they got sick. Gas is over $4 a gallon. Diesel over $6. Food is more expensive than it's ever been. It's time to hold these so-called leaders accountable for their actions and lack of action. We have the money if we pay for the things that benefit all the people...not just the 1%.