The Affordable Care Act transformed the medical system, expanding coverage to millions, injecting billions in tax revenue, changing insurance rules and launching ambitious experiments in quality and efficiency.
Less of that might disappear under President-elect Donald Trump’s pledge to “repeal and replace Obamacare” than many believe, say policy analysts. Republicans promising change might not quickly admit it, but in some respects Obamacare’s replacement may look something like the original.
“It gets into a questions of semantics,” said Mark Rouck, an insurance analyst for Fitch Ratings. “Are they really repealing the act if they replace it with new legislation that has some of the same characteristics?”
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For the past six years, Republicans — across Washington, and across the country — have virtually to a person run against Obamacare. Their campaign has helped them win numerous House and Senate seats, a majority of governorships, and now has given them unified control of Washington for the first time in 15 years. Like the dog that finally caught the proverbial car, Republicans will wake up Wednesday morning asking themselves — on Obamacare, as on many other issues — “What now?”
The answer might be less obvious than it first appears. Democrats used the decade and a half between the defeat of Hillary Clinton’s health plan in 1993–94 and the 2008 election to develop a consensus architecture about what their ideal health-care plan would look like. In the Democratic primaries that year, Senators Clinton and Obama disagreed strongly on the necessity of an individual mandate to purchase coverage — a difference they litigated very publicly, and at great length, during the primary campaign — but agreed on virtually everything else.
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A nationwide exit poll shows almost half of voters believe Obamacare went too far.
About 45 percent told NBC News that the law went too far, while 31 percent believe it didn’t go far enough and 18 percent said it was just right, according to a nationwide exit poll released Tuesday.
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The chairman of the National Republican Senatorial Committee said a GOP alternative to the Affordable Care Act must be mindful of those who currently have coverage through the law.
“Clearly we don’t want to do any harm to people in the system now,” Sen. Roger Wicker (R-Miss.) said at a Wednesday news conference at the Republican National Committee. “We want to be mindful.”
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Majority Leader Mitch McConnell signaled the Senate would move swiftly to repeal Obamacare now that the GOP Congress will have a Republican president next year.
“It’s pretty high on our agenda as you know,” the Kentucky Republican said on Wednesday. “I would be shocked if we didn’t move forward and keep our commitment to the American people.”
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After it became clear that Donald Trump had defeated Hillary Clinton for President, a lot of the news coverage focused on one of Donald Trump’s key policy promises: that, “on day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.” But fully repealing Obamacare—let alone replacing it with better reforms—will be far more difficult than a lot of observers believe.
To start, full repeal of Obamacare can’t happen unless 60 U.S. senators vote for it, thanks to the filibuster. And there aren’t 60 votes in the Senate for full repeal; if advocates are lucky, there will be 52. (In 2017, Republicans will control either 51 or 52 Senate seats, depending on the outcome of a runoff in Louisiana.)
Republicans could, in theory, get rid of the filibuster, but Senate Majority Leader Mitch McConnell (R., Ky.) and others have routine expressed opposition to that idea.
For the past six years, no law has served as a larger GOP whipping post than the Affordable Care Act, and the Republican sweep Tuesday of political Washington has imperiled the ACA’s expansive reach, putting at risk the insurance that more than 20 million Americans have gained.
During the final week of his campaign, President-elect Donald Trump vowed to repeal the 2010 health-care law so swiftly that he might summon Congress into a special session to accomplish the task. “We will do it, and we will do it very, very quickly. It is a catastrophe,” he said.
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Donald Trump’s ascension to the White House puts President Barack Obama’s Affordable Care Act in grave peril.
Ever since the law passed in 2010, Republicans have campaigned on a pledge to repeal Obama’s signature domestic policy achievement. Trump’s victory, with continued GOP control of Congress, gives them their first opportunity to do so.
Trump and congressional Republicans have set sky-high expectations for repealing Obamacare; he’s promised to scrap it “very very quickly.” And they have a road map to repeal significant parts of the law, even with a narrow Senate majority.
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We are nearing the grand finale of our long and disheartening election opera, one we dare not ignore because the outcomes matter so much. While the election results will not be determined by public reactions to the Affordable Care Act, the ACA’s fate will be mightily determined by Tuesday’s outcomes. What have we learned about our collective health future over the past 18 months and what might this mean for our health system’s future?
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While Obamacare is currently making headlines for (much) higher than predicted costs, the Centers for Medicare & Medicaid Services (CMS) want to create a national database of highly sensitive personal health information for the 30 million Americans with individual and small group coverage. Under Section 153.610 of a new Health and Human Services (HHS) rule for Obamacare, this proposal would require health plans to send CMS data on enrollees on an unprecedented scale, including:
- Amount paid
- Diagnoses received
- Drugs prescribed
- Procedures received
- Health care providers seen
- Out-of-pocket liabilities assumed
- Individual demographics
- Social Security Number
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