President Donald Trump has an Obamacare problem.
His administration restarted its efforts to kill the health care law this week, backing a lawsuit that argues all of the Affordable Care Act is unconstitutional. Now, Trump faces a question that has confounded Republicans in recent years: if courts toss out Obamacare, how do you replace it with an alternative that expands coverage, cuts costs and keeps the law’s most popular parts in place?
The White House has no easy answers. When the GOP tried several times to repeal Obamacare in 2017, voters overwhelmingly disapproved of the plans. Americans grew to like the existing law more when they saw projections that the Republicans’ alternatives would leaves tens of millions more people uninsured or increase costs.
Democrats flipped 40 House seats and control of the chamber in last year’s midterms in large part by criticizing the Republican push to repeal the ACA. After the drubbing, Republican leaders in Congress have had little appetite for reopening the Obamacare fight, instead focusing on several top Democratic presidential candidates’ calls for a government-run “Medicare-for-all” health care system.
Then Trump jumped into the fray in recent days. Focusing on health care ahead of a pivotal 2020 election, in which Republicans will try to defend the White House and a Senate majority and retake House seats, carries massive political risk. There’s little evidence to suggest voters trust Trump and the GOP to come up with a health care plan if the president gets his wish and the Supreme Court scraps Obamacare.
“The one lasting effect of the repeal and replace debate is that the ACA is actually more popular than ever. That will make it harder to talk about repealing and replacing it,” said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation. “The repeal and replace debate in 2017 did the one thing that seemed impossible: which was to make the ACA popular.”
For Democrats, Trump’s decision to make health care front and center of the political debate again is a welcome change of topic for the party after special counsel Robert Mueller concluded the Russia probe. After a two-year investigation, Mueller did not establish that members of the Trump campaign conspired with Russia’s interference in the 2016 presidential election, putting Democrats on the defensive.
House Speaker Nancy Pelosi quickly jumped on Trump’s latest moves against Obamacare, announcing a vote in the coming week to condemn his attempt to kill the law. And 2020 Democratic presidential candidates see health care as a winning issue as the campaign heats up. Sen. Kirstin Gillibrand, who officially launched her campaign the day Mueller’s key findings were released, said the debate over health care is a fight the party welcomes.
“If it’s a fight for healthcare this administration wants, it’s a fight they’ll get—and we will win,” Gillibrand said.
Gillibrand tweet: “If it’s a fight for healthcare this administration wants, it’s a fight they’ll get—and we will win.