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Obamacare 'Replacement' Might Look Familiar

News  |  By Kaiser Health News  
   November 10, 2016

Republicans promising change might not quickly admit it, but in some respects Obamacare's replacement may look something like the original.

This article first appeared November 9, 2016 on Kaiser Health News.

By Jay Hancock and Shefali Luthra

The Affordable Care Act transformed the medical system, expanding coverage to millions, injecting billions in tax revenue, changing insurance rules and launching ambitious experiments in quality and efficiency.

Less of that might disappear under President-elect Donald Trump's pledge to "repeal and replace Obamacare" than many believe, say policy analysts. Republicans promising change might not quickly admit it, but in some respects Obamacare's replacement may look something like the original.

"It gets into a questions of semantics," said Mark Rouck, an insurance analyst for Fitch Ratings. "Are they really repealing the act if they replace it with new legislation that has some of the same characteristics?"

Problems that helped give rise to the health law — rising costs, an aging population, mediocre medical results — haven't gone away. The ACA pushed insurers, hospitals and employers to launch their own reimbursement reforms, which are largely unaffected by who runs Washington.

Even fierce health-law opponents may pause at the political risk of taking benefits from millions who gained coverage since its implementation. Subsidies for the middle class to buy insurance may remain — even if they're not the Obamacare tax credits applied through online marketplaces, said Joseph Antos, a health economist at the American Enterprise Institute.

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Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.


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