Unfortunately, while the median effective tax rate is lower than 20%, it's safe to assume that you'd pay more on $200k.

But run the numbers to see what your tax rate would actually be (and how your cost of living would change). I don't think the healthcare is as bad as you think. Also, the "potential" for a second Trump term is basically non-existent. I know he announced he's running, but he had 80 million people vote against him in 2020. It's basically impossible to ever win another election in the US if 80 million people would prefer Joe Biden to you. Even if a miracle happened and he became president, it almost certainly wouldn't affect you unless you pay attention to politics