I guess my biggest question is whether they would need 51 or 60 votes in the Senate? I don’t remember for sure but it seems back in 2017 for some reason they would have only needed 51 votes. If it is 51 or more, and they have 55 Senators, would all Republicans vote to do so, or is the ACA popular enough in 5 states so those Senators would not vote for it? For that matter, let’s say the end up with a 10 vote majority in the House. Would it pass there?
Yes.
Stranger
Nobody will be able to stop them, so yes.
Trump did weaken the ACA during his first term, and they were a McCain vote away from overturning it completely. I would assume it’s gone and start looking for other options if you depend on it.
I imagine some of the larger blue states may try to set it up on their own, but smaller states probably don’t have enough people and if you’re in a red state, good luck!
This could get interesting.
Some local county governments in my state are doing away with private health insurance and requiring employees to sign up for the state’s ACA insurance or if you are over 65 you need to sign up for Medicare.
That’s one way to put a likely heath care disaster that this country is probably facing.
Our local county government has always had great health care insurance and one of the main reasons I stayed at my current position for so long.
Let me rephrase this. It’s an impending disaster.
I know of one county that has already made the switch and mine is considering it for the future. But I’m retiring shortly and won’t need to worry about it.
It depends on what they try to do.
What happened last time was that they tried a full repeal first (actually many times, even while Obama was President) which needed 60 votes due to the filibuster. This is a policy change, not strictly budgetary, which is why it can’t pass through reconciliation.
Then, they tried a “skinny repeal” through reconciliation. It repealed on some of the ACA (although plenty to be harmful). That is the vote that ultimately failed 49-51 with McCain, Collins, and Murkowski voting against it.
ETA: It only needed 50 because it was done through “reconciliation” which has limits on what is possible. It needs to be strictly budgetary, hit various revenue targets over 10 years (strictly speaking it’s supposed to be budget-netural IIRC). This has been stretched beyond belief, and there isn’t really any mechanism beyond the Senate parliamentarian to enforce the rules, AFAIK.
Every version of the bill was extremely unpopular, even with Republican voters.
And that was 7 years ago at this point. As @Ellecram points out, even more Americans are dependent on the ACA now and it is even more embedded in the very fabric of how healthcare is provided.
I won’t say it’s definitely not going to happen, but Trump and MAGA GOP has been very good lately at simply ignoring areas where there policies are unpopular (abortion, health care) and focusing on ones where they have a political advantage (immigration, tax policy). I fully expect that will be their initial focus, along with the changes to federal worker protections.
For them to jump in with an ACA repeal or an abortion ban before doing the immigration and tax policy stuff that was their primary platform would be surprising, and extremely bad politics.
George Bush ran on opposing gay marriage in his second term. When he won, the first thing his administration tried to do was…partially privatize social security.
I absolutely get your point, but GWB was much more of a “party man” than Trump is, and SS reform was the GOP white whale for decades (until they gave up being the party of fiscal responsibility entirely).
And, perhaps even more relevantly, that attempted reform failed spectacularly. Even though the GOP had a 55-seat majority in the Senate and a 30-seat majority in the House.
It did fail, but Republicans, and especially Trump, have never stopped complaining about the ACA, really even more than SS lately. Trump claims that he has a much better plan (which will unveiled in two weeks, no doubt).
What did they do in Trump’s first term? Put in extremely conservative justices and cut taxes, especially on the rich and on corporations – straight up Republican playbook. Trump doesn’t have any actual policy positions, so he’ll just sign what they put in front of him.
Many (most?) red states still haven’t done the free (well, federally funded) Medicaid expansion that comes from the ACA, just fucking over their constituents.
The Republican party hates the ACA because it shows that government can actually help people. Trump hates it because it’s something Obama did, and he has no understanding of health care policy, so he thinks he can make it better.
I really think it’s on the chopping block. They’ll destroy it, claim to have something better that they’ll implement, and then never do anything.
Only 10 states have not expanded Medicaid. A few of those states have expansion in work. One is Wisconsin, so not a red state but basically red a state legislative level due to gerrymandering.
I agree it’s possible, but I personally would be surprised and would expect/hope a repeal to fail.
So what about VIrginia. I know we have an insurance marketplace, i see now one of only 19 states that do. Does that mean it is not part of the ACA?
There is a moderate chance of overturning it, but they would need to replace it with something more popular or they would lose midterm elections. Past experience suggests writing better legislation is not straightforward…
Evidently, the majority of voters don’t want decent, low-cost health care. Nor do they have a problem with higher prices of imported goods. I don’t know why this is the case, you would have to ask them.
This is going to be the issue for many people (myself included) – there won’t be other options.
One of the key provisions of the ACA is preventing health insurance companies from disqualifying applicants due to pre-existing health conditions.
Prior to the ACA, health insurance companies sold lots of “individual” policies, to people who didn’t get health insurance from their employers (and who weren’t on Medicaid or Medicare), but the insurers could pick and choose who they insured: if you had a pre-existing condition (say, diabetes, high blood pressure, a cancer history, or even being overweight), they could refuse to cover you.
Without the ACA, there’ll be millions of Americans who simply won’t be able to obtain health insurance, at any price.
I agree about the fact that there will not be any other options if a repeal is passed. The Republicans have no plan to use government power to solve the issue; the only actual proposals that I heard during the campaign (other than “concepts of a plan”…yeesh) was JD Vance saying that they were going to set up high-risk pools; this would entail stuffing people with chronic health conditions into insurance markets together, where they will be offered health-care premiums that they cannot possibly afford.
Yup. Definitely a potential disaster for literally millions of Americans.
Hopefully, this particular disaster can be avoided.
Virginia’s healthcare insurance marketplace (at https://www.marketplace.virginia.gov/) is an exchange created by the state to comply with the ACA. Virginia is a large enough market that it made sense for the state to set up its own marketplace for residents. (It would make sense for a lot of states that are even larger, too; but frothing-at-the-mouth opposition to the ACA makes it politically untenable to do so in many states.)
I note, though, that “Affordable Care Act” cannot be found either on the front page or the top level of the FAQ on the site. This might be a wise choice given the knee-jerk opposition that a mention might create in certain aforementioned mouth-frothers, but it means that a lot of people who get the benefts of the ACA don’t really have a handle on how that act is helping them - which makes it poltically easier for those who oppose the act to do so. The benefits the ACA provides have always polled more popular than the name (or nickname) of the act itself; separating one from the other is a key way to make it poltically viable to kill the act while minimizing blowback.
I think the most likely approach is that they will cut the subsidies for it–so a huge number of people will drop it because they can’t afford the premiums.