So the major groups who will be hurt by Trump's proposal are those who receive no subsidy for their health insurance (i.e. who make more than 400% of the Federal poverty level, about $81,000 for a couple in Alaska) and who buy private health insurance. It is odd but probably not surprising that that in both this plan and his tax plan Trump is putting an extra burden on middle-income households and favoring wealthy households (is that why people voted for him?) If he really wanted to help middle-income groups he would extend the subsidies beyond the 400% level.