ObamaCare is back in the headlines

News Analysis

Former president and GOP presidential frontrunner Donald Trump ignited a firestorm this past week when he vowed to get rid of the Affordable Care Act (ACA) if elected, resurrecting an issue that no one has talked about lately — especially in the GOP — and prompting Democrats to proclaim it a political gift from Heaven.

The true popularity of the ACA, otherwise known as ObamaCare, in Heaven is unknown, but the program’s popularity — and its chops as a campaign issue — is very much arguable on earth.

Trump started it all after reading an editorial in the Wall Street Journal, in which the newspaper’s editorial board cast a spotlight on liberal Democratic Sen. (and once-fervent supporter of ObamaCare) Elizabeth Warren’s new found frustration with the ACA. Warren has complained about the law’s unintended effects: Higher health care prices and heath care consolidation. 

Among other things, the coverages everybody must carry — such as maternity coverage — have driven prices higher, and ironically so have profit caps, which have encouraged companies such as Cigna and Humana to attempt to merge and consolidate and which have also increased premiums.

That said, the ACA has remained very popular among the voting population, hovering at about 60 percent approval, give or take depending on the poll. Those numbers are a big reason none of the Republicans running for president have — until last week — uttered so much as a discouraging word about it.

Enter Donald Trump.

After reading the Wall Street Journal editorial, Trump took to Truth Social and revived the issue, promising to do away with the ACA and chiding some fellow Republicans for not already doing so.

“The cost of Obamacare is out of control, plus, it’s not good health care,” Trump wrote. “I’m seriously looking at alternatives. We had a couple of Republican Senators who campaigned for six 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!”

It didn’t take Democrats long to pounce, including in Wisconsin. The state Democratic Party issued a statement saying that the ACA’s repeal would have devastating consequences.

“The Affordable Care Act led to a historic expansion of health care coverage, ensuring more people than ever before are able to access the essential health care they need at an affordable cost,” the party’s statement asserted. “If Donald Trump and Republicans succeeded in repealing the ACA, it would have devastating consequences for millions of Wisconsinites who have access to health care thanks to the ACA.”

Specifically, Democrats alleged that 40 million Americans — and more than 200,000 Wisconsinites — could lose their health care coverage. In addition, the party stated, ending the ACA “would rip away protections for the over 800,000 Wisconsinites with preexisting conditions, allowing insurance companies to deny basic care like hospital visits and prescription drugs.”

The Democratic statement managed a plug for U.S. Sen. Tammy Baldwin, who is up for re-election next year, observing that she championed the provision in the ACA that allows children to stay on their parents’ insurance up to age 26.

“Without the ACA, 23 million adult children nationwide would be suddenly left without health insurance,” the party stated, while 1.2 million Wisconsin Medicare beneficiaries would face higher costs and disruptions to their care if the ACA were repealed, the party stated.

“Donald Trump has made clear his top priorities for a second term: take away Wisconsinites’ health care and force people to pay more for the care they need,” Democratic Party of Wisconsin spokeswoman Haley McCoy said. “Hundreds of thousands of Wisconsinites have access to affordable health coverage thanks to the Affordable Care Act, and Trump’s pursuit of a repeal of this lifesaving law is downright dangerous. It’s abundantly clear that Wisconsinites cannot afford another four years of Donald Trump.”

Democrats also say repealing ObamaCare would hurt rural areas such as northern Wisconsin, alleging that rural hospitals would lose critical support if the ACA were repealed and that insurance companies would once again be allowed to charge women more than men, cap lifetime coverage, and refuse coverage for prescription drugs and maternity care.

“Donald Trump continues to double down on his promise to repeal the Affordable Care Act with no plan in place to prevent millions from losing the coverage and critical protections they depend on to keep their families healthy,” Democratic Party of Wisconsin communications director Joe Oslund said. “Gutting the ACA would be a disaster for Wisconsin, leaving hundreds of thousands without care and putting families at the mercy of insurance companies and Big Pharma. Donald Trump is telling us exactly what he would do in a second disastrous term as president — we should believe him.”

The view from the other side 

Republicans have been largely silent or running for cover since Trump’s vow, but the Wall Street Journal editorial that started it all analyzed the downsides of the ACA.

“The reality is that ObamaCare has increased healthcare costs while producing few tangible benefits for patients,” the editorial stated. “As we recently pointed out, the law’s de facto profit cap has driven industry consolidation, resulting in higher costs for patients and taxpayers. Insurers have pocketed subsidies while increasing premiums and deductibles.”

While the share of Americans with insurance increased by about five percent in the six years after the law’s Medicaid expansion and health exchanges took effect, that fact was not so rosy as it sounded, the newspaper’s editorial board wrote. 

“This resulted in about 17 million Americans gaining health coverage,” the editorial stated. “But most newly insured are young, healthy adults on Medicaid. They could have afforded ‘skinny’ plans more appropriate for their age and health risks, but the Biden administration is restricting those plans.”

And that wasn’t all, the editorial board wrote.

“Medicaid spending was growing at an unsustainable 9 percent a year even before its pandemic expansion,” the editorial stated. “Taxpayers are shelling out $90 billion this year for ObamaCare subsidies — $6,324 per household —  which Democrats sweetened in 2021 to offset surging premiums for middle-and upper middle-income Americans. Meantime, insurance provider networks have become narrower while out-of-pocket costs increase for patients.”

The newspaper knocked Trump for agreeing with the editorial but not having a plan to replace the ACA, and it said the Democrats were equally ill-prepared to deal with the ACA’s shortcomings.

“Democrats have no plan to deal with these problems or soaring government healthcare spending other than drug price controls or rationed care,” the editorial stated. “But neither do most Republicans, who more or less stopped thinking about healthcare after their 2017 failure.”

That might be, but it’s arguable whether the issue will be a hot-button one for voters. Only about 18.2 million Americans are in the ObamaCare marketplace. While that’s a 29 percent increase over the previous year, it’s a fraction of the voting population.

What’s more, some GOP observers contend, most are already Democratic Party voters. While Obamacare might receive warm approval from the overall polling population, that doesn’t mean it’s a decisive voting issue when most Americans aren’t impacted for better or for worse.

Richard Moore is the author of “Dark State” and may be reached at richardd3d.substack.com.