Trump’s health care 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 health care idea: sending money “directly to the people so they can buy their own, much better health care.”

What Republicans are proposing is a bad deal for hard-working 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 to buy expensive plans that require you to pay thousands of dollars before they start paying for your care. Healthcare costs could skyrocket while undermining the entire Obamacare system, jeopardizing healthcare for millions of Americans. That doesn’t seem like a good deal to me.

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

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This discount code is then applied – in advance – to health insurance premiums, reducing premiums and making it easier for people to find – and buy – health insurance that best suits both their budget and their healthcare needs. Just like when you shop online. You shop for what 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 coming up with an idea that will make health insurance more expensive for hardworking Americans — 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 don’t pay for your doctor visits or other health care until you “meet” your deductible, which can be very expensive. In 2025, the average deductible for a family enrolled in these types 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 that you don’t know how much a visit to the doctor will cost you.

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Yes, you can use your health savings account to pay for your health care, but what happens when your savings run out and your expensive deductible hasn’t been met? Either you 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’s visit. How can a family live within their budget in this situation? It’s impossible!

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

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And if this isn’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 are not taxed. So rich people get a bigger advantage. Take a married couple earning $800,000, they save 37 cents for every dollar that goes into their savings account, but a married couple earning $30,000 only saves 12 cents – that’s a third of what the rich couple gets!

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