The GOP's Health Care Headache: Why Republicans Can't Let Go of the Past

The Affordable Care Act (ACA), often called Obamacare, has become a major political challenge for Republicans.

Growing Popularity and Recent Setbacks

• 57% of Americans now support the ACA.
• GOP voted to let key subsidies expire, potentially leading to significant premium hikes for over 20 million people.
• This decision could affect the party's standing in the 2026 midterm elections.

Republicans' Struggle with Health Care Politics

• Unlike other conservative parties worldwide, the GOP remains opposed to expanding access to universal health coverage.
• More Americans now believe health care is a government responsibility.

Challenges in the U.S. System

• The legislative process requires multiple majorities.
• The Senate gives conservatives disproportionate power.
• The employer-based insurance system, which emerged during World War II, complicates reforms.
• Congress has historically prioritized preserving insurance for those who have it over extending benefits to the uninsured.

The ACA's Breakthrough

• The ACA maintained the employer-based system while expanding coverage options.
• It provided Medicaid for low-income workers and subsidized coverage for higher-income individuals without employer coverage.
• Despite Republican predictions of failure, the exchanges worked well, drawing millions of customers and bending the health-care-cost curve downward.

Republicans' Response

• Republicans have yet to adjust to the changed political landscape.
• Taking away or making insurance more expensive is far more challenging than blocking reform efforts.
• Some Republicans, like House Speaker Mike Johnson, dismiss the ACA's success, calling it a "broken system" and ignoring its 24 million beneficiaries.

Former President Trump's Struggles

• Trump promised to "repeal and replace" the ACA with a better, cheaper system, but this proved impossible.
• In his second term, he suggested giving people money directly to buy insurance, ignoring the complexities of medical care and the need for insurance.

Political Consequences

• The GOP's refusal to adapt to the ACA's success could have significant political consequences.
• Until Republicans acknowledge the importance of health care access, they risk alienating millions of Americans who benefit from the ACA.