“I have concepts of a plan. I'm not president right now … Obamacare was lousy health care. Always was. It's not very good today and, what I said, that if we come up with something, we are working on things, we're going to do it and we're going to replace it.”
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As of July 2, 2026, about 17 months into his second term, Trump has neither enacted nor formally proposed a replacement for the Affordable Care Act. The 'Great Healthcare Plan' framework he sent to Congress on January 15, 2026 is a cost-reduction package that operates within the ACA - funding its cost-sharing reduction program and redirecting subsidy payments - rather than replacing the law, and it has not passed Congress. The ACA marketplaces continue to operate under existing law, and congressional Republicans have not advanced repeal-and-replace legislation this term. With full opportunity to pursue the promised replacement, the administration has instead pursued changes within the existing framework.
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