Here's the way Donald Trump is most likely to kill you

It’s the mass uninsuring.

There’s evil everywhere. A murder spree of fishermen in the Caribbean. A world war about to restart because Donald Trump handed Iran the Strait of Hormuz. And another war in Cuba because Marco Rubio wants his turn. ICE still beating down doors, trying to fill concentration camps. But here’s the biggest threat to your life and the lives of your loved ones that most of us face, coming from the Trump regime. And it’s the threat getting the least coverage, tracked obsessively by Charles Gaba and almost nobody else. Yes, I’m talking about the mass uninsuring of America.

Three million Americans have already lost ACA coverage this year, per internal CMS documents obtained by NOTUS. Wakely Consulting, one of the world’s leading actuarial firms, projects the year-end number could reach 5.8 million. The New York Times puts it starker still: over the next couple of years, Americans on ACA-backed insurance plans are likely to fall from 24 million to 19 million, a drop of more than 20 percent. In Georgia, the exchange is already reporting falloffs above 35 percent.

None of this happened by accident. It’s as plotted as every page of Project 2025. And anyone with a pulse knows mass uninsuring has been the GOP’s obsession since a Black man committed the crime of extending insurance coverage to more than 20 million Americans.

Under the original ACA, anyone between 138 and 400 percent of the federal poverty level could access tax credits on a sliding scale — but cross that 400 percent line by one dollar and you lost everything, overnight. The expanded tax credits passed during the pandemic closed that cliff. Millions of families who had been priced out finally had coverage at rates they could afford.

The Duma, sorry… The GOP Congress let those credits expire at Trump’s insistence, and the cliff came back.

What that meant in practice: for a young person just above the Medicaid cutoff, an extra $50 or $100 a month, itself an insuperable obstacle for someone covering their basic bills. For older people at the higher income end of the subsidy spectrum, monthly insurance bills rising by more than $1,000. For some families, more than $2,000 — a second mortgage payment, every month, that wasn’t there before.

“People who are older, they are the ones who got socked in a big way,” Anthony Wright, executive director of Families USA, told Truthout. “Congress made deliberate decisions to have premiums spike, to have more people uninsured or underinsured.”

And that’s before the reconciliation bill. In 2025, the Trump administration pushed Congress to enact nearly $1 trillion in health care cuts over the coming decade. The Congressional Budget Office estimated it would result in 10 million people losing Medicaid coverage by 2034. Early in the Iran war, Trump said aloud what the numbers were rigged to show after huge tax cuts to the richest Republicans: the richest country ever to exist could no longer “afford” its Medicare commitments, even though we’re the only rich country on earth that doesn’t insure everyone, now that the country was engaged in a war of aggression over nothing, and would have to roll back responsibility onto the states.

We know people will die because we have the numbers, courtesy of Mitt Romney. A 2014 study in the Annals of Internal Medicine found that Romneycare — the Massachusetts coverage expansion Romney signed in 2006 and later ran against as a candidate for president— saved more than 300 lives per year in a single state, a 4.5 percent reduction in mortality. The researchers found one fewer death for every 830 adults who gained insurance. At 5.8 million losing coverage, that’s roughly 7,000 Americans dead per year. If the worst-case projections hold and 15 million lose coverage, the number climbs past 18,000 — every year.

Ha. Anything for a ballroom or a war or two. But keeping Americans actually healthy and alive is too expensive.

You know the GOP’s whole plan is to hear the word “fraud” constantly, paired with the scary brown skin of our immigrant neighbors, and hope that will bring out the savage irrationality that has fueled all of America’s worst endeavors. But the lies behind this crafted atrocity are too embarrassing to repeat.

As we learn Donald Trump now spends almost as much time insider trading as he does golfing, the regime’s response to the people losing coverage has been to call them criminals. CMS sources told NOTUS the three million who dropped coverage were probably undeserving anyway. Dr. Oz, now running HHS, has offered a handful of measures to lower prescription drug costs and made it easier for younger, healthier patients to buy junk insurance with huge deductibles. Nothing for people who are older or have chronic conditions. But, again, plenty of money for war or tax cuts for billionaires and their corporations.

The people whose premiums surged by $1,000 a month or more get a serving of slander as they face life with no basic access to health care.

The geography of the damage maps exactly onto the political decisions made about it, as Charles Gaba has been tracking, again, obsessively. States that built their own ACA exchanges and added supplemental subsidies — California, for instance — have held up better, though even Covered California reported 135,000 fewer marketplace users than a year earlier by March 2026, a 7 percent drop, with more coming. States on the federal HealthCare.gov, most of them Republican-governed, shed coverage at rates that dwarf the blue-state losses. The people who voted for this are losing coverage fastest. Their information environment will tell them someone else is to blame.

By year’s end, this is the largest deliberate uninsuring in American history. A recession in its own right in a country where losing your health coverage can be even more disastrous than losing a job. This theft of coverage isn’t the largest ever yet — the Great Recession was bigger in raw numbers so far — but the disasters of the early 2010s were mostly the result of GOP incompetence rather than direct malice.

This is happening to us on purpose, by a party heading into the midterms as the author of it, revealing the health care plan Trump has had for us all along: Die broke while billionaires celebrate their tax breaks in the ballroom we bought them.

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