In his State of the Union address last night, President Trump sharply criticized the true beneficiaries of Obamacare, arguing that massive public subsidies—often hidden from taxpayers—have flowed to big insurance companies and bureaucrats rather than directly benefiting patients. He signaled a clear intent to reform this system.
Referring to Obamacare as the “Unaffordable Care Act,” Trump advocated shifting away from delivering taxpayer subsidies to insurance companies on behalf of patients. He referenced his “Great Healthcare Plan,” which aims to redirect those taxpayer dollars directly into patients’ hands for greater control and better outcomes. Trump stated: “It (Obamacare) was meant for the insurance companies, not for the people. With our government giving them hundreds and hundreds of billions of dollars a year as their stock prices soared 1,000, 1,200, 1,400 and even 1,700 percent.”
In Minnesota, individuals purchasing health insurance through the MNSure exchange receive subsidies that reduce their out-of-pocket costs, with taxpayers covering a significant portion. These enhanced subsidies, extended during the coronavirus pandemic, expired on January 1, leading to substantial premium increases—or “sticker shock”—for many enrollees. This was a major issue in recent budget negotiations.
It makes sense that funds would be used more efficiently if enrollees had full knowledge of and direct control over the money spent on their behalf. Medicaid recipients, whose care is entirely taxpayer-funded, often have little awareness of the costs involved. Research from the Center of the American Experiment has highlighted inefficiencies in the Medicaid program, including cases (as much as 20%) where enrollees were unaware they were enrolled—sometimes paying for separate private policies or covered under a spouse’s plan while taxpayers unknowingly funded redundant coverage through insurance companies.
The President also promoted his Most Favored Nation deals with pharmaceutical companies, which have lowered drug costs for Americans by aligning U.S. prices with the lowest in other developed nations. He urged Congress to codify these agreements into law to make them permanent: “So now I’m calling on Congress to codify my most favored nation program into law.”
During his first term, Trump enacted measures requiring price transparency for drugs, procedures, and providers, empowering consumers to avoid high-cost options. Last month, he launched TrumpRx, a platform posting initial discounts on 40+ drugs and enabling direct patient access through existing cost-reduction programs.
Finally, Trump announced that Vice President JD Vance will lead a major fraud crackdown in the coming year. Referencing corruption concerns—including cases tied to the Somali community in Minnesota—he stated: “The Somali pirates who ransacked Minnesota remind us that there are large parts of the world where bribery, corruption and lawlessness are the norm.” He emphasized that it is the “American people who ultimately bear the cost through higher medical bills.”
Overall, the President’s health care remarks focused on empowering patients through transparency, direct control of subsidies, lower drug prices, and aggressive anti-fraud efforts—aiming to prioritize people over bureaucracy and special interests.