Smart policy over the past 15 years lowered the percentage of uninsured Americans under age 65 by almost half, from roughly 1 in 5 to fewer than 1 in 10. That's a remarkable achievement largely benefiting working people.

Yet the Trump administration seems determined to reverse those hard-won gains.

Since January 2025, President Donald Trump and almost all congressional Republicans have been working to make it harder for middle- and low-income people to access care ‒ wreaking havoc on people’s health and lives ‒ while lying about their reasons for doing so.

First, Republicans falsely state that a large number of recipients of Medicaid, the nation’s health program for the lowest-income population, are choosing not to work.

Republican critics use this caricature to justify legislating burdensome and time-consuming requirements and documentation for applicants and enrollees, more than 90% of whom, even before the new law passed, were already participating in work, school or childcare responsibilities, or who live with disabilities, exempting them from the new requirements.

This “solution seeking a problem” creates a large and very real problem, because the law’s onerous red-tape demands will primarily lead to the

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