With Obamacare gone, how will Trumpcare affect US health?


The world is a less certain place than it was this time yesterday, and the health industry has not escaped waking up with that feeling of ‘what just happened?’

US President elect Donald Trump vowed through his campaign to ‘immediately repeal’ Obamacare, but it seems no one has any idea what Trumpcare will look like. The Affordable Care Act will be afforded no longer, and health analysts are scrambling to find much more than election sound bites to predict what might replace it.

To consult the modern oracles, one need never travel further than the stockmarket. As investors fled US-dollar exposed shares yesterday, health insurance stocks were caught in the maelstrom.

Repealing Obamacare entirely would leave 20 million without health insurance, and although few believe the Republicans will go so far, Trump is predictably unpredictable. That’s enough to spook health insurers and owners of private hospitals.

As a PricewaterhouseCoopers (PwC) report put it recently, “Trump’s candidacy raised more questions about his healthcare proposals than it provided answers.” The Washington Post this morning quotes a PwC analyst highlighting the problem: “These health organizations are like large ships, and you can’t turn them on a dime.”

A pre-election poll found that 79% of Clinton supporters believed Obamacare was working well, but an overwhelming 94% of Trump supporters felt it was working poorly. Perhaps Clinton should have proposed changing the name?

…waking up with that feeling of ‘What just happened?’

Interestingly, pharmaceutical stocks not only survived yesterday’s turmoil, but flourished. Pfizer shares opened 9% higher and, at the time of writing, all the major pharma stocks are up compared to yesterday.

Although again no one seems quite certain of Trump’s intentions, investors clearly took heart that Hillary Clinton’s vocal criticism of pharmaceutical pricing will not have a Whitehouse podium to host it. According to the same Washington Post article, the US pays 2.5 times what the rest of the world pays for its medicines, and the Republicans are clearly a lesser threat to that status quo.

Advocates of universally available birth control are also battening down, waiting for the knock on the door. Planned Parenthood, the nation’s largest provider of sex education, said in a media statement this morning, “we will never back down and we will never stop fighting” to keep their 650 health centres open.

During this year’s Republican debate, Trump said “I would defund [Planned Parenthood] because of the abortion factor”.

Medicare, the US funding program for seniors, was generally supported by both Trump and Clinton, and is thus protected to some degree from the storm. However, its trust fund is predicted to become insolvent by 2028, and the next four years will see a lot of pressure to top up the coffers.

On this day-after, we can predict plenty of changes afoot in the world’s most expensive healthcare system, but no one is quite sure what they will be. Not even the incoming president.


This article was first published in Medical Observer, Nov 2016

About Dr Justin Coleman

Justin is a GP in Brisbane and Director of Education for GPs in the NT. He edits a medical journal and two medical textbooks, and is a medical writer and educator. Further details at https://drjustincoleman.com/
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2 Responses to With Obamacare gone, how will Trumpcare affect US health?

  1. Timely, important and well written, thanks Justin. The irony is that the typical Trump supporter will be affected by the repeal of Obamacare more than most. They have effectively given up their health insurance and opportunity for cheaper medications in return for the license to shout racist slogans and dream of the kind of America which will never be.


  2. Pingback: House Republicans introduce Obamacare replacement legislation

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