With the Affordable Care Act once again under fire from Republicans, a leading health care economist explains what a Republican sweep might mean for the health coverage of 45 million Americans.
Though the fate of the Affordable Care Act has played a role in presidential elections in the U.S. for more than a decade, this race has been different. Apart from a few cameos, the 14-year old law — often called Obamacare — has been largely off-stage, as immigration, the economy and democracy dominate the fight between Vice President Kamala Harris and former President Donald Trump.
But 45 million Americans rely on the health law for their health coverage — either through private plans or Medicaid — and, in these final days of the race the ACA has returned to the spotlight.
At a campaign stop in Pennsylvania last week, House Speaker Mike Johnson told a crowd that “massive reform” of the health law is needed, adding no specifics. But he did promise a “very aggressive first-100-days agenda” if Trump wins. “Health care reform’s going to be a big part of the agenda,” Johnson said.
As part of a major speech on Tuesday in Washington, D.C., Harris warned Americans of what could happen if the ACA were to be repealed. “You will pay even more if Donald Trump finally gets his way and repeals the Affordable Care Act — which would throw millions of Americans off their health insurance,” Harris said, “and take us back to when insurance companies had the power to deny people with preexisting conditions.”
The upcoming elections could have “enormous” impact on the law, says Larry Levitt, an executive vice president of the nonpartisan health policy research organization KFF. Levitt has studied the ACA since its inception.
“I don’t think you can overstate the effect the ACA has had on the availability and the affordability of health insurance in this country,” he says.
He recently shared insights into the ACA’s track record and discussed what “massive reform” from Republicans might look like on the health policy podcast Tradeoffs.
Here are highlights from that conversation.
Interview highlights
On the risks to the Affordable Care Act
If Republicans sweep this election, I think the ACA, along with Medicaid, will have big targets on their back. If Harris wins or Democrats are able to hold on to one house in Congress, I think the ACA will be safe. And even though the ACA has not been a big topic in this campaign, it is still a fork-in-the-road election for the future of the law.
On how the American public views the ACA
We’ve been polling for more than a decade and a half about the ACA.
