The future of “Obamacare” has become a significant topic in the closing days of the presidential campaign, especially after a top Republican leader recently pledged that if Donald Trump wins the presidency, sweeping changes to the program would be implemented. This could threaten the stability of the ACA and affect the health coverage of millions.
During an interview with the Associated Press, U.S. Secretary of Health and Human Services Xavier Becerra emphasized the importance of the subsidies that have helped approximately 21 million people gain access to affordable health insurance. However, these subsidies, expanded during the COVID-19 pandemic, are set to expire next year, raising concerns about affordability.
Becerra remarked, “Americans now see health care not just as a privilege but as a right. I don’t think anyone wants to take away the right to affordable health insurance coverage.” His comments come as he prepares to visit politically significant Arizona to promote the start of open enrollment.
If Trump retakes the White House and Republicans gain control of Congress after the contentious elections on Tuesday, major changes to the ACA are likely. Trump and GOP leaders, including House Speaker Mike Johnson, have openly criticized the ACA, vowing to implement “major reforms” during a Trump administration.
In a video obtained by NBC News, Johnson stated that health care reform would be a central part of the GOP agenda. While Johnson’s office later clarified that there are no plans to completely repeal the law, his remarks underscore the Republicans’ intent to collaborate with Trump to reshape federal government programs, including those related to health care.
Trump has suggested that he has a conceptual plan to alter the ACA, a program he was unable to fully dismantle during his previous term. Recently, Republicans have raised concerns about spending and fraud in the program, signaling a potential shift in health care policy.
Enrollment in the ACA saw significant increases under the Biden administration after dropping to 11 million during Trump’s presidency. Achieving this enrollment surge required taxpayers to invest billions into the ACA, allowing subsidies to reduce premiums for many enrollees by nearly half.
To maintain these subsidies, Congress must pass new legislation, which could cost up to $335 billion over the next decade. Some Republicans are already pushing back against this figure, complicating the future of the program.
Democrats are warning voters that Republicans may renew their efforts to dismantle the ACA as Election Day nears, with Vice President Kamala Harris recently cautioning that Johnson’s statements demonstrate a plan to strip away health care coverage. She noted, “This has been part of Donald Trump’s agenda for a long time.”
The Biden administration has also taken steps to expand the ACA, including increasing funding for insurance navigators who assist individuals in obtaining coverage. A new rule has been implemented to extend eligibility for immigrants brought to the U.S. as children, known as “Dreamers,” allowing approximately 100,000 to sign up for coverage during this enrollment period.
Meanwhile, 15 Republican state attorneys general have filed lawsuits to halt enrollment for these immigrants, creating additional legal hurdles.
Open enrollment for ACA coverage will close on January 15, but to secure coverage for the new year, individuals must enroll by December 15.
