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While a full repeal of the Affordable Care Act (ACA) in Congress failed last year, the Trump administration, in the courts and through regulation, has managed to get closer and closer to its goal as a matter of practicality. As health policy watchers wait for an impending decision to drop in Texas v Azar, the case about the constitutionality of the ACA, here is a look back at the healthcare actions taken during the first 2 years of the Trump administration.

With health policy increasingly transferring to the state level, what’s the most effective way for states to cover the majority of their population through affordable health insurance leveraging public funds? On a day when the Trump administration unveiled 4 ways states can request Section 1332 waivers, some of which are aimed at avoiding key parts of the Affordable Care Act (ACA), an advocacy organization released its own proposal to cover more of the uninsured and lower health insurance costs.

CMS Administrator Seema Verma announced consumers buying health insurance through the exchanges set up by the Affordable Care Act (ACA) would be allowed to have heath savings accounts, and the agency will allow states to set their own subsidies and decide what type of health plan is eligible for subsidies. In addition, waivers would be evaluated against the Hyde amendment.

America's Health Insurance Plans (AHIP) released what it said are 12 proposals to help increase affordability for people who buy insurance on the individual market who do not qualify for subsidies. Meanwhile, CMS said 1.2 million people signed up for health insurance during the first 10 days of open enrollment for the individual marketplaces.

Project ECHO, which helps specialists disseminate knowledge to primary care providers, was created on the idea that patients should not be dying from curable diseases because they don’t have access to the right providers, said Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

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