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Is this 2023 or 2017?
With Donald Trump spouting off on social media, vowing once again to try to get rid of Obamacare, it’s hard to tell. It’s like we’re caught in a rerun of his presidency, when he fought a losing battle against the increasingly popular health insurance program.
“The cost of Obamacare is out of control, plus, it’s not good Healthcare,” he said on Truth Social over the Thanksgiving weekend. “I’m seriously looking at alternatives. We had a couple of Republican Senators who campaigned for 6 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!”
Republicans came within a single vote of repealing the law in 2017. That’s when Sen. John McCain of Arizona voted with Democrats to keep Obamacare.
Is Trump asking for a do-over? He might first want to take a good look around him. In his home state of Florida, Obamacare is more popular than ever. A record 3.2 million people in Florida obtained health insurance under the Affordable Care Act — aka Obamacare — early this year, a 19% increase over the previous year. Nationwide, that number reached 15.7 million.
The Florida numbers have been fueled in part by South Florida, particularly Miami-Dade County, Doral and Republican-heavy Hialeah. Hialeah is the same spot, by the way, where Trump held his counter-rally on Nov. 8, as Florida Gov. Ron DeSantis and other contenders for the GOP presidential nomination participated in a debate across town in Miami.
Florida is among the 10 states that still haven’t expanded Medicaid, the government healthcare program for low-income adults, effectively pushing some of that population into Obamacare plans. Enrollment is continuing right now for 2024, which could be another record-setting year, according to the health policy research organization KFF.
In other words, Floridians, like many Americans, have embraced Obamacare. Is Trump out of step with what his followers want? Maybe. But he was careful to tap into areas of potential dissatisfaction — the quality of care provided under some Obamacare plans and the costs — that might find a sweet spot even with voters who have Obamacare plans. Who can be against better quality of healthcare? Or healthcare that costs less?
Talking isn’t doing, though, especially when it comes to Trump and Obamacare. We’ve lost track of how many times he vowed to repeal Obamacare during his term. He may indeed be “looking at alternatives” now but that’s no small thing. Creating a new way to insure people would be an incredibly complex undertaking. He’d be unwinding a system that was signed into law 13 years ago and is now relied upon by more than 15 million people — and for something as critical as healthcare.
Plus, some of the more controversial portions of the law have been removed — notably, the “individual mandate,” the fine that initially was assessed on people without health insurance.
At the same time, some parts of the plan have become well accepted: being able to keep children on your insurance until they are 26 years old; the provision that means health insurers can no longer charge you more or reject you for coverage because of pre-existing health conditions; coverage of birth control without out-of-pocket costs.
Remember “repeal and replace”? Republicans have long since distanced themselves from that old rallying cry. Replace with what, exactly? That was always the problem.
It’s hard to know whether Trump’s latest round of shaking his fist at Obamacare is a first step toward action or just one of many trial balloons he lobs at Republicans. But it’s clear what it is for Democrats: an opportunity. President Joe Biden’s reelection campaign moved quickly to capitalize on it, too, casting Trump as an extremist who would rip away healthcare from millions of Americans. Given the numbers of people enrolled in Obamacare plans, that may be a sound strategy.
Beyond campaign politics, there may be an upside for voters. All this talk of Obamacare has put the spotlight back on healthcare costs in this country. And that’s a conversation our government needs to have, no matter how we get there.
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