Improve the ACA and Call It Trump Care
To the Editor:
“Costly Care” (11/14) addressed problems with “Obama Care” and Biden’s COVID extensions. The letter critiqued the status quo and offered advice regarding improvements. “The Democratic Party has shut down government and is holding it hostage claiming they are fighting for health care and demanding the Biden enhancements be extended.” The letter complained that “insurance companies have made billions off the enhancements.” (As an aside, during the original debate over ACA, critics doubted it could create a workable system to reach deserving citizens and inform them about the best options. Those critics underestimated the free enterprise ability of the insurance industry to create useful systems and make profit.) The letter complains that the Democrats want “to make illegal aliens eligible for Medicaid and Medicare by repealing OBBBA (One Big Beautiful Bill Act signed into law July 4, 2025) provisions that limit access to U.S. citizens, lawful permanent residents, and a few other legal entrants.” In addition to making immigration a stumbling block, the critique pointed to OBBBA’s “commonsense work requirements.” The letter asks FCR readers whether “these Democrats represent you?”
OBBBA is no longer the name of the bill. Some thought the name childish and narcissistic. During the Senate amendment process, it was dropped ( Congress.gov). Also, OBBBA did not remove the tax burden imposed on Social Security income. Perhaps that is covered by the additional deduction of $6,000/$12,000 for seniors. It increased funding for immigration enforcement from $10 billion to $170 billion and raised the debt limit by $5 trillion and increased the budget deficit by $3.4 trillion. What made it beautiful, was it that it did not fundACAand cut Medicaid? That legislative choice led Democrats to support the shutdown. A sufficient number of Democrats eventually supported the Senate version of OBBBA so it could pass, return to the House and get to the President’s desk. Realizing the harm this ACA budget cut would do to citizens, especially small business owners and selfemployed, Rep. Greene (R, GA-14) and others vowed to join Democrats to assure that ACA would be extended as agreed to during the Senate’s deliberation. Representative Greene pointed to the harm cutting ACA would do to her family and similar citizens. She charged that the Republicancontrolled Congress prioritized “foreign countries and foreign wars” over our citizens’ health care affordability.
Government reopened based on promises to engage in legislative deliberation to support and revise the ACA. The problem will be solved. Speaker Johnson assured “we the people” that on these matters “Republicans have a long list of ideas,” even “volumes of ideas” for improving medical care and focusing on marketbased solutions. So, we might not need to wring our hands or clutch our pearls.
A bipartisan group of House members recently offered the Fix It Act to extend ACA subsidies and serve as a bridge to improvements. If this kind of compromise struggles to get approval, we might imagine the legislative wisdom of nicknaming the new and improved ACA, Trump Care.
Bob Heath Carmine