There are several ways President-elect Donald Trump could successively weaken or repeal the Affordable Care Act during his second term, NPR reports.
Trump, a longtime ACA opponent, suggested he would rework the landmark 2010 legislation known as Obamacare during his campaign. Republican lawmakers have also stated that revamping ACA would be a priority for the next administration, arguing that the law is too expensive and represents government overreach.
With Republicans holding a majority in both the House and Senate, the path to weakening AKA, which could include curtailing the law's Medicaid expansion, raising the uninsured rate, diminishing patient protections, increasing premium costs for millions of people, and more, is more clear than ever.
Congress could change ACA without any Democratic support through a process called "reconciliation." Anti-ACA supporters could use budget reconciliation to gain lawmakers' approval to lower the share paid by the federal government for the expansion population. This would mostly affect higher-income adults and adults without children over traditional Medicaid beneficiaries like pregnant women, children, and people with disabilities.
Republicans could also weaken ACA by simply doing nothing. Temporary, enhanced subsidies that have reduced premium costs and led to the lowest rate of uninsured Americans in history are set to expire next year. Without congressional action, premiums would on average double for subsidized consumers in states using the federal ACA exchange. This means fewer people would be able to afford coverage through ACA.
Another option to weaken ACA includes Trump enacting executive orders.
"The early executive orders will give us a sense of policies that the administration plans to pursue," Allison Orris, a senior fellow at the Center on Budget and Policy Priorities, said in a statement. "Early signaling through executive orders will send a message about what guidance, regulations, and policy could follow."
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