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.
On Wednesday, House Speaker Paul D. Ryan (Wis.) and other congressional Republicans voiced fresh determination to complete the deed. After dozens of fruitless repeal votes in the House, and a major rescission attempt this year that President Obama blocked, Ryan noted that “now we have President Trump coming, who is asking us to do this.”
According to lawmakers and health-policy analysts, the GOP majorities in both chambers are likely to employ Congress’s reconciliation process to reverse critical aspects of the statute that involve federal spending, such as the subsidies helping millions of working- and middle-class Americans afford health plans. But analysts said a political path is less clear to dismantling other parts of the law, such as its insurance marketplaces, or to instituting a set of conservative health-care approaches.
The ACA’s most ardent supporters have begun a counteroffensive to stoke opposition to reversing ways in which the law has upgraded coverage and made it more affordable for some consumers. Families USA, a liberal consumer-health lobby, convened an afternoon call with more than 1,000 people from all 50 states to begin mapping a grass-roots campaign.
“The clock is ticking, because Republicans appear to be saying health care is going to be the first item on their list with repeal of the ACA being the banner for that,” said Ron Pollack, Families USA’s executive director for three decades. “This will be the most intense fight I remember. . . . One should never underestimate an extraordinary backlash that occurs when people have something that they really value and it is taken away.”
The Affordable Care Act, enacted in the spring of 2010 with virtually no GOP support, is a 2,000-page statute that has ushered in the broadest changes to the health-care system in half a century. With Trump’s election, “the ACA as we know it would seem to be toast,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation.