Republicans defended the decision by saying the burden on companies struggling to stay afloat amid the recession would be too great. The move: Despite pressure from Democrats, unions and worker advocates, OSHA refused to set rules for worker safety during the pandemic. Such a standard, issued when the Occupational Safety and Health Administration determines workers are in “grave danger,” would have established immediate and mandatory workplace safety rules employers must follow to protect employees from exposure. Trump failed to provide workplace guidance, making safety harder for workersĪrguably the most consequential decision Trump made involving American workers was something it chose not to do: It declined to implement a so-called “emergency temporary standard” when the coronavirus pandemic hit. The upshot: Despite differences in tone and rhetoric, this is a refocusing of the United States’ military posture that is expected to continue in the Biden administration. The impact: Already it has led to a reordering of the Pentagon budget and new investments supported by a bipartisan majority in Congress, including billions of dollars to beef up the U.S. As a result, the military is changing how it trains personnel, which technologies it buys, and the geographic areas of the world where it prioritizes its forces. The move: The 2018 strategy rewired the Defense Department’s vast bureaucracy away from a focus on fighting insurgents and terrorists in the Middle East toward a long-term strategic competition with China and Russia. But the Trump administration’s National Defense Strategy stands out as one of the most important defense policy shifts of the last generation, reorienting the American military to confront rising and increasingly aggressive powers Russia and China. Trump refocused national security on great power competitionĭefense policy documents are so abundant they could wallpaper the Pentagon. The incoming Biden administration isn’t likely to reverse course. The upshot: While Trump’s moves made Obamacare plans increasingly unaffordable for the unsubsidized, Democrats quickly tamped down their criticisms since it accomplished their goal of significantly boosting funding for Obamacare. The concept, known as “silver-loading,” grew government subsidizing of the exchanges by upwards of $20 billion per year. This meant that premiums for these “silver” plans spiked and as a result, the premium subsidies the government had to pay for low-income enrollees vastly increased. Instead, health plans and states quickly figured out a way to claw back the federal dollars they lost: They built the costs of the subsidies into premiums for Obamacare’s benchmark “silver” policies. The impact: The health exchanges didn’t collapse, as Trump had hoped. In 2017, Trump finally did it through administrative means after the GOP effort to replace the law fell apart - and he immediately drew intense outcry from Democrats and policy experts who called the move “sabotage.” The move: House Republicans had tried for years to cut off subsidies that helped low-income Obamacare enrollees with the co-pays, co-insurance and deductibles that come with their health plans.

But his most significant imprint on the Affordable Care Act was an accidental boost that happened when he stumbled into pouring billions of extra federal dollars into subsidizing Americans’ coverage. Trump came into office vowing to repeal Obamacare - and even took the law to court when that failed in Congress.

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