The Dictatorship
Trump’s new Obamacare replacement looks awfully familiar
President Donald Trump infamously asserted during the September 2024 presidential debate that he had “concepts of a plan” to replace the Affordable Care Act (ACA). This weekend, almost 10 months into his second term, he offered a glimpse of what that plan might look like.
Posting on his platform Truth Social on Saturday, Trump said that he was recommending to Senate Republicans that they replace the federal subsidies for ACA premiums, which are sent to private health insurers, with money sent directly to the American people. Although Treasury Sec. Scott Bessent said there was no “formal proposal,” Republican lawmakers jumped onboardand Sen. Rick Scott, R-Fla., said he was “writing the bill right now.”
Setting aside the irony that a Democratic politician would surely be pilloried for pursuing the redistribution of payments from private companies to the masses, let’s dig in.
The insufficiency of HSA funds is just the start of the problems with Trump’s proposal.
This is hardly the first time that Trump has proposed repealing the ACA, on which a record-high 24.3 million people now rely for marketplace plans. The most sweeping of these efforts notably fizzled back in 2017, when the late Sen. John McCain voted against it in the middle of the night. Even in the absence of outright repeal efforts, Republicans in Congress reduced the mandate penalty to $0 in the Tax Cuts and Jobs Act of 2017. This summer, the Centers for Medicare & Medicaid Services finalized a rule that will increase out-of-pocket costs and may lead to as many as 1.8 million Americans losing coverage. At the same time, the One Big Beautiful Bill Act advanced several changes that will limit the ACA’s effectiveness.
Amid such vitriol at the ACA, it can be easy to forget that the law brought America’s uninsured rate to a historic lowimproved health outcomes across a range of conditions and reduced health inequities. What’s more — and what’s especially important when evaluating Americans’ health care costs — Medicaid expansion through the ACA is also associated with reductions in medical debt. These gains help explain why 64% of Americans favor the ACAthough it garners considerably less support among Republicans.
Absent the preservation of the ACA’s core provisions, tens of millions of Americans with preexisting medical conditions would be vulnerable to outright denial of coverage by private insurers. In 2017, the health policy research group KFF estimated that 27% of non-elderly American adults had previously declinable preexisting conditions. That share has likely only increased as complications from Covid-19 have become more common and more people have enjoyed the ACA’s protections — whether gaining a primary care doctor or opting for tests that before the ACA might have revealed a preexisting condition.

But perhaps concerns about health care affordability could be offset by the amount of money that would be redirected to the people.
Trump’s first post was characteristically light on details. In a later post, he suggested that consumers bypass health insurers altogether to purchase plans directly, without explaining how or from whom those plans would be purchased. But Sunday morning, he specified that “Republicans should give money DIRECTLY to your personal HEALTH SAVINGS ACCOUNTS.” Through HSAs, people can put money away and withdraw the funds tax-free for qualifying medical expenses if they’re enrolled in a high-deductible health plan.
GOP policymakers have often championed HSAs because, in theory, they reflect Republicans’ preference for individuals’ choices over government intervention. In practice, HSAs tend to benefit people with higher incomes: They’re the ones with the means to contribute to the accounts, and because they’re in higher tax brackets, they benefit more from each dollar saved. Furthermore, researchers at the Center on Budget and Policy Priorities find that HSAs do not significantly benefit those who struggle with health care costs, and relatedly, that they exacerbate the racial disparities the ACA has effectively reduced.
To make matters worse, Trump is proposing these changes amid a shaky economy.
So, how much money are we talking about? The Congressional Budget Office estimated that in 2023, health insurers received approximately $92 billion in ACA subsidies. That would not come close to covering most Americans’ health care expenses — in 2023, Americans shelled out $500 billion just on out-of-pocket costs.
The insufficiency of HSA funds is just the start of the problems with Trump’s proposal. A core concept of health insurance is the spreading of risk across the pool of enrollees, in order to contain the costs of coverage. When the risk pool is diverse, the premiums of younger and healthier patients offset the expenses of covering older and sicker individuals, a principle at the heart of the ACA’s mandate to hold a minimum level of insurance.
With added reliance on HSAs, America would witness what is called “adverse selection” — healthier and wealthier people would more likely switch away from comprehensive health insurance products, leaving the insured population on average sicker and therefore more costly to insure. Thus, insurers would increase the premiums they charge, likely resulting in an increase in the population that only enrolls in insurance when they have more significant health care expenditures.

High health care costs are already a strain on many Americans, leading to delayed or forgone care or — in the case of about 9% of Americans — being uninsured. Trump’s concept of a plan would make this worse: What might appear at first blush to be a welcome move toward more individualized decision-making would ultimately increase costs. The consequences would include higher rates of uninsurance and underinsurance, as well as exacerbated racial and socioeconomic inequities in health care access.
To make matters worse, Trump is proposing these changes amid a shaky economy with considerable strain on Americans’ pocketbooks. In a country whose dominant health insurance model entails tying insurance to employment, when the jobless rate ticks upit is especially important to preserve access to quality, affordable plans through the ACA. That’s especially true given Republicans’ recent historic cuts to Medicaidweakening a key backstop for low-income Americans.
The American people would be forgiven if they looked at Trump’s and Scott’s words with skepticism in light of congressional Republicans’ opposition to extending marketplace subsidies for even one more year. That refusal has led to sticker shock for marketplace consumers during open enrollment and helped spark a weekslong government shutdown.
Politicians are right to want to confront the problem of high health care costs. But the president’s new proposal is the latest example of his administration’s policy preferences working against that important stated objective, sabotaging effective programs (the ACA) in favor of programs that research consistently shows are comparatively ineffective (HSAs).
Trump’s pledge to replace comprehensive health coverage with direct payments toward health care offers only a hollow hope, promising individual freedom while actually leaving Americans to fend for themselves.
Miranda Yaver
Miranda Yaver is an assistant professor of health policy and management at the University of Pittsburgh and a health care fellow at the Roosevelt Institute.
The Dictatorship
Trump wraps up his Beijing visit
BEIJING (AP) — U.S. President Donald Trump said Friday that he has not made a decision on whether to move forward with a major arms package for Taiwan after hearing concerns about it from Chinese President Xi Jinping.
Trump’s comments on Taiwan — a self-ruled island that China claims as its own territory — came as he flew back to Washington after wrapping up critical talks in which both leaders said important progress was made in stabilizing U.S.-China relations even as deep differences persist between the world’s two biggest powers on Iran and Taiwan.
“I’ll be making decisions,” Trump said. “But, you know, I think the last thing we need right now is a war that’s 9,500 miles away.”
Trump’s Republican administration in December authorized a record-setting $11 billion weapons package for Taipei, but it has yet to move forward. Lawmakers also approved a $14 billion arms sale to Taiwan in January, but the sale cannot advance until Trump formally sends it to Congress. China opposes such sales and has suggested that Washington’s relationship with the self-governing island is the key factor in U.S.-China relations.
AP AUDIO: Trump weighs Taiwan arms package after summit aimed at steadying US-China ties
AP correspondent Donna Warder reports on President Donald Trump’s trip to China.
Trump said Xi also reiterated China’s strong opposition to Taiwan’s independence. “I heard him out,” Trump said. “I didn’t make a comment.”
Trump’s consultation with Xi about arms sales to Taiwan may violate the so-called Six Assurances, a set of nonbinding U.S. policy principles formulated in 1982 under President Ronald Reagan that have helped guide the U.S. relationship with Taipei, according to analysts.
The second of the Six Assurances states that the U.S. “did not agree to consult with the People’s Republic of China on arms sales to Taiwan.”
Trump said the issue of the 1982 assurances came up in the talks with Xi.
Chinese President Xi Jinping and U.S. President Donald Trump attend a meeting on the sidelines of their visit to the Zhongnanhai Garden in Beijing, China, Friday, May 15, 2026. (Evan Vucci/Pool Photo via AP)
Chinese President Xi Jinping and U.S. President Donald Trump attend a meeting on the sidelines of their visit to the Zhongnanhai Garden in Beijing, China, Friday, May 15, 2026. (Evan Vucci/Pool Photo via AP)
Trump says Xi is ‘very positive’ about a potential nuclear deal
Trump also said he raised a potential three-way nuclear deal that would involve the U.S., Russia and China. He wants each of the three countries to sign a pact that would cap the number of nuclear warheads in their arsenals. China has previously been cool to entering such a pact.
Beijing’s arsenal, according to Pentagon estimates, exceeds 600 warheads and is far from parity with the U.S. and Russia, which are each estimated to have more than 5,000 warheads. But Trump suggested Xi was receptive to the idea.
“I got a very a positive response,” Trump said. “This is the beginning.”
The last nuclear arms pactknown as the New START treaty, between Russia and the United States expired in February, removing any caps on the two largest atomic arsenals for the first time in more than a half-century. As the treaty was set to expire, Trump rejected a call by Russia to extend the two-country deal for another year and called for “a new, improved and modernized” deal that includes China.
The Pentagon estimates China will have more than 1,000 nuclear warheads by 2030.
President Donald Trump walks with China’s President Xi Jinping at the Zhongnanhai leadership compound, Friday, May 15, 2026, in Beijing. (AP Photo/Mark Schiefelbein, Pool)
President Donald Trump walks with China’s President Xi Jinping at the Zhongnanhai leadership compound, Friday, May 15, 2026, in Beijing. (AP Photo/Mark Schiefelbein, Pool)
Trump was impressed by Chinese presidential residence
Xi welcomed Trump at his official residence, Zhongnanhai, on Friday for their final engagement of the summit before the U.S. leader’s return to Washington. The leaders took a short walk through the grounds that feature ancient trees and Chinese roses, and they strolled through a covered passageway with green columns and archways painted with birds and traditional Chinese mountain scenes.
Over tea and lunch, Trump and Xi — with top aides and translators in tow — huddled for nearly three hours of talks before the U.S. leader completed his three-day visit to China.
Trump appeared impressed by the bucolic grounds, remarking that the roses were the most beautiful he had ever seen. Xi promised to send him some rose seeds.
President Donald Trump walks with China’s President Xi Jinping at the Zhongnanhai leadership compound, Friday, May 15, 2026, in Beijing. (AP Photo/Mark Schiefelbein, Pool)
President Donald Trump walks with China’s President Xi Jinping at the Zhongnanhai leadership compound, Friday, May 15, 2026, in Beijing. (AP Photo/Mark Schiefelbein, Pool)
“It’s been really a great couple of days,” Trump told reporters.
Xi, for his part, called it a “milestone” visit. “We have established a new bilateral relationship, or rather a constructive, strategic, stable relationship,” he said.
But the optimistic outlook collides with some difficult truths about the thorniest issues between the two superpowers.
Beijing has shown little public interest in U.S. entreaties to get more involved in solving the conflict in Iraneven though Trump said in an interview with Fox News’ Sean Hannity that Xi had in their conversations offered to help.
In recent weeks, the U.S. State Department has accused Chinese firms of providing satellite imagery to the Iranian government, and the Treasury Department has moved to target Chinese oil refineries accused of buying oil from Tehran, as well as shippers of the oil.
Xi on Thursday warned Trump during private talks that their differences on Taiwan, if handled poorly, could hurtle the world’s dominant powers toward “clashes and even conflicts,” according to Chinese government officials.
But Trump, as he made his way home, said he was not concerned that the U.S.-China relationship was in danger. “I think we will be fine,” he said.

President Donald Trump, left, walks with Chinese President Xi Jinping at the Temple of Heaven on Thursday, May 14, 2026, in Beijing. (AP Photo/Mark Schiefelbein)
President Donald Trump, left, walks with Chinese President Xi Jinping at the Temple of Heaven on Thursday, May 14, 2026, in Beijing. (AP Photo/Mark Schiefelbein)
Taiwan remains the most important issue for China
Xi’s sharp language on Taiwan loomed large over the visit, with Chinese government officials amplifying his view that differences on the island pose the biggest risk to U.S.-Chinese relations.
But Secretary of State Marco Rubio told NBC News that U.S. policy toward Taiwan was “unchanged” and cautioned that it would be “a terrible mistake” for China to try to take Taiwan by force. He also framed Xi’s comments as standard practice.
“They always raise it on their side. We always make clear our position, and we move on to the other topics,” said Rubio, who was among senior aides to join Trump for the talks.
Some Republicans in Congress expressed displeasure at Trump’s pronouncement that he has not decided whether to move forward with the arms package for Taiwan.
“We have to support Taiwan, just like we have to support Ukraine,” said Rep. Brian Fitzpatrick, a Pennsylvania Republican. “These are the fortresses of democracy, and they’re on the front lines, and we have to protect and defend them.”

U.S. Trade Representative Jamieson Greer, Defense Secretary Pete Hegseth, Treasury Secretary Scott Bessent and Secretary of State Marco Rubio arrive before President Donald Trump is greeted by Chinese President Xi Jinping at a welcome ceremony at the Great Hall of the People, Thursday, May 14, 2026, in Beijing. (AP Photo/Mark Schiefelbein)
U.S. Trade Representative Jamieson Greer, Defense Secretary Pete Hegseth, Treasury Secretary Scott Bessent and Secretary of State Marco Rubio arrive before President Donald Trump is greeted by Chinese President Xi Jinping at a welcome ceremony at the Great Hall of the People, Thursday, May 14, 2026, in Beijing. (AP Photo/Mark Schiefelbein)
Republican Rep. Michael McCaul said he was not surprised that Xi came out with an aggressive posture on Taiwan.
“We’ve got to arm Taiwan so they can defend themselves for deterrence,” McCaul said.
China wants the Strait of Hormuz opened
Trump said he and Xi also spoke at length about Iran.

President Donald Trump shakes hands with China’s Foreign Minister Wang Yi before boarding Air Force One, Friday, May 15, 2026, at Beijing Capital International Airport in Beijing. (AP Photo/Mark Schiefelbein)
President Donald Trump shakes hands with China’s Foreign Minister Wang Yi before boarding Air Force One, Friday, May 15, 2026, at Beijing Capital International Airport in Beijing. (AP Photo/Mark Schiefelbein)
The leaders agreed that the critical Strait of Hormuz — effectively closed since the start of the Iran conflict — needs to be reopened to support global energy demands. About 20% of the world’s oil flowed through the strait before the war started on Feb. 28.
“We feel very similar about (how) we want it to end,” the president said. “We don’t want them to have a nuclear weapon.”
White House officials said Xi was also opposed to any implementation of tolls on vessels crossing the strait and expressed interest in China potentially purchasing U.S. oil to reduce Chinese dependence on Gulf oil in the future.
Trump earlier this week downplayed the importance of talks with Xi on the 11-week-old Iran war that has led to surging energy prices and threatens to plunge the global economy into recession if the conflict does not conclude soon.
___
Mistreanu reported from Bangkok. Associated Press writers Huizhong Wu in Bangkok and Darlene Superville, Stephen Groves and Josh Boak in Washington contributed to this report.
The Dictatorship
Trump to be feted and spend hours with Xi during China trip
BEIJING (AP) — China’s Xi Jinping warned President Donald Trump on Thursday that their two countries could clash over Taiwan if the issue is not handled properly, an unusually harsh admonition that stood in contrast to the American leader’s praise for his counterpart.
The exchange at a highly anticipated summit in Beijing underscored just how far apart Trump and Xi still are on thorny issues, including the war in Iran, trade disputes and Washington’s relations with Taiwan, which is self-ruled but which China claims as part of its territory.
It also suggested that Trump’s three-day visit to China is likely to be longer on pageantry and symbolism than substantive political or economic breakthroughs.
The pair met for about two hours behind closed doors at the Great Hall of the People after an elaborate welcome ceremony featuring booming cannons, a band playing “The Star-Spangled Banner” and China’s national anthem, and hundreds of schoolchildren jumping and waving flowers and American and Chinese flags.
According to a post on X by Chinese Foreign Ministry spokesperson Mao Ning, Xi told Trump that “the Taiwan question is the most important issue in China-U.S. relations.”
“If it is handled properly, the bilateral relationship will enjoy overall stability. Otherwise, the two countries will have clashes and even conflicts, putting the entire relationship in great jeopardy,” she wrote.
That comment followed a brief public exchange before the meeting began in which Trump told Xi: “You’re a great leader. Sometimes people don’t like me saying it, but I say it anyway, because it’s true.”
“It’s an honor to be your friend,” Trump said before promising that the U.S.-China relationship “is going to be better than ever before.”
Trump later told Fox News’ Sean Hannity in an interview that Xi said during their conversations that he “would like to be of help” in negotiating an end to the Iran war and reopening the Strait of Hormuz to oil shipments.
Xi was far more stark in his opening public remarks, expressing hope that the U.S. and China could avoid conflict and asking “whether the two countries can transcend the ‘Thucydides Trap’ and forge a new model for relations between major powers.”
That’s a term, popular in foreign policy studies, referring to the idea that when a rising power threatens to displace an established one, the result is often war. Xi has used the term for years, but using it as Trump offered optimism was noteworthy and foreshadowed his closed-door comments on Taiwan.
Secretary of State Marco Rubio later said U.S. policy toward Taiwan was “unchanged” but warned that it would be “a terrible mistake” for China to take Taiwan by force.
“They always raise it on their side. We always make clear our position, and we move on to the other topics,” Rubio, who is traveling with the president, said in an interview with NBC News.
Both emphasized the importance of China-US relations
After their meeting, Xi took Trump on a tour of the Temple of Heaven, then hosted a state banquet for him. The Chinese leader used his evening toast to note that he and Trump had kept U.S.-China relations “generally stable” in a turbulent world.
“Achieving the great rejuvenation of the Chinese nation and making America great again can go hand in hand,” Xi said, referring to Trump’s political movement. “We can help each other succeed and advance the well-being of the whole world.”
In his toast, Trump said his visit had been “a great honor” punctuated by a “fantastic” day. He said matters “all good for the United States and China” were discussed.
Trump also said Xi would make a reciprocal visit to the White House on Sept. 24 — a date not previously announced.
The positive tone was reflected in the White House assessment of the earlier meetings, which said both leaders had touched on ways to enhance economic cooperation, including expanding market access for American businesses in China and increasing Chinese investment into U.S. industries.
The White House readout did not mention Taiwan directly, but, in relation to Iran, said both sides had agreed that the strait must remain open. The strait’s closure has stranded tankers and caused energy prices to spike, threatening global economic growth.
The war is dominating Trump’s domestic agenda and stoking fears about the prospect of a weakening U.S. economy as November’s midterm elections — when Republicans hope to maintain control of Congress — approach.
China is the largest purchaser of Iranian oiland Rubio said in an interview with Fox News that Trump would make the case for Beijing to exert its influence on Iran, noting that administration officials would underscore that “economies are melting down because of this crisis,” which means consumers are “buying less Chinese product.”
It’s not clear if Trump persuaded Xi to wield his influence. The White House instead said Xi opposed any implementation of tolls on vessels crossing the strait — as Iran has proposed — and expressed interest in China potentially purchasing more U.S. oil to reduce Chinese dependence on Gulf oil in the future.
When asked Thursday at a congressional hearing whether China is providing intelligence to Iran to help it target U.S. forces, Adm. Brad Cooper, head of U.S. Central Command, would not discuss intelligence but said the Iranian military “is largely made up of Russian and Chinese equipment.”
Taiwan issues remain contentious
Xi’s warning about Taiwan reflects China’s displeasure with a U.S. plan to sell weapons to the island. The Trump administration has approved an $11 billion arms package for Taiwan, but has yet to begin fulfilling it.
The U.S. has a longstanding commitment to help the island defend itself if attacked, but Trump has shown greater ambivalence toward Taiwanfueling speculation about whether the president could be persuaded to dial back American support.
Taiwan said after the Xi-Trump meeting that it was grateful for Washington’s “long-term support.”
“The government views all actions that contribute to regional stability and the management of potential risks from authoritarian expansion positively,” Michelle Lee, a spokesperson for Taiwan’s premier, told reporters. She added that the U.S. “has also repeatedly reiterated its firm and clear position of support for Taiwan.”
US still hopes to secure trade wins
The White House has insisted that Trump would not be making the trip without an eye toward securing concrete results, suggesting there could be coming announcements on trade.
That likely includes a Chinese commitment to buy U.S. soybeans, beef and aircraft. Trump told Fox News that Xi had indicated a commitment to buying 200 jets from Boeing.
Trump administration officials also want to work toward establishing a board of trade with China to address commercial differences between the countries.
Trump and Xi discussed trade on Thursday, with Xi saying that China’s door of opportunity will open wider. Xi also met with a collection of U.S. business leaders who accompanied Trump.
The U.S. and China reached a trade truce last year that calmed each side’s threats to impose steep tariffs on the other. The White House says there have been ongoing discussions and mutual interest in extending the agreement.
The leaders also discussed further stemming the flow of fentanyl precursor chemicals into the United States and increasing Chinese purchases of U.S. agricultural products, according to the White House.
___
Associated Press writers Seung Min Kim, Darlene Superville and Michelle L. Price in Washington, Simina Mistreanu in Bangkok and Kanis Leung in Hong Kong contributed to this report.
The Dictatorship
In pursuit of a Jim Crow gerrymander, Georgia’s governor calls another special session
Georgia Gov. Brian Kemp is officially joining the GOP’s push to reinstitute Jim Crow governance after conservative Supreme Court justices opened the door to racist gerrymandering with their decision in the Callais v. Louisiana case.
On Wednesday, Kemp — who has signed multiple voter suppression laws in recent years — called for a special legislative session in an effort to gerrymander his state’s congressional districts ahead of the 2028 elections. The map would take effect after this year’s midterms.
Kemp, notably, has been floated as a potential presidential candidate in 2028. His announcement comes as other Republican governors have eagerly pressed conservatives in their states to rig their congressional maps in their favor, now that the Supreme Court has effectively allowed them to draw majority-Black districts out of existence.
Next month’s special session will mark the third time in five years that Georgia Republicans will attempt to gerrymander their map, a remarkable data point underscoring the GOP’s illiberalism in the state.
These repeated returns to the well were rebuked by the Georgia state Senate’s minority leader, Harold Jones II. In a statement on Xhe said in part:
If Republicans ever used their power to help Georgians, they wouldn’t have to waste time and money redrawing the maps every few years to keep their majorities.
June will be our third redistricting since 2021. Republicans need to undo their last gerrymander because it wasn’t good enough to keep their waffling political party in power. Most parties would try out some new ideas. Republicans choose to strip political power from Black people and undo the progress the South made in the last 60 years.
Jones also noted that Black people make up Georgia’s largest bloc of middle-class and working-class voters, adding: “When Republicans strip Black people’s political power away, it doesn’t just strip one community of power. It strips political power from every single middle and working class person and hands it over to billionaires and big corporations.”
🚨Senate Minority Leader Harold Jones II released the following statement today on Governor’s Kemp’s call for special session:
“If Republicans ever used their power to help Georgians, they wouldn’t have to waste time and money redrawing the maps every few years to keep their… pic.twitter.com/85Sv2ChNSC
— Georgia Senate Democrats (@GASenateDems) May 13, 2026
As the Southern Poverty Law Center explained in JanuaryGeorgia Republicans forced through a map in 2021 that voting rights activists said discriminated against Black voters. After a federal court struck down that map, Georgia Republicans replaced it with a different map in 2023 that has been similarly criticized.
And now — amid what some people fear could be the largest purge of Black lawmakers from Congress since the Jim Crow era — Kemp is planning yet another assault on Black political power.
And he’s not stopping there. Just a day prior to calling the special session, Kemp signed a law to make elections for district attorneys and other offices nonpartisan in five Atlanta counties where Democratic DAs are in charge, all of whom are Black women.
As writers Jeff Singer and David Nir explained in The Downballotthis change, which is being challenged by Fulton County District Attorney Fani Willis, could make it easier for Republicans to flip these five offices.
Ja’han Jones is an MS NOW opinion blogger. He previously wrote The ReidOut Blog.
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