Instead, the GOP lawmakers want Trump to focus on extending the tax cuts he signed into law at the end of 2017, which are due to expire at the end of next year.
The Affordable Care Act (ACA) has become engrained in the fabric of the nation’s health care system, as more than 21 million Americans selected health plans through the law’s insurance exchanges in 2024.
After Trump and congressional Republicans failed to repeal the law in 2017 by a single vote, its popularity soared. Democrats won back control of the House in the 2018 midterms in part by campaigning on protecting preexisting conditions.
When Trump was elected in November 2016, just 43 percent of adults supported ObamaCare, according to a tracking poll conducted by the nonpartisan health research group KFF. The most recent poll published in May showed 62 percent of respondents view the law favorably.
Trump declared at the Sept. 10 presidential debate that “ObamaCare was lousy health care” and pledged “we’re going to replace it” if he wins in November. But he added he would “only change it if we come up with something better and less expensive,” claiming that he has “concepts of a plan.”
But Republican senators see the health care debate as filled with political land mines, and they’re eager to avoid a reprise of the 2017 failure. GOP Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine), who voted with Democrats that year, are still in the Senate.
Still, health advocates have said another attempt at replacing the law could come down to how large a majority the GOP has. If there’s divided government, any Republican-led ACA action would be an uphill push.
Sen. Kevin Cramer (R-N.D.), a Trump ally who was serving in the House the last time Republicans debated major health care reform, said there are concepts like high-risk pools and giving states more freedom over Medicaid that could be explored, but only after tax reform.
“I think tax relief. It’s got to be tax policy,” Cramer said. “I just wouldn’t tackle [health care] as an overhaul or a repeal of ObamaCare. We do have to improve and make permanent the Tax Cuts and Jobs Act.”