Since Donald Trump’s defeat in the 2020 Presidential election, there seemed to be a general assumption that the Republican Party’s long-standing quest to dismantle President Obama’s key legislative achievement, the Patient Protection & Affordable Care Act (ACA), was finally drawing to a close.
Healthcare journalist Jonathan Cohn even released his comprehensive history of the ACA, “The Ten Year War,” although there was still a significant legal matter pending resolution about eight months later.
Subsequently, while there have been some minor disputes over aspects of the ACA and a handful of federal lawsuits challenging specific provisions, the general consensus among the public, commentators, and politicians (both Democrats and Republicans) appeared to be that the ACA had become as entrenched as Medicare or Medicaid. Although Republican members of Congress continued to express their dissatisfaction, they seemed to have largely come to terms with its permanence.
However, about a week ago, Donald Trump, presumed to be the Republican presidential nominee for the third consecutive time, reignited his fixation with dismantling “Obamacare”:
“The cost of Obamacare is out of control, plus, it’s not good Healthcare. I’m seriously looking at alternatives. We had a couple of Republican Senators who campaigned for 6 years against it, and then raised their hands not to terminate it. It was a low point for the Republican Party, but we should never give up!”
The initial response from Republican Senators varied from denial to confusion:
Senator Susan Collins of Maine, one of the three Republicans who voted against repealing Obamacare in 2017, expressed doubt about a full repeal. GOP Senator Bill Cassidy of Louisiana, who previously led a replacement effort, declined to comment upon hearing Trump’s remarks. Senator John Cornyn of Texas called the ACA a “fraud on the American people,” expressing interest in Trump’s replacement plan. However, Senator J.D. Vance of Ohio, a Trump ally, noted that key elements of Obamacare, like protections for pre-existing conditions, are widely popular, even among Republicans.
Despite this, Trump has doubled down on his rhetoric to “never give up” on terminating Obamacare, claiming that:
“Getting much better Healthcare than Obamacare for the American people will be a priority of the Trump Administration. It is not a matter of cost, it is a matter of HEALTH. America will have one of the best Healthcare Plans in the world. Right now it has one of the WORST!”
He then added:
“I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!”
Despite the apparent contradiction (since replacing legislation does indeed mean terminating the original), it seems Trump’s focus on abolishing the ACA is not merely a passing remark. As Trump is synonymous with the modern Republican Party, if this is his objective, it seems likely the party will have to strive to fulfill it.
Gov. DeSantis says he would “replace and supersede” Obamacare with a “better plan” if he were elected president. – @MeetThePress https://t.co/zpPV0VreGp— NBC News (@NBCNews) December 3, 2023
…Beyond that and a list of principles — “more transparency, more consumer choice, more affordable options, less red tape” — he did not go deep on his plan. Of the more than 40 million Americans covered by A.C.A. plans, he said, “We’ll have a plan that will offer them coverage, so the coverage will be different and better, but they’re still going to be able to be covered.”
He said he would release a full proposal “probably in the spring,” which would be after a majority of states have held their primaries or caucuses.
