Former U.S. President Donald Trump is shifting to a more populist health care stance, publicly placing blame for rising medical expenses on health insurance corporations — a move that appears aimed at countering Democratic criticism that Republicans have failed to keep health care affordable.
Democrats are currently pushing Congress to vote on extending Affordable Care Act (ACA) premium tax credits, set to expire at the end of the year. Trump, however, is crafting his own alternative — a proposal that would extend the subsidies for two years, paired with Republican-leaning reforms. The announcement has been temporarily held back amid resistance within the GOP.
In the midst of negotiations, Trump has chosen a clear target.
“The only healthcare I will support or approve is sending the money directly back to the people, with nothing going to the big, fat, rich insurance companies, who have made $trillions, and ripped off America long enough,”
— Trump, on Truth Social
Polling Shows Americans Agree — Insurers Seen as Main Culprit
Trump’s rhetoric aligns strongly with national sentiment. Recent polls show:
- 63% of voters believe insurance companies are most responsible for medical debt
- 76% want a system where they can remain insured even if unemployed or self-employed
Republican strategists say Trump’s new message could help reclaim ground traditionally dominated by Democrats.
“He’s one of the best politicians at seizing the other party’s strong issues and making them his,” a GOP strategist told The Hill.
Analysts Say Strategy Could Work — If Republicans Produce a Plan
Robert Cahaly of Trafalgar Group believes blaming insurers could resonate across party lines — but warns Republicans must present a tangible alternative to the ACA.
“The idea is popular because there’s a belief insurers got rich from Obamacare,” Cahaly said.
Polls show the public largely favors extending the ACA tax credits. However, supporters say opinions shift when framed as COVID-era relief still being funded years later.
Insurers Push Back — Point to Hospitals & Pharma Costs
Insurance industry representatives defended their role, noting that their profit margins are tightly regulated — dropping to 0.8% last year. In contrast, pharmaceutical companies logged 23% average annual profit margins between 2017 and 2023.
“Premiums reflect the underlying cost of care,” AHIP spokesman Chris Bond said, adding that 24 cents of every premium dollar goes to prescription drugs, while over 40 cents goes to hospital fees.
Pharmaceutical manufacturers countered that they are investing billions in new R&D and U.S.-based drug production, insisting they are pushing toward lower costs while improving access.
The Fight is Just Beginning
Health care remains one of Democrats’ strongest campaign weapons. Trump appears ready to turn that strength against them — not by defending past Republican policy, but by attacking the most profitable players in the system.
The question now is whether Republicans will deliver a replacement — or run on outrage alone.
