Will Section IV of the 25th Amendment be used during Trump's Presidency?

Section 4 of the 25th Amendment is an extremely high bar: it requires the vice president and a majority of the cabinet to conclude the president is unable to discharge the powers and duties of office, and it almost certainly triggers an immediate political crisis. That makes it fundamentally different from ordinary health scares, short medical procedures, or temporary absences, which are much easier to handle through Section 3 or simple delegation. Historically, Section 4 has never been used, and the institutional incentives against being the first are strong because the act would be seen as a direct constitutional removal of a sitting president by his own appointees.

Trump’s age and the possibility of medical or cognitive decline do create some real risk, and a presidency that extends through early 2029 leaves enough time for an adverse event to occur. But the key constraint is not only whether Trump might become impaired; it is whether his vice president and cabinet would be willing and able to mount a successful formal challenge. In a highly loyalist political environment, the more likely response to serious concerns is pressure for resignation, limited delegation, or behind-the-scenes management rather than invoking Section 4. Even a major health episode would not automatically translate into constitutional usage.

The 27% market price appears to overstate how often the mechanism would actually be used. That number may be implicitly pricing in the broad possibility of a severe medical or political crisis, but it underweights the fact that Section 4 requires elite coordination, public confrontation, and a level of certainty that is rarely achievable. I would treat the market as somewhat mispriced to the high side, with the most plausible outcomes being no formal invocation even if Trump experiences intermittent incapacity or controversy.