While it is not incredibly unusual for Presidents to issue Executive Orders (EO) that undo their predecessors partisan decrees, it does seem like Trump and Biden have taken great pleasure in issuing EOs to signify a strong policy shift with their administration.

Trump’s verbal salvo against President Obama’s Affordable Care Act(ACA), commonly referred to as “Obamacare”, on the campaign trail seemed a little more personal than the typical Presidential stump speech. Trump seemed particularly motivated to run for President by Obama in 2016, and it is clear that it is a true policy disagreement not just a personality conflict regardless of how it plays out in the media.

Trump’s First Term Healthcare Policy

Trump made ACA a top issue for his first campaign, arguably second after his “build the wall” immigration policy. It was no secret that Trump was running because of Obama (and to a lesser extent, Seth Myers) and Obamacare was an easy drum to beat. From the botched rollout of healthcare.gov, to how the ACA actually worked, it was not clear that this new system was better than the old one, but it was definitely more expensive for most people.

Trump wanted an end to the program, calling it a burden and pledged to repeal and replace the ACA with something better.

Biden’s Healthcare Policy

Biden was elected to the Presidency during the COVID-19 Pandemic and healthcare was an even larger concern for more people. Biden allowed for an expanded enrollment period and expanded the types of procedures covered and allowed the states more latitude in who can participate in their state run exchanges.

There is some controversy and dispute about whether or not this means that illegal immigrants can use Medicaid or not. There are several PhD think-tank-types who say that illegal immigrants cannot access Medicaid at all but also admit that they have access to state run exchanges that are 70% funded by Medicaid dollars.

Trump’s Second Term Healthcare Policies -This time, it’s even more personal.

Trump began his second term much like he began the first term, with a direct frontal assault on Biden’s EOs expanding Medicaid enrollment and coverage. In total , 68 Biden EOs and 11 presidential memoranda were revoked by Trump.

Aside from ending special enrollment periods, Trump also removed coverages for “gender affirming care”, reinstated the “Hyde Amendment” blocking federal funds for providing abortion, and removed subsidies for enrollees.

One Big Beautiful Bill Act (OBBA) is what actually cut funding from Medicaid. Congress removed $900B – $1.2T (that is billion and trillion) from Medicaid over the next 10 years, an estimated 8-10 million Americans will be moved off of Medicaid. Not necessarily losing all insurance coverage, some Medicaid recipients have additional health insurance.