President Trump was elected promising to repeal the Affordable Care Act (ACA). ACA supporters assert that the president’s actions mirror his words; that he is deliberately “sabotaging” enforcement of the ACA. This does not capture the complexity of the Trump administration’s approach to the ACA, particularly in regard to the reforms of the individual market. In fact, while the administration has undermined certain individual market programs, reduced or eliminated the federal role in administering others, and created an alternative individual health insurance market independent of the ACA, it has continued to implement other ACA programs that stabilize and support the individual market.
