President Donald Trump and his GOP allies in Congress are working to “dismantle” what the New York Times Editorial Board — the newspaper’s opinion arm, which operates separately from its newsroom — called one of the federal government’s “great achievements this century,” and the board said the consequences are likely to worsen.

In a Saturday editorial, the board wrote that making health insurance more affordable has been a major policy success. “One of the federal government’s great achievements this century was making health insurance affordable to millions more Americans,” the board said. “In 2010, nearly 18 percent of people under 65 lacked insurance. By 2024, the rate had fallen below 10 percent, thanks to the Affordable Care Act and later legislation that built on it. President Trump and congressional Republicans are working to dismantle that achievement. They have effectively cut subsidies for the Affordable Care Act’s marketplaces, making it harder for people who do not receive insurance through work to afford a plan. This year, the subsidy cuts led three million people to lose their health insurance. In Ohio, nearly a third of previous marketplace enrollees lost their insurance.”

The board also accused Trump and Republicans of making a “deliberate” effort to keep the issue out of sight before the midterm elections. It said the subsidy cuts were included in the “Big Beautiful Bill” spending package — formally the One Big Beautiful Bill Act, signed into law in July 2025 — which is also expected to include “sweeping cuts to Medicaid,” though those cuts do not take effect until next year. That delay, the board said, may help Republicans avoid an immediate political cost.

According to the editorial board, the Republican agenda could erase about half of the gains achieved under the Affordable Care Act by 2034, leaving around 14 million people without health insurance. The board described those gains as “a positive counterexample of the government working to genuinely improve people’s live.” The projection is consistent with independent analyses, including from the Congressional Budget Office, which estimated that the 2025 law would leave millions of additional Americans uninsured over the coming decade.

“Republicans’ attacks on affordable health care have taken two forms: one more passive, the other more direct,” the board wrote. “In the passive approach, Mr. Trump and congressional Republicans allowed the expiration of enhanced subsidies for the Affordable Care Act’s marketplaces. The Obama administration and congressional Democrats created the marketplaces for people who fell through the cracks. These people did not receive coverage through their jobs, and they were not poor enough to qualify for Medicaid.” Those enhanced subsidies were first expanded under President Joe Biden in the 2021 American Rescue Plan Act and extended through 2025 by the Inflation Reduction Act, and the board tied their lapse directly to this year’s coverage losses.

The editorial continued that Republicans also moved more directly against Medicaid, the program for low-income and disabled Americans. “In the more direct approach to cutting health care coverage, Republicans targeted Medicaid, the program focused on the poor and disabled. Last year, the federal government enacted what Republicans call a work requirement. In reality, it is a paperwork requirement — one that forces Medicaid enrollees, most of whom are working or have a valid reason for not working, to file repeated documents proving they have a job or a valid exemption. Americans lead busy lives, and many of them may not know of the new requirement. About two in three enrollees who will lose health insurance should, in fact, be eligible for it, the Center on Budget and Policy Priorities estimated.” The Center on Budget and Policy Priorities is a progressive-leaning research organization, and similar work requirements piloted during Mr. Trump’s first term — most notably in Arkansas — led to thousands of enrollees losing coverage before a federal judge blocked that state’s program in 2019.