Former President Donald Trump has reiterated his commitment to repealing the Affordable Care Act, commonly known as Obamacare, should he return to the White House. This comes despite the fact that the health reform law has gained increasing acceptance among Americans in recent years.
“We’re going to fight for a health care system that is far superior to Obamacare. Obamacare has been a disaster, yet it rarely gets discussed. If it weren’t for John McCain, we would have already achieved this,” Trump stated during a speech in Newton, Iowa, referencing the late Republican senator’s pivotal vote against dismantling the Affordable Care Act in 2017.
Obamacare has seen a record number of sign-ups and enjoys higher public favorability ratings than ever before. Despite this, and the fact that it has been a politically damaging issue for Republicans in recent elections, Trump has reignited his campaign to abolish Obamacare in his latest bid for the GOP nomination.
Florida Governor Ron DeSantis, another contender for the Republican nomination, echoed Trump’s sentiments late last year, stating his intention to “replace and supersede” the Affordable Care Act with a “better plan,” arguing that “Obamacare has not worked.”
However, the task of dismantling the Affordable Care Act would be even more challenging than it was in 2017, even if Republicans were to gain control of the White House and Congress in the upcoming elections. The nearly 14-year-old law is more deeply ingrained in the nation’s health care system than when Trump first took office, promising to eliminate Obamacare.
Trump and the Republican-controlled Congress were unable to repeal and replace the Affordable Care Act after several unsuccessful attempts to devise an alternative. The majority of the nation, particularly Republican voters and many GOP lawmakers, have since moved on from the idea of repealing and replacing the law.
Trump’s remarks have provided President Joe Biden and congressional Democrats with an opportunity to criticize Trump and the GOP for attempting to strip people of their health care. Despite a rocky start, Obamacare has stabilized and now provides health care coverage to more than 40 million Americans, a significant increase from just under 27 million in 2017, according to the Department of Health and Human Services.
Obamacare’s popularity surged after congressional Democrats enhanced the federal premium subsidies in 2021. The law’s provisions, which protect people with preexisting conditions from being denied coverage or charged higher premiums by insurers, allow children to remain on their parents’ plans until age 26, and provide a range of preventive services at no cost, benefit many more people.
“We’re as close as we’ve been to meeting the aspirational goals of 2010 for the ACA,” said Rodney Whitlock, vice president at McDermott+Consulting and a former health policy adviser on the Senate Finance Committee under Republican Sen. Chuck Grassley of Iowa. “It was still in its infancy in 2017. Now it has matured enough that it is stable and functioning.”
Here is why the Affordable Care Act would be more difficult to dismantle now:
Record interest in Obamacare coverage:
More people are insured through the Affordable Care Act exchanges than ever before. Some 15.7 million people were enrolled in Obamacare plans in February 2023, up 13% from a year earlier, according to the Centers for Medicare and Medicaid Services, which oversees the exchanges. Plus, 1.5 million more people enrolled between March and September 2023, compared with the same period in 2022. Americans are continuing to flock to the exchanges for 2024 coverage too.
More states implement Medicaid expansion:
There are now 40 states that have adopted the Obamacare provision expanding Medicaid coverage to more low-income adults. That’s nine more than in 2017. In most of the states, voters forced resistant Republican-led legislatures to broaden Medicaid by approving ballot initiatives.
Higher favorability ratings:
Nearly 60% of adults had a favorable view of the Affordable Care Act in May 2023, close to the highest share since the law was passed in 2010, according to the KFF Health Tracking Poll. That’s quite a difference from December 2016, when only 43% had a favorable opinion of Obamacare.
Supreme Court leaves law intact:
After Congress failed to repeal Obamacare, a coalition of GOP-led states and the Trump administration tried to take it down through the US court system. The states argued the act’s individual mandate was rendered unconstitutional when Congress in 2017 reduced the penalty for not having coverage to $0. They also contended that because the mandate was intertwined with a multitude of other provisions, the entire law should fall. But the Supreme Court dismissed the lawsuit in 2021, saying the challengers did not have the legal right to bring the case. The case marked the third time the law survived a significant challenge in the Supreme Court.
CNN’s Alayna Treene and Veronica Stracqualursi contributed to this story.