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On the presidential campaign trail, former President Donald Trump is, once again, promising to repeal and replace the Affordable Care Act a nebulous goal that became one of his administrations splashiest policy failures. Use Our Content

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Were going to fight for much better health care than Obamacare. Obamacare is a catastrophe, Trump said at a campaign stop in Iowa on Jan. 6.

The perplexing revival of one of Trumps most politically damaging crusades comes at a time when the Obama-era health law is even more popular and widely used than it was in 2017, when Trump and congressional Republicans proved unable to pass their own plan to replace it. That failed effort was a big part of why Republicans lost control of the House of Representatives in the 2018 midterms.

Despite repeated promises, Trump never presented his own Obamacare replacement. And much of what Trumps administration actually accomplished in health care has been reversed by the Biden administration.

Still, Trump secured some significant policy changes that remain in place today, including efforts to bring more transparency to prices charged by hospitals and paid by health insurers.

Trying to predict Trumps priorities in a second term is even more difficult given that he frequently changes his positions on issues, sometimes multiple times.

The Trump campaign did not respond to a request for comment.

Perhaps Trumps biggest achievement is something he rarely talks about on the campaign trail. His administrations Operation Warp Speed managed to create, test, and bring to market a covid-19 vaccine in less than a year, far faster than even the most optimistic predictions.

Many of Trumps supporters, though, dont support and some even vehemently oppose covid vaccines. Email Sign-Up

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Here is a recap of Trumps health care record:

Public Health

Trumps pandemic response dominates his overall record on health care.

More than 400,000 Americans died from covid over Trumps last year in office. His travel bans and other efforts to prevent the global spread of the virus were ineffective, his administration was slower than other countries governments to develop a diagnostic test, and he publicly clashed with his own governments health officials over the response.

Ahead of the 2020 election, Trump resumed large rallies and other public campaign events that many public health experts regarded as reckless in the face of a highly contagious, deadly virus. He personally flouted public health guidance after contracting covid himself and ending up hospitalized.

At the same time, despite what many saw as a politicization of public health by the White House, Trump signed a massive covid relief bill (after first threatening to veto it). He also presided over some of the largest boosts for the National Institutes of Healths budget since the turn of the century. And the mRNA-based vaccines Operation Warp Speed helped develop were an astounding scientific breakthrough credited with helping save millions of lives while laying the groundwork for future shots to fight other diseases including cancer.

Abortion

Trumps biggest contribution to abortion policy was indirect: He appointed three Supreme Court justices, who were instrumental in overturning the constitutional right to an abortion.

During his 2024 campaign, Trump has been all over the place on the red-hot issue. Since the Supreme Court overturned Roe v. Wade in 2022, Trump has bemoaned the issue as politically bad for Republicans; criticized one of his rivals, Florida Gov. Ron DeSantis, for signing a six-week abortion ban; and vowed to broker a compromise with both sides on abortion, promising that for the first time in 52 years, youll have an issue that we can put behind us.

He has so far avoided spelling out how hed do that, or whether hed support a national abortion ban after any number of weeks.

More recently, however, Trump appears to have mended fences over his criticism of Floridas six-week ban and more with key abortion opponents, whose support helped him get elected in 2016 and whom he repaid with a long list of policy changes during his presidency.

Among the anti-abortion actions taken by the Trump administration were a reinstatement of the Mexico City Policy that bars giving federal funds to international organizations that support abortion rights; a regulation to bar Planned Parenthood and other organizations that provide abortions from the federal family planning program, Title X; regulatory changes designed to make it easier for health care providers and employers to decline to participate in activities that violate their religious and moral beliefs; and other changes that made it harder for NIH scientists to conduct research using fetal tissue from elective abortions.

All of those policies have since been overturned by the Biden administration.

Health Insurance

Unlike Trumps policies on reproductive health, many of his administrations moves related to health insurance still stand.

For example, in 2020, Trump signed into law the No Surprises Act, a bipartisan measure aimed at protecting patients from unexpected medical bills stemming from payment disputes between health care providers and insurers. The bill was included in the $900 billion covid relief package he opposed before signing, though Trump had expressed support for ending surprise medical bills.

His administration also pushed over the vehement objections of health industry officials price transparency regulations that require hospitals to post prices and insurers to provide estimated costs for procedures. Those requirements also remain in place, although hospitals in particular have been slow to comply.

Medicaid

While first-time candidate Trump vowed not to cut popular entitlement programs like Medicare, Medicaid, and Social Security, his administration did not stick to that promise. The Affordable Care Act repeal legislation Trump supported in 2017 would have imposed major cuts to Medicaid, and his Department of Health and Human Services later encouraged states to require Medicaid recipients to prove they work in order to receive health insurance.

Drug Prices

One of the issues the Trump administration was most active on was reducing the price of prescription drugs for consumers a top priority for both Democratic and Republican voters. But many of those proposals were blocked by the courts.

One Trump-era plan that never took effect would have pegged the price of some expensive drugs covered by Medicare to prices in other countries. Another would have required drug companies to include prices in their television advertisements.

A regulation allowing states to import cheaper drugs from Canada did take effect, in November 2020. However, it took until January 2024 for the FDA, under Trumps successor, to approve the first importation plan, from Florida. Canada has said it wont allow exports that risk causing drug shortages in that country, leaving unclear whether the policy is workable.

Trump also signed into law measures allowing pharmacists to disclose to patients when the cash price of a drug is lower than the cost using their insurance. Previously pharmacists could be barred from doing so under their contracts with insurers and pharmacy benefit managers.

Veterans Health

Trump is credited by some advocates for overhauling Department of Veterans Affairs health care. However, while he did sign a major bill allowing veterans to obtain care outside VA facilities, White House officials also tried to scuttle passage of the spending needed to pay for the initiative.

Medical Freedom

Trump scored a big win for the libertarian wing of the Republican Party when he signed into law the Right to Try Act, intended to make it easier for patients with terminal diseases to access drugs or treatments not yet approved by the FDA.

But it is not clear how many patients have managed to obtain treatment using the law because it is amed at the FDA, which has traditionally granted requests for compassionate use of not-yet-approved drugs anyway. The stumbling block, which the law does not address, is getting drug companies to release doses of medicines that are still being tested and may be in short supply.

Trump said in a Jan. 10 Fox News town hall that the law had saved thousands and thousands of lives. Theres no evidence for the claim.

Julie Rovner: jrovner@kff.org, @jrovner Related Topics Elections Insurance Medicaid Medicare Public Health Abortion COVID-19 Drug Costs Obamacare Plans Pregnancy Trump Administration Vaccines Women's Health Contact Us Submit a Story Tip

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Entertainment

Lady Gaga puts on her biggest-ever show for free on Rio’s Copacabana Beach

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Lady Gaga puts on her biggest-ever show for free on Rio's Copacabana Beach

Lady Gaga has performed in front of an estimated 2.1 million people at a free show on Rio de Janeiro’s Copacabana Beach.

Some 500,000 tourists travelled to watch the concert, which was paid for by the city in an attempt to boost the struggling economy.

Saturday night’s two-hour show, which marked Gaga’s biggest ever, marked the first time she had played in Brazil since 2012, having cancelled an appearance at the Rock in Rio festival in 2017 over health issues.

Gaga, who released her seventh studio album, Mayhem, in March, opened with a dramatic, operatic edition of her 2011 track Bloody Mary, before launching into Abracadabra, one of her most recent hits.

Lady Gaga performs during her free concert on Copacabana Beach in Rio de Janeiro, Saturday, May 3, 2025. (AP Photo/Silvia Izquierdo)
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Pic: AP

Lady Gaga, centre, performs during her free concert on Copacabana Beach in Rio de Janeiro, Saturday, May 3, 2025. (AP Photo/Silvia Izquierdo)
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Pic: AP

“Brazil! I missed you. I missed you so much,” she exclaimed, before launching into Poker Face, one of her biggest hits.

The American pop star drew in a similar crowd to Madonna’s in May last year, who performed at the same beach, which is transformed into an enormous dance floor for the shows.

Addressing the crowd in English and through a Portuguese translator, Gaga became emotional as she said: “I’m so honoured to be here with you tonight.

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People attend Lady Gaga's open concert at Copacabana beach in Rio de Janeiro, Brazil, May 3, 2025. REUTERS/Tita Barros
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Gaga addresses the crowd. Pic: Reuters

Gaga seen performing on giant screens set up across the beach. Pic: Reuters
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Gaga seen performing on giant screens set up across the beach. Pic: Reuters

“Tonight we’re making history, but no one makes history alone. Without all of you, the incredible people of Brazil, I wouldn’t have this moment. Thank you for making history with me.

“The people of Brazil are the reason I get to shine today. But of all the things I can thank you for, the one I most am grateful for is this: that you waited for me. You waited more than 10 years for me.”

She said it took so long to come back because she was “healing” and “getting stronger”. The pop sensation cancelled many of her shows in 2017 and 2018 due to her fibromyalgia condition, which can cause pain and fatigue.

It is estimated Gaga’s show will have injected around 600 million reais (£79.9m) into the economy, nearly 30% more than Madonna’s show.

People gather to attend Lady Gaga's open concert, in Copacabana beach in Rio de Janeiro, Brazil May 3, 2025. REUTERS/Pilar Olivares
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Pic: Reuters

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The large-scale free shows are set to continue annually until at least 2028, always taking place in May, which is considered the economy’s “low season”, according to the city’s government.

A hefty security plan was in place, including the presence of 3,300 military and 1,500 police officers, along with 400 military firefighters.

‘A dream come true’

Fans gather on the beach. Pic: Reuters
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Fans gather on the beach. Pic: Reuters

Fans find a spot to watch the show. Pic: AP
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Pic: AP

The city has been swarmed with Gaga fans since her arrival on Tuesday, with some even keeping vigil outside of the hotel she has been staying at.

Many arrived at the beach at the crack of dawn on Saturday to secure good spots on the beach, despite the show not starting until 9.45pm.

An aerial view shows fans gathering on Copacabana beach ahead of Lady Gaga's arrival. Pic: Reuters
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An aerial view shows fans gathering on Copacabana beach ahead of Lady Gaga’s arrival. Pic: Reuters

Ana Lara Folador, who attended with her sister, said it was “a dream come true”, and that Gaga had “really shaped a part of my personality, as a person and an artist”.

Ingrid Serrano, a 30-year-old engineer who made a cross-continent trip from Colombia to Brazil to attend the show, turned up in a T-shirt featuring Lady Gaga’s outlandish costumes over the years.

“I’ve been a 100% fan of Lady Gaga my whole life,” she said, adding the 39-year-old megastar represented “total freedom of expression – being who one wants without shame”.

A fan dons an unusual face mask. Pic: AP
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A fan dons an unusual face mask. Pic: AP

A fan strikes a pose. Pic: AP
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A fan strikes a pose. Pic: AP

Matheus Silvestroni, 25, an aspiring DJ and a Gaga fan since the age of 12, endured an eight-hour bus ride from Sao Paulo for the show.

He said it was Gaga who had inspired him to embrace his sexuality and pursue his dream of becoming an artist.

“I was bullied because I was a fat, gay kid, so I was an easy target,” he said. “Gaga was very important because she sent a message that everything was okay with me, I wasn’t a freak, because I was ‘Born This Way’.”

Rio is known for holding massive open-air concerts, with Rod Stewart holding a Guinness World Record for the four million-strong crowd he drew to Copacabana Beach in 1994.

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Politics

Conservatives call for Labour’s Lucy Powell to resign over grooming gang remarks

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Conservatives call for Labour's Lucy Powell to resign over grooming gang remarks

The Conservatives are calling for Lucy Powell to resign after the Labour MP’s exchange with a commentator about grooming gangs.

The comment was made by Ms Powell, the leader of the House of Commons, after Conservative political commentator Tim Montgomerie started to ask a question on BBC Radio 4’s Any Questions.

“I don’t know if you saw the documentary on Channel 4 about rape gangs,” he started, in relation to the recent programme Groomed: A National Scandal, which centred around five girls who were sexually abused by rape gangs.

Ms Powell, who is MP for Manchester Central, responded: “Oh, we want to blow that little trumpet now, do we? Yeah, OK, let’s get that dog whistle out.”

Sir Keir Starmer and the government have been under sustained pressure from political opponents over the handling of historical sex abuse cases in the UK.

ConservativeHome founder Mr Montgomerie, who will be appearing on Sunday Morning With Trevor Phillips, continued: “There is a real issue where… There were so many people in local government, in the authorities, who, for good reason, were worried about upsetting community tensions, that those girls went undefended.”

The conversation moved on, but politicians criticised Ms Powell’s comment, with some calling for her to resign.

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Shadow home secretary Chris Philp said in a statement: “This shocking outburst from a Labour cabinet minister belittles the thousands of girls and women who were raped by grooming gangs over decades.

“We have consistently called for a national enquiry in parliament, which has been blocked by Labour ministers who don’t seem to know or care about the disgusting crimes which have been perpetrated.

“Anyone who has seen the shocking Channel 4 documentary will know that it is clearer than ever that this is not a ‘dog whistle’.

“To dismiss thousands of victims who were raped and the cover up that followed is sickening. She should resign.”

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Shadow justice secretary Robert Jenrick said: “Labour’s Lucy Powell thinks it’s a ‘dog whistle’ to demand arrests and accountability for the rape gangs. What a disgusting betrayal of the victims. They are part of the cover-up.”

Ousted Reform MP Rupert Lowe, now an independent, shared a letter he wrote to Ms Powell demanding she apologise, calling her comments “deeply, deeply offensive”.

On X on Saturday night, Ms Powell said: “In the heat of a discussion on AQ, I would like to clarify that I regard issues of child exploitation and grooming with the utmost seriousness. I’m sorry if this was unclear.

“I was challenging the political point scoring around it, not the issue itself. As a constituency MP I’ve dealt with horrendous cases. This Gvt is acting to get to the truth, and deliver justice.”

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Sky News has contacted the office for the Leader of the House of Commons for comment.

The long-running row over grooming cases has continued after Labour promised five local inquiries into grooming gangs in January.

Tech billionaire Elon Musk had accused Sir Keir of being “complicit” in the failure of authorities to protect victims and prosecute abusers while the PM was director of public prosecutions from 2008-2013.

The prime minister has repeatedly defended his record, saying it shows he tackled the issue head-on.

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World

Israeli pilots’ protest letter reveals deepening rift over ongoing war in Gaza

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Israeli pilots' protest letter reveals deepening rift over ongoing war in Gaza

The Israeli Air Force is regarded as one of the country’s most elite units.

So, when hundreds of current and former pilots call for an end to the war in Gaza to get the hostages out, Israelis take notice.

This month, 1,200 pilots caused a storm by signing an open letter arguing the war served mainly “political and personal interests and not security ones”.

The pilots' protest letter
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The pilots’ protest letter

Part of the letter translated
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Part of the letter translated

Israeli Prime Minister Benjamin Netanyahu said the original letter was written by “bad apples”.

But Guy Paron, a former pilot and one of those behind the letter, said the Israeli government had failed to move to phase two of the ceasefire deal with Hamas, brokered under US President Donald Trump.

That deal called for a full withdrawal of Israeli forces from Gaza and the release of all the remaining hostages. Mr Netanyahu continues to argue that the war must continue to put pressure on Hamas.

Mr Paron said the (Israeli) government “gave up or violated a signed agreement with Hamas” and “threw it to the trash”.

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“You have to finish the deal, release the hostages, even if it means stopping that war,” he argued.

It’s not the first time Israeli pilots have taken up a cause. Many of them also campaigned against Mr Netanyahu’s 2023 judicial reforms.

“In this country, 1,000 Israeli Air Force pilots carry a lot of weight,” Mr Paron added.

“The Air Force historically has been the major force and game-changer in all of Israel’s wars, including this current one. The strength of the Air Force is the public’s guarantee of security.”

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UN runs out of food aid in Gaza

Anti-government campaign spreads

Now, the open letter campaign has spread to other parts of the military.

More than 15,000 people have signed, including paratroopers, armoured corps, navy, special units, cyber and medics. The list goes on.

Dr Ofer Havakuk has served 200 days during this war as a combat doctor, mostly in Gaza, and believes the government is continuing the war to stay in power.

He has also signed an open letter supporting the pilots and accused the prime minister of putting politics first.

Israeli Prime Minister Benjamin Netanyahu speaks during the annual ceremony at the eve of Israel's Remembrance Day for fallen soldiers (Yom HaZikaron) at the Yad LaBanim Memorial in Jerusalem on Tuesday, April 29, 2025.  (Abir Sultan/Pool Photo via AP)
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Israeli Prime Minister Benjamin Netanyahu described the authors of the original letter as ‘bad apples’. Pic: AP

He said Mr Netanyahu “wants to keep his coalition working and to keep the coalition together. For him, this is the main purpose of the war”.

A ceasefire could lead to the collapse of the prime minister’s fragile far-right coalition, which is opposed to ending the war.

Threat of dismissal

The Israeli military has threatened to dismiss those who have signed protest letters.

We met a former pilot who is still an active reservist. He didn’t want to be identified and is worried he could lose his job.

“This is a price that I’m willing to pay, although it is very big for me because I’m volunteering and, as a volunteer, I want to stay on duty for as long as I can,” he told us.

The controversy over the war and the hostages is gaining momentum inside Israel’s military.

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It is also exposing deep divisions in society at a time when there is no clear sign about how the government plans to end the war in Gaza, or when.

The renewed war in Gaza over the last year and a half followed deadly Hamas attacks on Israel on 7 October 2023, which killed 1,200 people, mostly civilians, and saw around 250 taken hostage.

More than 51,000 people have been killed in Gaza during the Israeli military’s response, many of them civilians, according to the enclave’s Hamas-run Ministry of Health.

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