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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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Cardinals’ Contreras gets 6-game ban for tirade

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Cardinals' Contreras gets 6-game ban for tirade

ST. LOUIS — First baseman Willson Contreras has been suspended for six games and fined an undisclosed amount for his tirade during the St. Louis Cardinals‘ 7-6 win over the Pittsburgh Pirates on Monday night.

Contreras has informed Major League Baseball he will appeal the suspension, which means it will not take effect immediately. He was in the lineup for Tuesday night’s game against the Pirates.

Contreras threw a bat that mistakenly hit Cardinals hitting coach Brant Brown and tossed bubble gum on the field after he was ejected. Manager Oliver Marmol also was tossed during an animated argument with the umpires after a called third strike in the seventh inning.

Contreras said he didn’t understand why he was thrown out of the game. He said he argued balls and strikes with plate umpire Derek Thomas but didn’t address a specific pitch and didn’t say anything disrespectful.

“Apparently, he heard something [he thought] I said. I did not say that,” Contreras said.

Crew chief Jordan Baker told a pool reporter that Contreras and Marmol were ejected for “saying vulgar stuff” to Thomas. Baker also said Contreras made contact with the plate umpire.

After Monday’s win, Marmol agreed with his player.

“We’ll have to dive into it to make sure what Willson’s saying is what happened,” he said at the time. “But I believe him.”

The Associated Press contributed to this report.

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AL Cy Young contender Eovaldi likely done for ’25

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AL Cy Young contender Eovaldi likely done for '25

ARLINGTON, Texas — Right-hander Nathan Eovaldi is likely done for the season because of a rotator cuff strain, another huge blow to the Texas Rangers and their hopes of making a late push for a playoff spot.

Eovaldi, who is 11-3 with a career-best 1.73 ERA in 22 starts but just short of the innings needed to qualify as the MLB leader, was among the favorites for the American League Cy Young Award.

He said Tuesday that he had an MRI after shutting down a bullpen session between starts because of continued soreness. The 35-year-old pitcher said he was more sore than normal but was surprised by those results since he hasn’t had any shoulder issues in his 14 MLB seasons.

“It just felt like it was getting a little worse, so I shut it down and had the trainers look at it,” Eovaldi said. “Obviously, it’s just frustrating given how great the season’s been going. … I don’t want to rule out the rest of the season, but it’s not looking very great.”

Rangers president of baseball operations Chris Young said Eovaldi likely will be put on the 15-day injured list Wednesday. He was supposed to start against the Los Angeles Angels in another opportunity to become MLB’s qualified ERA leader.

After allowing one run in seven innings against the Cleveland Guardians in his last start Friday, Eovaldi was the official ERA leader for one night. That put him at 130 innings in 130 Rangers games, and ahead of All-Star starters Paul Skenes (2.07) and Tarik Skubal (2.28) until Texas played the following day — pitchers need to average one inning per team game to qualify.

Entering Tuesday, Eovaldi was tied for third among AL Cy Young favorites with 30-1 odds at ESPN BET.

“Obviously it’s a big blow. He’s been just a tremendous teammate and competitor for us all year long,” Young said. “Hate to see this happen to somebody who’s been so important to the organization. But it seems par for the course with how some of the season has gone. So hate it for Evo, hate it for the team.”

With 29 games remaining going into Tuesday night, the Rangers were 5½ games back of Seattle for the American League’s last wild-card spot. The Mariners and Kansas City both hold tiebreakers over Texas.

The Rangers lost center fielder Evan Carter because of a right wrist fracture when he was hit by a pitch in Kansas City on Thursday. In that same game, durable second baseman Marcus Semien fouled a pitch off the top of his left foot, sending him to the IL for only the second time in his 13 MLB seasons. First baseman Jake Burger (left wrist sprain) also went on the IL during that road trip.

Semien and Eovaldi could potentially return if the Rangers make the playoffs and go on a deep run since neither is expected to need surgery. Semien’s recovery timeline is four to six weeks, and Eovaldi said he would get another MRI in about four weeks. Just under five weeks remain until the regular-season finale Sept. 28 at Cleveland.

Eovaldi has been one of baseball’s best pitchers all season, and part of the Rangers’ MLB-leading 3.43 ERA as a staff. He was left off the American League All-Star team and hasn’t been among qualified leaders after missing most of June with elbow inflammation, but Texas still gave him a $100,000 All-Star bonus that is in his contract.

This is Eovaldi’s third consecutive season with at least 11 wins since joining his home state team, and last December he signed a new $75 million, three-year contract through 2027. The 35-year-old Eovaldi and Hall of Fame strikeout king Nolan Ryan are the only big league players from Alvin, Texas.

Eovaldi has a 102-84 career record and 3.84 ERA over 14 big league seasons with six teams and has won World Series championships with Boston in 2018 and Texas in 2023. He made his MLB debut with the Los Angeles Dodgers (2011-12) and later pitched for Miami (2012-14), the New York Yankees (2015-16), Tampa Bay (2018) and Boston (2018-22).

“I take a lot of pride in being able to go every five days,” Eovaldi said. “To have the outcome that we have now, it’s very tough for me. And you always feel like there’s some way to be able to prevent an injury from happening. And, unfortunately, I wasn’t able to do that.”

The Associated Press contributed to this report.

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Mets rush ‘dominating’ prospect Tong into rotation

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Mets rush 'dominating' prospect Tong into rotation

NEW YORK — The Mets are calling up top-tier pitching prospect Jonah Tong, manager Carlos Mendoza announced Tuesday, as the club continues to bolster its staff with young talent for the stretch run.

Mendoza said Tong will start against the Miami Marlins on Friday in his major league debut.

Tong pitched himself into the big league picture with arguably the best season for a pitcher in the minor leagues, going 10-5 with a 1.43 ERA in 113 ⅔ innings across 22 starts between Double-A and Triple-A this season. The 22-year-old right-hander was recently promoted to Triple-A Syracuse, where he tossed 11 ⅔ scoreless innings over two outings.

“I think it’s all about dominating the minors,” Mendoza said. “It’s hard to keep him there.”

The consistent dominance, in combination with debilitating underperformance from veterans in the Mets’ starting rotation, prompted president of baseball operations David Stearns, who preaches patience in player development, to make the call.

Tong was the No. 21 prospect in baseball in the latest rankings by ESPN’s Kiley McDaniel. The Canadian will join Nolan McLean, the team’s No. 2 prospect who soared through the upper minors and was called up to boost the Mets’ struggling rotation earlier this month.

“This is fast,” Stearns said. “There’s no question this is fast. He’s pushed us on this because of his performance. We think he’s ready for this. We also acknowledge that this has gone faster than any of us would have anticipated at the start of this year.”

The decision to summon Tong came one day after veteran right-hander Kodai Senga continued his recent struggles, logging just four innings against the Philadelphia Phillies on four days’ rest.

Senga has a 5.40 ERA and has not completed six innings in eight starts since coming off the injured list last month. Mendoza indicated the team prefers to give Senga an extra day of rest moving forward.

“I’m going to be honest: Performance matters,” Mendoza said about Senga. “We’re to a point now where we got to see performance. And that was a conversation with him. We need him because he’s an ace. We’ve seen it in the past, but we haven’t been able to get that consistency. So, yeah, maybe it’s the regular rest, the extra day, whatever that is. We’re getting to a point where like every game, we got to put our best guys out there.”

Entering Tuesday, the Mets are 2 ½ games ahead of the Cincinnati Reds for the final National League wild card spot.

The baby-faced Tong, a seventh-round pick out of high school in 2022, made a significant leap forward in his development in 2024, but he reported to spring training this year seemingly on a path for a 2026 major league debut — as evidenced by the Mets’ decision not to invite him to big league camp.

Mendoza said he met Tong while watching a minor league game on a back field in which Tong was the ball boy.

“When you’re in the minor leagues, you got to go through those duties,” Mendoza said. “And that day, he happened to be on the Triple-A bench, and he was the ball boy and I sat right next to him, and I had a brief conversation. Kind of introduced myself [to] kind of get to know him.

“Genuine, humble and you could just see the youth on his face. It was, I don’t know, 10 minutes that we sat there and watched the game while I was trying to get to know him a little bit.”

Tong, who represented the Mets at the Futures Game last month, leads all 196 qualified minor league pitchers in ERA, FIP (1.66), batting average against (.148) and strikeout rate (40.5%) this season. His 0.92 WHIP ranks second. He has compiled 179 strikeouts and allowed just two home runs.

He boasts a fastball in the mid-90s that touches 97 mph and has produced a whiff rate of 36.5% this season. This year, he added a changeup in the mid-80s that has emerged as his second-most used offering and improved his effectiveness against left-handed hitters. A curveball and slider complete his repertoire.

Slight for a pitcher — he’s listed at 6-foot-1, 180 pounds — with a smooth and deceptive over-the-top delivery, Tong has drawn comparisons to former Cy Young Award winner Tim Lincecum.

“What’s impressed us the most is the speed with which he’s expanded his arsenal in really effective ways,” Stearns said. “So, he’s added a changeup this year that’s been really good. And we’ve seen outings that have shown, I think, tremendous maturity on the mound — where something’s not working, he’s then able to switch an approach and go to the slider more, throw a few more curveballs, and allow himself to get through outings really successfully, even if he’s not following the exact plan that he thought he was going to follow when he went into the game.”

The Mets chose promoting Tong over Brandon Sproat, another highly regarded pitching prospect in Triple-A. Stearns explained the organization’s decision as a product of Tong’s excellence and the timing of the start, which will keep Tong, who last pitched on Saturday, on turn.

Sproat, 24, gave up seven runs across 3 ⅔ innings out of the bullpen for Syracuse on Saturday after recording a 2.05 ERA over his previous nine outings, all starts.

“Brandon’s done a tremendous job, and he’s probably had as good a second half of season as any pitcher in minor league baseball,” Stearns said. “He’s made some real adjustments. He’s pitched great.”

The Mets’ plan for Tong after Friday is unclear. While McLean has cemented himself in the club’s starting rotation after allowing just two runs over 12 ⅓ innings in his first two starts, Tong will join the Mets as their sixth starter.

Mendoza said he didn’t know if Tong would move to the bullpen following Friday’s start.

“We’re going turn by turn at this point,” Stearns said. “And it’s going to be a combination of what the matchups are, who we think match up well, how our guys are throwing, who needs rest, who doesn’t need rest. I think in September, we try not to plan too far ahead and we’re going to go turn by turn.”

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