The Trump Presidency Is Going Great

Trump has unveiled TrumpRx, a government-branded prescription drug site he’s bragging up as “the largest reduction in prescription drug prices in history” – a bold claim for a portal that lists just 43 drugs, many of which are old, off-patent, and already cheaper pretty much everywhere else. One example: Protonix is a cool $200.10 on TrumpRx, while the generic version is $6.07 on Mark Cuban’s Cost Plus Drugs. That’s not a savings, that’s performance art.

Experts point out that patients could usually do better by just asking their pharmacist, using existing sites like GoodRx or Cost Plus, or – wild idea – relying on insurance. TrumpRx is even reportedly powered by GoodRx, which makes this whole thing the healthcare equivalent of screenshotting someone else’s website and calling it innovation. In some narrow cases, like a few fertility drugs or a specific weight loss med, the deals are decent – but they’re often identical to the manufacturer’s own offers, and the GLP-1 discounts for Wegovy and Ozempic expire in a month or two and only apply to the lowest dose.

Meanwhile, Republicans are pushing nearly $1bn in Medicaid cuts and letting ACA tax credits expire, making healthcare more expensive while Trump stands in front of a podium yelling about imaginary 578% savings on Novo Nordisk drugs. The actual site quietly admits the discounts are more like 74–85% off list price, which is still not as good as many people already get through insurance. As one advocate put it, the administration is pretending it just saved America, when in reality many people who use TrumpRx will pay more than they needed to. It doesn’t fix drug pricing, it doesn’t increase transparency – it just adds one more confusing, misleading layer to a broken system and calls it victory.

The Trump administration is very proud of its new $50 billion Rural Health Transformation Program, a five-year "experiment" in which every state gets at least $100 million a year and maybe more if they say the magic words: Make America Healthy Again. Because nothing says evidence-based health policy like tying survival money for rural hospitals to whether a state adopts the administration’s political priorities.

There’s bipartisan applause for finally throwing something at the rural health crisis, but there’s a small catch: this flashy $50 billion pot sits next to roughly $1 trillion in cuts to Medicaid and Obamacare that Congress already passed. In other words, Trump, RFK Jr., and Mehmet Oz are holding a rural health roundtable to celebrate a shiny new life raft while quietly drilling holes in the ship’s hull. Experts note the proposals have promising ideas, but if you really wanted to transform rural health care, you probably wouldn’t start by defunding the main programs keeping people alive.

States were given 52 days to design sweeping overhauls of rural care delivery, workforce, and innovation—which is perfect, because nothing complicated has ever gone wrong when the federal government rushes massive health funding out the door. And with allocations partially based on how closely states align with Trump’s health agenda, this isn’t just health policy—it’s a loyalty test with ventilators attached. But sure, zip codes are predicting life expectancy because of bad luck, not because the government keeps swapping long-term coverage for short-term press releases.

The Trump administration celebrated its ongoing war on reality by dropping hundreds of surprise termination letters on mental health and addiction providers, effective immediately, because nothing says “serious governance” like nuking $2 billion in lifesaving grants with zero warning. Nonprofits from Salt Lake City to El Paso to Detroit woke up to find their funding gone and their patients—people dealing with addiction, homelessness, and severe mental illness—left to discover that the safety net has been replaced with vibes and bootstraps.

Ryan Hampton of Mobilize Recovery says his group alone lost about $500,000 overnight, and warns that overdose prevention, naloxone distribution, and peer recovery services are being forced to stop right now. In other words, the administration has chosen the middle of a declared public health emergency—at a moment when overdose deaths were finally starting to decrease—to rip out the wiring from the system and walk away. SAMHSA’s letters blandly claim these programs no longer align with the Trump administration’s "priorities," which, based on the results, appear to include increasing preventable deaths while pretending it’s just a routine “restructuring.” But sure, tell us more about how this is the pro-life, law-and-order, protect-the-people administration.

Congress let enhanced Obamacare subsidies expire, so millions of Americans are starting 2026 with the fun surprise of massive premium hikes — because nothing says "pro-family values" like turning health insurance into a luxury product. After engineering the longest government shutdown in U.S. history over this fight, Republicans still couldn't manage to pass anything, and now a bipartisan group of senators is frantically trying to duct-tape together a deal to resurrect the subsidies before the health care markets fully implode.

The catch: according to Sen. Peter Welch, this is only "doable" if Donald Trump deigns to bless it, since he effectively owns the Republican majorities in both chambers. In other words, the health coverage of millions now depends on whether Trump feels like being "Health Care President" for a news cycle instead of "Let It Burn President." Meanwhile, premiums are jumping from $900 to $3,200 a month for people like a Vermont farmer Welch cites, and rural hospitals are staring down a revenue cliff — but sure, let's keep pretending this is about fiscal responsibility and not about using human misery as a bargaining chip.

Over in the House, a handful of Republicans dared to sign a discharge petition with Democrats to force a vote on a three-year extension of the subsidies, openly defying Speaker Mike Johnson and the Trumpist wrecking crew. One of them, Rep. Brian Fitzpatrick, admits he doesn’t even like the bill but understands that maybe letting constituents go bankrupt from medical bills is politically suboptimal. So the current governing model is: Congress breaks the system, Trump refuses to lead, a few Republicans try not to look like cartoon villains, and millions of Americans get to play "Will I Still Have Health Insurance?" as their new annual tradition.

Congress is packing its bags for holiday recess and, in a bold new experiment in governing by neglect, is just going to let enhanced ACA subsidies expire. Because nothing says “Merry Christmas, middle class” like watching your health insurance premiums double or triple on January 1 so Mike Johnson can go on Fox and mumble about freedom. Millions of Americans are about to learn that the real preexisting condition is living under a party that thinks ‘market forces’ will cure cancer.

Instead of extending subsidies, House Republicans are teeing up a vote on their favorite zombie ideas: association health plans and tinkering with pharmacy benefit managers — the policy equivalent of replacing your seatbelt with thoughts and prayers. Rank-and-file members are still having “bipartisan talks,” which is DC-speak for “we’re going to do nothing and hope you forget who did this to you by November.”

Meanwhile, as these premium spikes land, Trump’s economic approval has cratered to 36%, his lowest in six years of Marist polling. The GOP’s old 16-point advantage on “who do you trust on the economy” has magically transformed into a Democratic lead, because it turns out people notice when their groceries, rent, and health care all go up while the administration’s big plan is… deregulating nuclear reactors and yelling about wokeness. In other words: the “greatest economy ever” is polling like a used timeshare scam.

But sure, keep telling voters that everything is fine and this is all Biden’s fault somehow, while you literally vote to make their health care more expensive. The leopards-ate-my-face caucus is about to find out what happens when the leopards start itemizing their medical bills.

In a shocking display of callousness, the Trump administration has ripped apart nearly 10,000 foreign aid programs—services that save lives around the globe—because, apparently, playing politics is a national priority over human decency. Secretary Rubio's hollow assurances that 'we don’t want to see anybody die' ring completely hollow as thousands are left to fend for themselves, while officials seem more obsessed with aligning aid with Trump's agenda than with basic humanitarian needs. In a classic act of bureaucratic incompetence, they even managed to cut off phone services for those working in war zones—because who needs communication when you're busy dismantling compassion? Good luck explaining this to the children who will pay the ultimate price for their 'case-by-case review'—one that clearly never happened.