A CNN graphic about Trump's threat to eliminate insurance for 40 million Americans by repealing Obamacare

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TV news coverage since Trump threatened to repeal the ACA mostly failed to mention these critical stakes

Repealing the Affordable Care Act could eliminate health insurance for tens of millions

Written by Zachary Pleat

Research contributions from Charis Hoard

Published

TV news coverage of Republican presidential candidate Donald Trump’s November 25 threat to “terminate” the Affordable Care Act if he’s elected to another term as president mostly failed to mention the effects that repealing the law would have. By not focusing their coverage on the stakes of Trump regaining office, major cable and broadcast news networks risk leaving voters unaware that their votes may mean they and tens of millions of other Americans lose health coverage.

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  • Trump said he wanted to “terminate” the Affordable Care Act, to mixed GOP reactions

    • On Truth Social, Trump wrote on November 25 that he’s “seriously looking at alternatives” to Obamacare and that “we should never give up” efforts “to terminate it.” [Truth Social, 11/25/23]
    • Trump doubled down on his threat with a promise to “REPLACE IT with MUCH BETTER HEALTHCARE,” adding, “Obamacare Sucks!!!” NBC News reported that he “hasn’t offered a replacement plan” and that in 2016 he endorsed a bill to undo part of the law, which was projected to eliminate coverage for about 23 million people. [NBC News, 11/29/23]
    • Republican lawmakers reacted to Trump’s threat in various ways, from open support to concern that they would need to create a replacement first. NBC News reported that Sen. Ted Cruz (R-TX) said he “would love to see us revisit it.” Sen. Mike Rounds (R-SD) said that repealing the ACA “would require us to start proposing what the change would be now so that we wouldn’t be in a position of repealing without having a better replacement.” Sen. Mike Crapo (R-ID) opposed campaigning on repealing the ACA, saying of his preferred approach, “I don’t think it should be characterized as repealing any particular law.” [NBC News, 11/29/23]

  • A Trump repeal of the ACA could eliminate health care coverage for up to half of non-elderly Americans

    • A 2017 analysis by the U.S. Department of Health and Human Services found that as many as 133 million people, or 51%, of non-elderly Americans could be denied coverage without the ACA because they have preexisting medical conditions. [U.S. Department of Health and Human Services, 1/5/17]
    • A 2022 report from HHS showed that 35 million Americans were enrolled in health coverage related to the ACA, including 21 million enrolled through the law’s Medicaid expansion. That figure also included those with marketplace coverage or the ACA’s basic health program. HHS reported that the uninsured population by the end of 2021 “was at nearly an all-time low of 8.8%.” [Centers for Medicare & Medicaid Services, 4/29/22]
    • HHS reported that “in 2020, 58 million women benefited from the ACA’s preventive services and birth control coverage, which has saved billions of dollars in out-of-pocket spending on contraceptives since the ACA was passed.” [U.S. Department of Health and Human Services, 7/28/22]

  • TV news coverage mostly failed to mention these critical stakes of Trump’s threat to repeal the ACA

    • None of the ABC, CBS, and NBC morning, evening, and weekend news programs had segments on Trump’s threat to repeal the ACA.
    • Fox News covered Trump’s threat in only 2 segments. Both segments failed to mention the loss of benefits that would affect millions of Americans.
    • CNN covered Trump’s threat to repeal the ACA in 16 segments, but mentioned its expected effects on millions of Americans in only 2 of them, or in 13% of segments.
    • MSNBC had the most substantial coverage of Trump’s threat, with 17 segments, and discussed its effects on millions of Americans in 8 of those segments, or 47%.
    • Overall, cable news covered Trump’s threat in 35 segments, but covered its effects on millions of Americans in only 10 of those segments, or 29%.
  • A chart showing cable news coverage of Trump's threat to repeal Obamacare, between November 25, 2023, and December 3, 2023. CNN aired 14 segments without context of the consequences of repeal, and 2 segments with that context. Fox News aired only 2 segments, both without context. MSNBC aired 9 segment without context, and 8 segments with context.

  • Methodology

  • Media Matters searched transcripts in the SnapStream video database for all original programming on CNN, Fox News Channel, and MSNBC as well as all original episodes of ABC’s Good Morning America, World News Tonight, and This Week; CBS’ Mornings, Evening News, and Face the Nation; and NBC’s Today, Nightly News, and Meet the Press for either of the terms “Trump” or “former president” within close proximity of any of the terms “Obama care,” “Obamacare,” “health care,” “healthcare,” “Affordable Care Act,” or “ACA” from November 25, 2023, when Trump posted on Truth Social about the possible repeal, through December 3, 2023.

    We included segments, which we defined as instances when Trump's threat to repeal the Affordable Care Act was the stated topic of discussion or when we found significant discussion of the threat. We defined significant discussion as instances when two or more speakers in a multitopic segment discussed the threat with one another.

    We did not include mentions, which we defined as instances when a single speaker in a segment on another topic mentioned Trump's threat without another speaker in the segment engaging with the comment, or teasers, which we defined as instances when the anchor or host promoted a segment about Trump's threat scheduled to air later in the broadcast.

    We then reviewed the identified segments about Trump’s threat for whether they mentioned how many people could lose coverage from the repeal and/or how many people currently have insurance through the ACA, the loss of coverage for preexisting conditions, or the loss of prescription birth control for Americans who need it.