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.
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HBD: The Human Being Diet – by Petronella Ravenshear
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We don’t often review diet books, so why did this one catch our attention? The answer lies in its comprehensive nature without being excessively long and complex.
Ravenshear (a nutritionist) brings a focus on metabolic balance, and what will and won’t work for keeping it healthy.
The first part of the book is mostly informational; covering such things as blood sugar balance, gut health, hormones, and circadian rhythm considerations, amongst others.
The second, larger part of the book is mostly instructional; do this and that, don’t do the other, guidelines on quantities and timings, and what things may be different for some people, and what to do about those.
The style is conversational and light, but well-grounded in good science.
Bottom line: if you’d like a “one-stop shop” for giving your diet an overhaul, this book is a fine choice.
Click here to check out the Human Being Diet, and enjoy the best of health!
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Hashimoto’s Food Pharmacology – by Dr. Izabella Wentz
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The author is a doctor of pharmacology, and we’ve featured her before as an expert on Hashimoto’s, which she has. She has recommendations about specific blood tests and medications, but in this book she’s mainly focussing on what she calls the “three Rs” of managing hypothyroidism:
- Remove the causes and triggers of your hypothyroidism, so far as possible
- Repair the damage caused to your body, especially your gut
- Replace the thyroid hormones and related things in which your body has become deficient
To this end, she provides recipes that avoid processed meats and unfermented dairy, and include plenty of nutrient-dense whole foods specifically tailored to meet the nutritional needs of someone with hypothyroidism.
A nice bonus of the presentation of recipes (of which there are 125, if we include things like “mint tea” and “tomato sauce” and “hot lemon water” as recipes) is explaining the thyroid-supporting elements of each recipe.
A downside for some will be that if you are vegetarian/vegan, this book is very much not, and since many recipes are paleo-style meat dishes, substitutions will change the nutritional profile completely.
Bottom line: if you have hypothyroidism (especially if: Hashimoto’s) and like meat, this will be a great recipe book for you.
Click here to check out Hashimoto’s Food Pharmacology, and get cooking!
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The Health Fix – by Dr. Ayan Panja
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The book is divided into three main sections:
- The foundations
- The aspirations
- The fixes
The foundations are an overview of the things you’re going to need to know, about biology, behaviors, and being human.
The aspirations are research-generated common hopes, desires, dreams and goals of patients who have come to Dr. Panja for help.
The fixes are exactly what you’d hope them to be. They’re strategies, tools, hacks, tips, tricks, to get you from where you are now to where you want to be, health-wise.
The book is well-structured, with deep-dives, summaries, and practical advice of how to make sure everything you’re doing works together as part of the big picture that you’re building for your health.
All in all, a fantastic catch-all book, whatever your health goals.
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Four Ways To Upgrade The Mediterranean Diet
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Four Ways To Upgrade The Mediterranean Diet
The Mediterranean Diet is considered by many to be the current “gold standard” of healthy eating, and with good reason. With 10,000+ studies underpinning it and counting, it has a pretty hefty weight of evidence.
(For contrast, the Ketogenic Diet for example has under 5,000 studies at time of writing, and many of those include mentioning the problems with it. That’s not to say the Keto is without its merits! It certainly can help achieve some short term goals, but that’s a topic for another day)
Wondering what the Mediterranean Diet consists of? We outlined it in a previous main feature, so here it is for your convenience 😎
To get us started today, we’ll quickly drop some links to a few of those Mediterranean Diet studies from the top:
- Definition of the Mediterranean Diet; a Literature Review
- Mediterranean Diet In Healthy Aging
- Cancer and Mediterranean Diet: A Review
- Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity
- Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies
- Adherence to Mediterranean diet and health status: meta-analysis
The short version is: it glows, in a good way.
The anti-inflammatory upgrade
One thing about the traditional Mediterranean Diet is… where are the spices?!
A diet focusing on fruits and non-starchy vegetables, healthy oils and minimal refined carbs, can be boosted by adding uses of spices such as chili, turmeric, cumin, fenugreek, and coriander:
The gut-healthy upgrade:
The Mediterranean Diet already gives for having a small amount of dairy, mostly in the form of cheeses, but this can be tweaked:
Mediterranean diet with extra dairy could be a gut gamechanger
The heart-healthy upgrade
The Mediterranean Diet is already highly recommended for heart health, and it offers different benefits to different parts of cardiovascular health:
The DASH (Dietary Approaches to Stop Hypertension) diet can boost it further, specifically in the category of, as the name suggests, lowering blood pressure.
It’s basically the Mediterranean Diet with a few tweaks. Most notably, red meat no longer features (the Mediterranean Diet allows for a small amount of red meat), and fish has gone up in the list:
Description of the DASH Eating Plan
The brain-healthy upgrade:
The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet combines several elements from the above, as the name suggests. It also adds extra portions of specific brain-foods, that already exist in the above diets, but get a more substantial weighting in this one:
MIND and Mediterranean diets linked to fewer signs of Alzheimer’s brain pathology
See also: The cognitive effects of the MIND diet
Enjoy!
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Exercises for Aging-Ankles
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Can Ankles Deterioration be Stopped?
As we all know (or have experienced!), Ankle mobility deteriorates with age.
We’re here to argue that it’s not all doom and gloom!
(In fact, we’ve written about keeping our feet, and associated body parts, healthy here).
This video by “Livinleggings” (below) provides a great argument that yes, ankle deterioration can be stopped, or even reversed. It’s a must-watch for anyone from yoga enthusiasts to gym warriors who might be unknowingly crippling their ankle-health.
How We Can Prioritise Our Ankles
Poor ankle flexibility isn’t just an inconvenience – it’s a direct route to knee issues, hip hiccups, and back pain. More importantly, ankle strength is a core component of building overall mobility.
With 12 muscles in the ankle, it can be overwhelming to work out which to strengthen – and how. But fear not, we can prioritise three of the twelve: the calf duo (gastrocnemius and soleus) and the shin’s main muscle, the tibialis anterior.
The first step is to test yourself! A simple wall test reveals any hidden truths about your ankle flexibility. Go to the 1:55 point in the video to see how it’s done.
If you can’t do it, you’ve got work to be done.
If you read the book we recommended on great functional exercises for seniors, then you may already be familiar with some super ankle exercises.
Otherwise, these four ankle exercises are a great starting point:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Superfood Energy Balls
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They are healthy, they are tasty, they are convenient! Make some of these and when you need an energizing treat at silly o’clock when you don’t have time to prepare something, here they are, full of antioxidants, vitamins and minerals, good for blood sugars too, and ready to go:
You will need
- 1 cup pitted dates
- 1 cup raw mixed nuts
- ¼ cup goji berries
- 1 tbsp cocoa powder
- 1 tsp chili flakes
Naturally, you can adjust the spice level if you like! But this is a good starter recipe.
Method
(we suggest you read everything at least once before doing anything)
1) Blend all the ingredients in a good processor to make a dough
2) Roll the dough into 1″ balls; you should have enough dough for about 16 balls. If you want them to be pretty, you can roll them in some spare dry ingredients (e.g. chopped nuts, goji berries, chili flakes, seeds of some kind, whatever you have in your kitchen that fits the bill).
3) Refrigerate for at least 1–2 hours, and serve! They can also be kept in the fridge for at least a good while—couldn’t tell you how long for sure though, because honestly, they’ve never stayed that long in the fridge without being eaten.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Dates vs Figs – Which is Healthier?
- Why You Should Diversify Your Nuts!
- Goji Berries: Which Benefits Do They Really Have?
- The Sugary Food That Lowers Blood Sugars
- Enjoy Bitter Foods For Your Heart & Brain
- Capsaicin’s Hot Benefits
Take care!
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