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Donald Trump has been inconsistent on what his plans are regarding the Affordable Care Act (ACA), the landmark law signed in 2010 by then-President Barack Obama. During his first term, Trump tried several times to repeal the ACA but was unsuccessful. In November 2023, he also vowed to replace it in a post on his social media platform, Truth Social. Since then, he has shifted course. In March, Trump said is "not running to terminate" the ACA but said he wanted to make it "better" and "less expensive," in a post on Truth Social. There could also be changes to Medicare, a federal health insurance program for people aged 65 or older and younger people with disabilities. (Kekatos, 11/6)

Though some of Donald Trump’s largest agenda items — tax breaks and Affordable Care Act changes — will take congressional approval, many won’t. The Trump administration will be able to change immigration enforcement, impose tariffs, change health regulations, intervene in overseas wars and shape the education system without help from the Hill. (Payne, 11/6)

Bipartisan groups in Congress have been pursuing greater transparency across the health sector, ways to reduce prescription drug prices and tougher oversight of pharmacy benefit managers as they seek to trim hospital spending in Medicare, boost pay for physicians, and curb prior authorizations in Medicare Advantage. Donald Trump did not talk much about such issues in the campaign, but in his previous term he supported price transparency rules for hospitals, sought to ban PBMs from keeping drug rebates and proposed linking U.S. pharmaceutical prices to international benchmarks. (McAuliff, 11/6)

Few agencies face a future quite as uncertain as the Bureau of Alcohol, Tobacco, Firearms and Explosives, which is responsible for gun regulations. And Mr. Trump’s return to power could lead to significant upheaval for millions of Americans dependent on the Affordable Care Act, after record levels of enrollment under Mr. Biden. Increased subsidies could expire next year without action from congressional Republicans and Mr. Trump, causing premiums to spike. (Baker and Savage, 11/6)

With former President Trump headed back to the White House, the U.S. Medicaid program, which covers medical care for people with low incomes, could face cuts. But Medicaid’s transformation to a program mostly run by private insurers adds an influential industry to its list of guardians, alongside the rural hospitals that rely on the program to balance their budgets. (Wilkerson, 11/6)

Project 2025, the rightwing playbook for a second Trump term, proposes using the 1873 Comstock Act, which outlaws the mailing of abortion-related materials, to ban people from shipping abortion pills. These pills account for about two-thirds of US abortions. If enacted to its fullest extent, the Comstock Act could not only ban pills but the very equipment that clinics need to do their jobs, and Trump could use the legislation to implement a nationwide de facto abortion ban. Donald Trump could also weaken the Emergency Medical Treatment and Labor Act (EMTALA), a federal law that protects emergency abortion access. (11/6)