The election of Trump could impact your healthcare.

• The return of President-elect Donald Trump to the White House is set to bring significant changes to consumer health care.
• Information about possible alterations to Medicaid and Affordable Care Act plans is available.

The return of President-elect Donald Trump to the White House is set to bring significant changes to consumer health care.

Experts predict that Republicans will have fewer obstacles in Congress to achieve their objective of reforming healthcare in the U.S., as they retained their House majority and gained control of the Senate and presidency.

Experts predict that households with Medicaid or marketplace health insurance plans may experience significant disruptions due to Trump and Republican lawmakers' reforms.

They said that such reforms would enable the release of federal funds, which could then be utilized to finance other Republican policy objectives, such as tax reductions.

The number of uninsured Americans has decreased to just under 8% from 17% when the Affordable Care Act was passed, according to Michael Sparer, a professor at Columbia University and head of its Health Policy and Management department.

"That rate will start going up again," Sparer said.

Trump declared on November 14th that he intends to appoint Robert F. Kennedy Jr. to head the Department of Health and Human Services, which oversees the Centers for Medicare and Medicaid Services (CMS). CMS, in turn, manages the Affordable Care Act marketplace and the Children's Health Insurance Program (CHIP), among other initiatives.

Kennedy, a vaccine skeptic and conspiracy theorist, has pledged to reform the U.S. health care system.

The Trump transition team did not respond to CNBC's request for comment on the President-elect's health policy plans.

According to experts, the incoming Trump administration could bring changes to health care for consumers.

Affordable Care Act marketplace

'Betting' premium subsidies will expire

It is likely that the enhanced subsidies under the Affordable Care Act will not be renewed after their expiration in 2025, according to Cynthia Cox, vice president and director of the ACA program at KFF, a health policy research organization.

Cox stated that if he were to place a bet on this, he would feel more comfortable betting that they would expire.

What a Trump presidency could mean for your finances.

The American Rescue Plan, a government-backed aid program, has reduced the cost of health insurance coverage for individuals purchasing plans on the ACA marketplace. This aid is particularly beneficial for those who do not have access to workplace plans, such as students, self-employed consumers, and unemployed people.

According to Cox's estimate, an individual earning $60,000 a year now pays $425 monthly for premiums, compared to $539 before the enhanced subsidies. Meanwhile, a family of four making about $120,000 currently pays $850 monthly instead of $1,649.

The Congressional Budget Office estimates that permanently extending the enhanced ACA subsidies would cost approximately $335 billion over the next 10 years.

Republicans are likely to cut taxes next year, which is causing concern among them about the cost, according to Cox.

Still, it's a 'big' gamble to forgo health insurance

If the subsidies expire, approximately 3.8 million individuals will lose their health insurance, and those who keep their coverage may have to pay higher premiums, according to the Congressional Budget Office's estimate.

Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University's McCourt School of Public Policy, stated that "uncertainty is the bottom line."

Corlette stated that the enhanced subsidies will be accessible until 2025, which means no immediate changes for marketplace consumers.

If subsidies are eliminated, it's crucial to remain enrolled in health insurance, even if it means making sacrifices on coverage to stay within budget.

A cheaper plan with a high annual deductible can provide a valuable safeguard against unexpected medical expenses, such as surgery, according to Carolyn McClanahan, a physician and financial planner in Jacksonville, Florida.

McClanahan, founder of Life Planning Partners and a member of the CNBC Financial Advisor Council, stated that going without health insurance is a huge risk.

"Without insurance, someone out of pocket can expect to pay $100,000 for a heart attack, she said."

Medicaid

A 'pretty big target' for lawmakers

Medicare is the third-largest program in the federal budget, with $616 billion in spending in 2023, according to the Congressional Budget Office. Trump pledged not to reduce funding for the two largest programs, Social Security and Medicare, during his campaign.

Larry Levitt, executive vice president for health policy at KFF, stated that Medicaid is the "obvious place" for Republicans to raise revenue to finance their agenda.

Levitt stated that Medicaid would face a significant threat.

Fewer households would receive benefits if cuts were made to Medicaid, according to Levitt. This program primarily serves lower-income households, individuals with disabilities, and seniors in nursing homes.

The repeal and replacement of the Affordable Care Act (Obamacare) in 2017 was a key factor in the push for Medicaid cuts, according to Levitt.

Those efforts were ultimately unsuccessful.

How Medicaid might be curtailed

Experts predict that the new Medicaid cuts could come in various forms, based on past proposals, Trump administration comments, Republican lawmakers' statements, and the Project 2025 conservative policy blueprint.

Columbia University's Sparer stated that the Trump administration may attempt to implement work requirements for Medicaid recipients, as it did during his first term.

Experts predicted that Republicans could limit the federal funds allocated to states for Medicaid.

The federal government typically contributes more than half of the states' Medicaid expenses, with no limit on the amount spent.

Levitt stated that Republicans might opt for transforming Medicaid into a block grant, which would offer a fixed annual sum to each state, or implementing a per-capita cap, which would restrict benefits for each Medicaid beneficiary.

Experts predicted that lawmakers might attempt to reverse the Medicaid expansion under the Affordable Care Act, which enlarged the group of individuals eligible for coverage.

By cutting federal financing to the 40 states (plus the District of Columbia) that have expanded Medicaid eligibility, the enormous financial risk to states would shift, potentially causing many states to drop Medicaid expansion, according to Levitt.

Short-term health insurance plans

The Trump administration's policies led to an increase in non-ACA compliant health insurance options, and it is expected to continue under the next administration.

Comprehensive coverage is not provided by short-term health insurance plans, which offer coverage for a limited time and fewer medical services.

Supporters of these plans argue that they enable insurers to provide lower monthly premiums to consumers by not mandating them to cover as many services. However, these plans can also deny or charge more to individuals with pre-existing conditions. During Trump's presidency, enrollment in short-term plans increased.

According to Corlette of Georgetown University, the previous Trump administration and many Republicans have advocated for increasing the availability of short-term plans and other insurance products that do not adhere to the ACA's pre-existing condition standards and consumer safeguards.

Often, consumers are drawn to plans due to their low costs, but later discover that the coverage is insufficient.

Drug prices

Health experts said that the stance of the Trump administration on drug pricing is less clear.

In 2022, President Biden signed the Inflation Reduction Act into law, which brought about numerous drug price reforms.

Trump has pledged to repeal certain provisions of the law, which include climate-related measures and tax incentives that he opposes.

Experts said it's unclear if lawmakers would maintain the current drug policies. Trump signed executive orders in 2020 aimed at reducing prescription medication costs.

Sparer stated that it is unclear whether Trump will be supportive of the pharmaceutical industry.

Medicare now allows the federal government to negotiate drug prices with pharmaceutical companies for the first time, thanks to the Inflation Reduction Act.

Medicare will implement a provision for 10 of its "most costly and most used" medications, which treat various ailments such as heart disease, diabetes, arthritis, and cancer, in 2026, as announced by the Centers for Medicare and Medicaid Services.

In 2026, CMS estimates that the measure will save patients $1.5 billion in out-of-pocket costs, and the federal government will expand the list of medications in the following years.

The Inflation Reduction Act set a cap on Medicare co-pays for insulin at $35 a month, which was previously uncapped. In 2020, the average Medicare Part D insulin user paid $54 out-of-pocket per insulin prescription.

Medicare previously had no cap on out-of-pocket costs for prescription drugs, but this will change in 2025 with a cap of $2,000 per year.

In 2020, over 1.4 million Medicare Part D enrollees incurred more than $2,000 in out-of-pocket expenses for medications, according to KFF. On average, each person spent $3,355 on prescription drugs.