One of the most pivotal issues of the Obama presidency was the implementation of the Affordable Care Act (ACA) otherwise known as Obamacare. This was instituted March 23rd 2010 and since then there have been over 60 attempts to repeal the law. It has became a savior to some who could not afford coverage before it passed, and a pariah to those who have seen coverage costs rise or have made the decision to forgo health insurance, only to realize there are fines for not being covered.
Knowing how controversial this law has been, the GOP has made its repeal a top priority, and Donald Trump has entered office fully expecting to follow through on the wishes of his voting base. With all this in mind, something strange has been happening. The momentum has seemed to stall, right as the GOP has attained the power of the Presidency, the House and the Senate. Why has the sprint to eliminate the program slowed to a crawl?
Before the ACA was passed, many Americans simply saw healthcare as a luxury for the healthy, and an unfortunate reality for the sick and injured. With its passing, health insurance coverage has increased significantly, with (depending on who you cite) 10-20 million additional Americans receiving coverage as a result of the law. This has made it very popular to many who have reaped the benefits, including people within the GOP’s core constituency.
The fact is, repealing the ACA without a replacement would immediately hurt those receiving coverage, and that alone is politically damaging. Additionally, provisions in the law such as young adults remaining on their parents insurance until the age of 26, coverage for preexisting conditions, and other consumer protections have become popular even in conservative circles. This is where the problems begin to arise.
If for example we want to retain the ability for people to receive coverage even when they are sick and have severe pre-existing conditions, we must find a way to offset those medical costs for insurers. The ACA covered this gap by forcing even the young and healthy to pay for insurance under threat of a fine. The GOP finds fault with this ideologically, but know that this provision is the only thing allowing costs to be absorbed from those with legitimate medical needs who would otherwise be denied coverage and consequently care. Democrats know this, and should this repeal go into effect without covering this and other similar issues, they will roll out example after example of people who have experienced life altering changes as a result of losing coverage. This would kill the GOP in the very critical upcoming election cycles, and now they must find a way to adjust.
The GOP has created this scenario by not planning properly or taking their own party and policies seriously. They have pushed for over 6 years to repeal the ACA, and did not have a plan in place to address the popularity of the concept it familiarized the American people with.
What will happen?
Americans have reached a point of frustration with the government and medical industry, in which any large scale push against consumers will result in a revolt against all involved. If they do not quickly repeal the ACA, their constituents will be furious with them for broken promises. If they do not have a sufficient plan the replace it in the wings, then they will face the fury of people with cancer, diabetes and heart conditions who can no longer afford or even buy care.
The GOP has put themselves between a rock and a hard place with emotionally driven policy that has no well constructed plan to address their constituents concerns. Until they get those plans in place, I doubt the ACA will be repealed. The promises of the last half decade will have to wait for the reality of the present day.
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