Donald Trump is reshaping American health care
The Economist
February 19, 2026
AI-Generated Deep Dive Summary
Donald Trump’s presidency has brought significant changes to American health care, reshaping the system in ways that are both controversial and far-reaching. His administration has rolled back key provisions of the Affordable Care Act (ACA), particularly during the pandemic, which has left many low-income individuals struggling to afford coverage. The elimination of pandemic-era subsidies, for example, has made it increasingly difficult for uninsured patients to access affordable care, particularly in underserved communities like Miami.
In Midtown Miami, the Care Resource clinic serves as a safety-net provider, offering essential medical services to vulnerable populations. Despite its critical role, the clinic’s survival is precarious, relying on a patchwork of funding sources—including grants, insurance payments, and pharmacy income. Over half of the clinic’s patients in 2024 lacked health insurance, and this number is expected to rise as ACA marketplace enrollment declines. Karin Sabey, the clinic’s boss, describes the situation as a “house of cards,” warning that any systemic changes could push the facility—and others like it—to collapse.
From a business perspective, the ripple effects of these policy shifts are significant. The closure of safety-net clinics could strain emergency rooms, increase costs for insured patients, and exacerbate health disparities. For businesses, this could mean higher premiums as insurers grapple with sicker populations. Additionally, the political implications of Trump’s approach to health care are undeniable, as his administration continues to promote free-market principles over systemic reforms. These changes not only affect individual access to care but also shape the future of American health care policy and politics.
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Originally published on The Economist on 2/19/2026