How The Hell Did We End Up With Trumpcare? 5 Events in History That Paved the Way

Doctor giving injection to a child

“Your medical bills costs thousands of dollars,” my mother remarked one summer day almost 20 years ago. “Good thing I have health insurance.”

Good thing indeed.

After I was diagnosed with a chronic condition discovered during a standard physical, my mother’s insurance covered countless doctor appointments to rule out more serious diseases. Our insurance was provided by her stable job as a registered nurse.

That was the first time I’d ever paid attention to health insurance, and in my naive 12-year-old mind, I figured everyone had access to it. As a young adult, I realized how wrong I’d been.

By the time former Pres. Obama’s mandate that children could stay on their parents’ health insurance until age 26 went into effect in 2014, I was too old to reap its benefits.

During most of my early and mid-20s, I struggled without insurance, foregoing essential treatment and medications because I couldn’t afford them on my meager income. I learned the hard way that healthcare is a luxury in this country.

The U.S. is one of the only developed countries in the world where health care isn’t considered a human right and a public service.

Beatrix Hoffman, a history professor at Northern Illinois University who researches health care social movements, says this anomaly can be attributed to two main factors:

  1. The belief that health care should be treated as a market product.
  2. The belief that not everyone deserves equal health care.

The beliefs named by Hoffman resonate with me as a working-class Black, queer, gender non-binary person. Black people have been dehumanized in this country ever since Africans were brought here in chains to make profits for wealthy white people.

Trumpcare is the latest attempt of white male supremacist legislators to control and disregard the bodies of not only Black people but all historically oppressed groups.

According to the Congressional Budget Office, Trumpcare, also known as the American Health Care Act in the House of Representatives and the Better Care Reconciliation Act (BCRA) in the Senate, would result in 22 million people losing their health care over the next decade by cutting taxes for the rich and rolling back Obama’s Medicaid expansion.

Between 2014-2017, Medicaid expansion opened the publicly funded health insurance program up to 11 million new low-income Americans in 31 states and the District of Columbia.

While I’m currently insured through my wife’s job, the loss of Medicaid expansion would disproportionately impact those in my communities here in Washington State.

Laura Durso of the Center for American Progress estimates that Trumpcare would result in half a million LGBTQ+ Americans losing their Medicaid, and Families USA estimates that up to 13.9 million African Americans could lose their Medicaid.

Several of my queer and trans people of color friends would be hurt by this disaster of a bill, which is why I won’t shut up about it.

Fortunately, I’m not alone in my disdain for Trumpcare. According to a survey by NBC News and the Wall Street Journal, 48 percent of Americans think the Republicans’ health care bill is a bad idea.

While the House narrowly passed Trumpcare earlier this year, the Senate version of the bill (the BCRA) has yet to be brought to a vote due to opposition from a handful of Republican senators.

Since the BCRA hasn’t gained enough support, Republicans have introduced the Obamacare Repeal Reconciliation Act, which would repeal the ACA over a period of two years without replacing it.

The GOP seems determined to take health care away from millions of Americans, including their own constituents, in service of capitalism and systemic oppression.

While Trumpcare is new in name, it’s actually the result of a series of unfortunate events that have taken place over centuries.

In the hopes that identifying and reflecting on these events can help us organize towards a future where all Americans are covered by universal healthcare, I have compiled the following list.

Below are five events in history that paved the way for Trumpcare:

1. 1872: The Freedmen’s Bureau is dismantled, taking free health care away from millions of formerly enslaved Black people.

Right before the Civil War ended, the Freedmen’s Bureau was established by an act of Congress. The agency provided a wide range of social services to many of the 4 million formerly enslaved Blacks in the South, including medical aid.

Unfortunately, it closed down in 1872 due to pressure from white Southerners.

I imagine my life would be easier if an agency like the Freedmen’s Bureau existed today.

Descendants of enslaved people like me are told to pull ourselves up by our bootstraps instead of being offered services, despite the reality that we’re still suffering from the effects of slavery.

If African Americans ever win our reparations, I pray they include free health care.

2. 1896: The case of Plessy v. Ferguson leads to Jim Crow laws, creating separate and unequal health care for Blacks and whites.

In 1896, the Supreme Court ruled that facilities for Blacks and whites should be “separate but equal” when deciding the case of Plessy v. Ferguson.

This manifested in Jim Crow laws that provided for facilities that were separate but unequal, including federally-funded segregated hospitals until 1963.

While Brown v. Board of Education legally ended segregation in 1955, health care for people of color remains separate and unequal, as evidenced by Trumpcare.

Jennifer Nelson, a gender studies professor at the University of Redlands who researches women’s health, says that Trumpcare was made possible by white supremacist beliefs that people of color are somehow getting something they don’t deserve by receiving public services.

3. 1947: The Cold War begins, causing universal health care to be viewed as “socialist” by the political right.

After World War II, the U.S. entered into a 44-year conflict called the Cold War with the now disbanded Soviet Union in opposition to their Communist government.

According to Nelson, anti-Communist discourse during that period portrayed government-funded health care as an evil “socialist” ploy.

It was the Cold War that prevented former Pres. Harry Truman from being able to pass a national health insurance program in the late 1940s.

Even the American Medical Association lobbied against the bill, characterizing it as “socialized medicine.”

Strangely, the “socialist” label affiliated with universal health care still holds weight today in a climate where socialism is becoming more mainstream than ever.

4. 1965-1966: Medicaid and Medicare, both publicly funded health insurance programs, are designed to make money for the private sector.

Hoffman says the influence of powerful private interests on legislators resulted in Medicaid and Medicare making major concessions to the private sector when they were established in the mid-1960s.

“Each reform created huge government subsidies for private interests,” says Hoffman. “So, taxpayers pay for these programs, but doctors, hospitals, and the insurance industry have controlled them, and make lots of profit doing so.”

Medicaid and Medicare would look much different if they weren’t designed to subsidize the private market. Our tax dollars should be directly funding care for those in need, not for enriching the pockets of the powerful and greedy.

5. 2010: Democrats refuse to advocate for universal health care in the Affordable Care Act.

Back when Democrats were crafting the ACA in 2009-2010, polls showed that support for publicly funded health insurance was high.

However, even the most optimistic progressives in Congress, including Sen. Bernie Sanders of Vermont, doubted that a bill including universal health care could pass.

A few years must have changed Sanders’ mind because universal healthcare was one of his major talking points during his 2016 run for president.

While it wasn’t enough to secure him the Democratic nomination, the mere mention of it dared millions of voters to dream of a government that takes care of its people by providing free and accessible healthcare to all.


I’m just another starry-eyed millennial daydreaming about universal health care who’s also terrified about the present threat that is Trumpcare.

If you haven’t yet, please take time TODAY to call your senators and ask them to publicly voice their opposition to the Better Care Reconciliation Act and the Obamacare Repeal Reconciliation Act.

Now that we know how we ended up with Trumpcare, let’s fight like hell to stop it. We deserve so much better than this.

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Neesha Powell-Twagirumukiza (she & they pronouns) is an Everyday Feminism Reporting Fellow. Neesha identifies as an intersectional feminist, womanist, writer, community organizer, facilitator, dancer, freedom fighter, wife, and cat mama. She’s constantly conspiring in the name of liberated Black futures, queer and trans people of color power, solidarity economics, and transformative justice/community accountability. Neesha’s based in a suburb south of Seattle, where she lives, loves, and creates with chosen family.