President Donald Trump is ready to play ball when it comes to healthcare. Trump on Tuesday suggested he was open to extending Obamacare subsidies that are set to expire at the end of the year if it would give Congress time to make changes that he supports to the federally run healthcare plan.
“Some kind of an extension may be necessary to get something else done, because the unaffordable care act has been a disaster,” Trump told reporters on Air Force One, referring to Obamacare’s official name, the Affordable Care Act.
Trump in recent weeks has backed a plan to give money directly to Obamacare enrollees through health savings accounts, diverting federal funds from enhanced subsidies that lower insurance premiums.
“Don’t give any money to the insurance companies. Give it to the people directly, let them go out, buy their own health care plan,” Trump said again Tuesday. “We’re looking at that.”
Trump’s plan is not finalized, and the White House has emphasized that it remains a draft. It is unclear whether Congress will approve the proposal, given significant opposition from Republican lawmakers who object to extending subsidies or altering premium structures.
READ: Trump to unveil new healthcare cost proposal as ACA subsidies expire (
Core details, such as exactly who qualifies, how much each individual would receive, and the final premium and out-of-pocket costs, have not been publicly released. Any predictions about the plan’s impact on Americans, insurers, or taxpayers remain speculative.
“Somebody said I wanna extend them for two years. I don’t want to extend them for two years. I’d rather not extend them at all,” Trump said.
The Affordable Care Act (ACA) continues to provide health coverage through marketplaces, Medicaid expansion in participating states, and protections for pre-existing conditions. Insurers must cover essential health benefits, including preventive services, maternity care, mental health care, and prescription drugs.
Marketplace plans allow individuals and small businesses to compare coverage and receive subsidies based on income, ensuring affordability for many Americans.
READ: The myth of the ‘free market’ in fossil fuels (
In 2025, Centers for Medicare & Medicaid Services finalized the “Marketplace Integrity and Affordability Final Rule,” which requires stricter income verification, enforces payment of past-due premiums before granting new coverage, and eliminates certain special enrollment periods for low-income individuals. Core ACA protections, including coverage for pre-existing conditions and essential benefits, remain intact. However, the specific effects of these changes on premiums, out-of-pocket costs, and enrollment for individuals and families are not yet fully known. The ultimate impact on overall coverage rates, affordability, and market stability remains uncertain and may vary by state and insurer.
Shifts in policy, regulatory updates, and proposed reforms illustrate that the system is dynamic and subject to frequent adjustments, influenced by both government decisions and market responses. The effects of these changes on individuals, families, and insurers are not yet fully known, and outcomes may differ across regions, income levels, and populations.
Despite uncertainty, the system continues to provide critical protections for many Americans, underscoring the importance of maintaining foundational coverage while adapting to evolving challenges.