What Would a Second Trump Presidency Look Like for Health Care?
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On the presidential campaign trail, former President Donald Trump is, once again, promising to repeal and replace the Affordable Care Act — a nebulous goal that became one of his administration’s splashiest policy failures.
“We’re going to fight for much better health care than Obamacare. Obamacare is a catastrophe,” Trump said at a campaign stop in Iowa on Jan. 6.
The perplexing revival of one of Trump’s most politically damaging crusades comes at a time when the Obama-era health law is even more popular and widely used than it was in 2017, when Trump and congressional Republicans proved unable to pass their own plan to replace it. That failed effort was a big part of why Republicans lost control of the House of Representatives in the 2018 midterms.
Despite repeated promises, Trump never presented his own Obamacare replacement. And much of what Trump’s administration actually accomplished in health care has been reversed by the Biden administration.
Still, Trump secured some significant policy changes that remain in place today, including efforts to bring more transparency to prices charged by hospitals and paid by health insurers.
Trying to predict Trump’s priorities in a second term is even more difficult given that he frequently changes his positions on issues, sometimes multiple times.
The Trump campaign did not respond to a request for comment.
Perhaps Trump’s biggest achievement is something he rarely talks about on the campaign trail. His administration’s “Operation Warp Speed” managed to create, test, and bring to market a covid-19 vaccine in less than a year, far faster than even the most optimistic predictions.
Many of Trump’s supporters, though, don’t support — and some even vehemently oppose — covid vaccines.
Here is a recap of Trump’s health care record:
Public Health
Trump’s pandemic response dominates his overall record on health care.
More than 400,000 Americans died from covid over Trump’s last year in office. His travel bans and other efforts to prevent the global spread of the virus were ineffective, his administration was slower than other countries’ governments to develop a diagnostic test, and he publicly clashed with his own government’s health officials over the response.
Ahead of the 2020 election, Trump resumed large rallies and other public campaign events that many public health experts regarded as reckless in the face of a highly contagious, deadly virus. He personally flouted public health guidance after contracting covid himself and ending up hospitalized.
At the same time, despite what many saw as a politicization of public health by the White House, Trump signed a massive covid relief bill (after first threatening to veto it). He also presided over some of the largest boosts for the National Institutes of Health’s budget since the turn of the century. And the mRNA-based vaccines Operation Warp Speed helped develop were an astounding scientific breakthrough credited with helping save millions of lives while laying the groundwork for future shots to fight other diseases including cancer.
Abortion
Trump’s biggest contribution to abortion policy was indirect: He appointed three Supreme Court justices, who were instrumental in overturning the constitutional right to an abortion.
During his 2024 campaign, Trump has been all over the place on the red-hot issue. Since the Supreme Court overturned Roe v. Wade in 2022, Trump has bemoaned the issue as politically bad for Republicans; criticized one of his rivals, Florida Gov. Ron DeSantis, for signing a six-week abortion ban; and vowed to broker a compromise with “both sides” on abortion, promising that “for the first time in 52 years, you’ll have an issue that we can put behind us.”
He has so far avoided spelling out how he’d do that, or whether he’d support a national abortion ban after any number of weeks.
More recently, however, Trump appears to have mended fences over his criticism of Florida’s six-week ban and more with key abortion opponents, whose support helped him get elected in 2016 — and whom he repaid with a long list of policy changes during his presidency.
Among the anti-abortion actions taken by the Trump administration were a reinstatement of the “Mexico City Policy” that bars giving federal funds to international organizations that support abortion rights; a regulation to bar Planned Parenthood and other organizations that provide abortions from the federal family planning program, Title X; regulatory changes designed to make it easier for health care providers and employers to decline to participate in activities that violate their religious and moral beliefs; and other changes that made it harder for NIH scientists to conduct research using fetal tissue from elective abortions.
All of those policies have since been overturned by the Biden administration.
Health Insurance
Unlike Trump’s policies on reproductive health, many of his administration’s moves related to health insurance still stand.
For example, in 2020, Trump signed into law the No Surprises Act, a bipartisan measure aimed at protecting patients from unexpected medical bills stemming from payment disputes between health care providers and insurers. The bill was included in the $900 billion covid relief package he opposed before signing, though Trump had expressed support for ending surprise medical bills.
His administration also pushed — over the vehement objections of health industry officials — price transparency regulations that require hospitals to post prices and insurers to provide estimated costs for procedures. Those requirements also remain in place, although hospitals in particular have been slow to comply.
Medicaid
While first-time candidate Trump vowed not to cut popular entitlement programs like Medicare, Medicaid, and Social Security, his administration did not stick to that promise. The Affordable Care Act repeal legislation Trump supported in 2017 would have imposed major cuts to Medicaid, and his Department of Health and Human Services later encouraged states to require Medicaid recipients to prove they work in order to receive health insurance.
Drug Prices
One of the issues the Trump administration was most active on was reducing the price of prescription drugs for consumers — a top priority for both Democratic and Republican voters. But many of those proposals were blocked by the courts.
One Trump-era plan that never took effect would have pegged the price of some expensive drugs covered by Medicare to prices in other countries. Another would have required drug companies to include prices in their television advertisements.
A regulation allowing states to import cheaper drugs from Canada did take effect, in November 2020. However, it took until January 2024 for the FDA, under Trump’s successor, to approve the first importation plan, from Florida. Canada has said it won’t allow exports that risk causing drug shortages in that country, leaving unclear whether the policy is workable.
Trump also signed into law measures allowing pharmacists to disclose to patients when the cash price of a drug is lower than the cost using their insurance. Previously pharmacists could be barred from doing so under their contracts with insurers and pharmacy benefit managers.
Veterans’ Health
Trump is credited by some advocates for overhauling Department of Veterans Affairs health care. However, while he did sign a major bill allowing veterans to obtain care outside VA facilities, White House officials also tried to scuttle passage of the spending needed to pay for the initiative.
Medical Freedom
Trump scored a big win for the libertarian wing of the Republican Party when he signed into law the “Right to Try Act,” intended to make it easier for patients with terminal diseases to access drugs or treatments not yet approved by the FDA.
But it is not clear how many patients have managed to obtain treatment using the law because it is aimed at the FDA, which has traditionally granted requests for “compassionate use” of not-yet-approved drugs anyway. The stumbling block, which the law does not address, is getting drug companies to release doses of medicines that are still being tested and may be in short supply.
Trump said in a Jan. 10 Fox News town hall that the law had “saved thousands and thousands” of lives. There’s no evidence for the claim.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Chorus or Cacophony? Cicada Song Hits Some Ears Harder Than Others
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ST. LOUIS — Shhhooo. Wee-uuu. Chick, chick, chick. That’s the sound of three different cicada species. For some people, those sounds are the song of the summer. Others wish the insects would turn it down. The cacophony can be especially irritating for people on the autism spectrum who have hearing sensitivity.
Warren Rickly, 14, lives in suburban south St. Louis County, Missouri. Warren, who has autism, was at the bus stop recently waiting for his younger brother when the sound of cicadas became too much to bear.
“He said it sounds like there’s always a train running next to him,” his mother, Jamie Reed, said.
Warren told her the noise hurt.
Starting this spring, trillions of the red-eyed insects crawled their way out of the ground across the Midwest and Southeast. It’s part of a rare simultaneous emergence of two broods — one that appears every 13 years, the other every 17.
The noisy insects can be stressful. People with autism can have a sensitivity to texture, brightness, and sound.
“I think the difference for individuals with autism is the level of intensity or how upsetting some of these sensory differences are,” said Rachel Follmer, a developmental and behavioral pediatrician at Lurie Children’s Hospital in Chicago.
“It can get to the extreme where it can cause physical discomfort,” she said.
When a large group of cicadas starts to sing, the chorus can be as loud as a motorcycle. Researchers at the University of Missouri-St. Louis this year crowdsourced cicada noise levels as high as 86 decibels, about as loud as a food blender.
That can be stressful, not melodic, Follmer said.
To help children cope, she suggests giving them a primer before they encounter a noisy situation. For cicadas, that could mean explaining what they are, that they don’t bite or sting, and that they’ll be here for just a short time.
“When something is uncomfortable, not having power in that situation can be very scary for a lot of individuals, whether you’re on the spectrum or not,” Follmer said.
Jamie Reed’s family has been using this and other strategies to help her son. Warren wears noise-canceling headphones, listens to music, and has been teaching himself about cicadas.
“For him, researching it and looking into it I think grounds him a little bit,” Reed said.
Fatima Husain is a professor and neuroscientist at the University of Illinois Urbana-Champaign and studies how the brain processes sound. She said people with tinnitus may also struggle with cicada song.
Tinnitus, a ringing or other noise in the ears, is a person’s perception of sound without an external source.
“Some people say it sounds like buzzing, like wind blowing through trees, and ironically, quite a few people say it sounds like cicadas,” Husain said.
For most people with tinnitus the cicada’s song is harmless background noise, according to Husain, but for others the ringing can prevent easy conversation or sleep. Those with tinnitus are also more likely to have anxiety or depression. A loud persistent sound, like singing cicadas, can make someone’s tinnitus worse, Husain said.
It’s not always bad, though. The cicada’s song can also be a relief.
For some, tinnitus gets worse in a quiet environment. Husain said she’s seen reports this year of patients saying the cicadas’ song has been like soothing white noise.
“The sound is loud enough that in some ways it’s drowning their internal tinnitus,” Husain said.
As loud as the cicadas can be, they won’t necessarily damage anyone’s hearing, according to the Centers for Disease Control and Prevention. Hearing loss builds up over time from repeated exposure to loud sounds. Cicadas aren’t loud enough for long enough to do lasting damage, Husain said.
Everyday sources of noise come with a higher risk. Husain said constant exposure to loud highways, an airport, industrial sites, or household appliances like blenders and hair dryers can be a concern. And they can take a toll on someone’s emotional well-being.
“If you are being exposed to very loud sounds for a part of your school day or your working day, it may make you more stressed out; it may make you more angry about things,” she said.
Unlike the highway or an airport, cicadas won’t be around long. Most of the current brood will be gone in the next few weeks. Just in time for another noisy summer event: the Fourth of July.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Calisthenics for Beginners – by Matt Schifferle
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For those who are curious to take up calisthenics, for its famed benefit to many kinds of health, this is a great starter-book.
First, what kind of benefits can we expect? Lots, but most critically:
- Greater mobility (as a wide range of movements is practiced, some of them stretchy)
- Cardiovascular fitness (calisthenics can be performed as a form of High Intensity Impact Training, HIIT)
- Improved muscle-tone (because these are bodyweight strength-training exercises—have you seen a gymnast’s body?)
- Denser bones (strong muscles can’t be built on weak bones, so the body compensates by strengthening them)
A lot of the other benefits stem from those, ranging from reduced risk of stroke, diabetes, heart disease, osteoporosis, etc, to improved mood, more energy, better sleep, and generally all things that come with a decent, rounded, exercise regime.
Schifferle explains not just the exercises, but also the principles, so that we understand what we’re doing and why. Understanding improves motivation, adherence, and—often—form. Exercise diagrams are clear, and have active muscle-groups highlighted and color-coded for extra clarity.
As well as explaining exercises individually, he includes three programs, increasing in intensity. He also offers adjustments to make exercises easier or more challenging, depending on the current condition of your body.
The book’s not without its limitations—it may be a little male-centric for some readers, for instance—but all in all, it’s a very strong introduction to calisthenics… Enough to get anyone up and running, so to speak!
Get started with “Calisthenics for Beginners” from Amazon today!
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How To Escape From A Despairing Mood
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When we are in a despairing mood, that’s when it can feel hardest to actually implement anything we know about getting out of one. That’s why sometimes, the simplest solutions are the best:
Imagination Is Key
Despairing moods occur when it’s hard to envision a better life. Imagination is the power to envision alternatives, such as new jobs, relationships, or lifestyle, but sadness can cloud our ability to imagine solutions like changing careers, moving house, or starting fresh. With enough imagination, most problems can be worked around—and new opportunities can always be found.
Importantly: we are not bound by our past or present circumstances; we have the freedom and flexibility to choose new paths. That doesn’t mean it’ll always be a walk in the park, but “this too shall pass”.
You may be thinking: “sometimes the hardship does pass, but can last many years”, and that is true. All the more reason to check if there’s a freer lane you can slip into to speed ahead. Even if there isn’t, the mere act of imagining such lanes is already respite from the hardships—and having envisioned such will make it much easier for you to recognise when opportunities for change do come along.
To foster imagination, we are advised to expose ourselves to different narratives, preparing ourselves for alternative ways of living. Thus, we can reframe life’s challenges as intellectual puzzles, urging us to rebuild creatively and find new solutions!
For more on all this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Behavioral Activation Against Depression & Anxiety
Take care!
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Improving Women’s Health Across the Lifespan – by Dr. Michelle Tollefson et al.
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We say “et al.”, because this hefty book (504 pages) is a compilation of contributions by about 60 authors, of whom, 100% are doctors and about 90% are women.
As one might expect from a book with many small self-contained chapters by such a lot of doctors, the content is very diverse, though the style is consistent throughout, likely due to the authors working from a style sheet, plus the work of the editorial team.
About that content: the focus here is lifestyle medicine, and while much of the advice will go for men too (most people are unlikely to go wrong with “eat more fruits and vegetables and get better sleep” etc), anything more detailed than that (of which there’s a lot) is focussed on women. Hence, we get chapters on optimal nutrition for women, physical activity for women, sleep and women’s health, etc, as well as topics that can affect everyone but disproportionately affect women—ranging from autoimmune diseases to social burdens that affect health in measurable ways. There’s also, as you might expect, plenty about sexual health, pregnancy-related health, menopausal health, and so forth.
The strength of this book is really in its diversity; it’s very much a case of “60 heads are better than one”, and as such, we’re pretty much getting 60 books for the price of one here, as each author brings what they are most specialized in.
Bottom line: if you are a woman and/or love a woman, this book is packed with information that will be of interest and applicable use.
Click here to check out Improving Women’s Health Across The Lifespan, and do just that!
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Want the health benefits of strength training but not keen on the gym? Try ‘exercise snacking’
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The science is clear: resistance training is crucial to ageing well. Lifting weights (or doing bodyweight exercises like lunges, squats or push-ups) can help you live independently for longer, make your bones stronger, reduce your risk of diseases such as diabetes, and may even improve your sleep and mental health.
But not everyone loves the gym. Perhaps you feel you’re not a “gym person” and never will be, or you’re too old to start. Being a gym-goer can be expensive and time-consuming, and some people report feeling unwelcome or awkward at the gym.
The good news is you don’t need the gym, or lots of free time, to get the health benefits resistance training can offer.
You can try “exercise snacking” instead.
Pressmaster/Shutterstock What is exercise snacking?
Exercise snacking involves doing multiple shorter bouts (as little as 20 seconds) of exercise throughout the day – often with minimal or no equipment. It’s OK to have several hours of rest between.
You could do simple bodyweight exercises such as:
- chair sit-to-stand (squats)
- lunges
- box step-ups
- calf raises
- push-ups.
Exercise snacking like this can help improve muscle mass, strength and physical function.
It’s OK to hold onto a nearby object for balance, if you need. And doing these exercises regularly will also improve your balance. That, in turn, reduces your risk of falls and fractures.
OK I have done all those, now what?
Great! You can also try using resistance bands or dumbbells to do the previously mentioned five exercises as well as some of the following exercises:
When using resistance bands, make sure you hold them tightly and that they’re securely attached to an immovable object.
Exercise snacking works well when you pair it with an activity you do often throughout the day. Perhaps you could:
- do a few extra squats every time you get up from a bed or chair
- do some lunges during a TV ad break
- chuck in a few half squats while you’re waiting for your kettle to boil
- do a couple of elevated push-ups (where you support your body with your hands on a chair or a bench while doing the push-up) before tucking into lunch
- sneak in a couple of calf raises while you’re brushing your teeth.
Exercise snacking involves doing multiple shorter bouts (as little as 20 seconds) of exercise throughout the day. Cavan-Images/Shutterstock What does the evidence say about exercise snacking?
One study had older adults without a history of resistance training do exercise snacks at home twice per day for four weeks.
Each session involved five simple bodyweight exercises (chair sit-to-stand, seated knee extension, standing knee bends, marching on the spot, and standing calf raises). The participants did each exercise continuously for one minute, with a one-minute break between exercises.
These short and simple exercise sessions, which lasted just nine minutes, were enough to improve a person’s ability to stand up from a chair by 31% after four weeks (compared to a control group who didn’t exercise). Leg power and thigh muscle size improved, too.
Research involving one of us (Jackson Fyfe) has also shown older adults found “exercise snacking” feasible and enjoyable when done at home either once, twice, or three times per day for four weeks.
Exercise snacking may be a more sustainable approach to improve muscle health in those who don’t want to – or can’t – lift heavier weights in a gym.
A little can yield a lot
We know from other research that the more you exercise, the more likely it is you will keep exercising in future.
Very brief resistance training, albeit with heavier weights, may be more enjoyable than traditional approaches where people aim to do many, many sets.
We also know brief-and-frequent exercise sessions can break up periods of sedentary behaviour (which usually means sitting too much). Too much sitting increases your risk of chronic diseases such as diabetes, whereas exercise snacking can help keep your blood sugar levels steady.
Of course, longer-term studies are needed. But the evidence we do have suggests exercise snacking really helps.
Just a few short exercise sessions can do you a world of good. eggeegg/Shutterstock Why does any of this matter?
As you age, you lose strength and mass in the muscles you use to walk, or stand up. Everyday tasks can become a struggle.
All this contributes to disability, hospitalisation, chronic disease, and reliance on community and residential aged care support.
By preserving your muscle mass and strength, you can:
- reduce joint pain
- get on with activities you enjoy
- live independently in your own home
- delay or even eliminate the need for expensive health care or residential aged care.
What if I walk a lot – is that enough?
Walking may maintain some level of lower body muscle mass, but it won’t preserve your upper body muscles.
If you find it difficult to get out of a chair, or can only walk short distances without getting out of breath, resistance training is the best way to regain some of the independence and function you’ve lost.
It’s even more important for women, as muscle mass and strength are typically lower in older women than men. And if you’ve been diagnosed with osteoporosis, which is more common in older women than men, resistance exercise snacking at home can improve your balance, strength, and bone mineral density. All of this reduces the risk of falls and fractures.
You don’t need heavy weights or fancy equipment to benefit from resistance training.
So, will you start exercise snacking today?
Justin Keogh, Associate Dean of Research, Faculty of Health Sciences and Medicine, Bond University and Jackson Fyfe, Senior Lecturer, Strength and Conditioning Sciences, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Polyphenol Paprika Pepper Penne
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This one’s easier to promptly prepare than it is to pronounce unprepared! Ok, enough alliteration: this dish is as full of flavor as it is full of antioxidants, and it’s great for digestive health and heart health too.
You will need
- 4 large red bell peppers, diced
- 2 red onions, roughly chopped
- 1 bulb garlic, finely chopped
- 2 cups cherry tomatoes, halved
- 10oz wholemeal penne pasta
- 1 tbsp nutritional yeast
- 1 tbsp smoked paprika
- 1 tbsp black pepper
- Extra virgin olive oil for drizzling
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 200℃ / 400℉ / Gas mark 6
2) Put the vegetables in a roasting tin; drizzle with oil, sprinkle with the seasonings (nooch, paprika, black pepper), stir well to mix and distribute the seasonings evenly, and roast for 20–25 minutes, stirring/turning occasionally. When the edges begin to caramelize, turn off the heat, but leave to keep warm.
3) Cook the penne al dente (this should take 7–8 minutes in boiling salted water). Rinse in cold water, then pass a kettle of hot water over them to reheat. This process removed starch and lowered the glycemic index, before reheating the pasta so that it’s hot to serve.
4) Place the roasted vegetables in a food processor and blitz for just a few seconds. You want to produce a very chunky sauce—but not just chunks or just sauce.
5) Combine the sauce and pasta to serve immediately.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Which Bell Peppers To Pick? A Spectrum Of Specialties ← note how red bell peppers are perfect for this, as their lycopene quadruples in bioavailability when cooked
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- The Many Health Benefits Of Garlic
- What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
Take care!
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