The Patient Protection and Affordable Care Act (ACA), also known as Obamacare, was a lightning rod for controversy during this year’s presidential campaign. Hillary Clinton pledged to expand aspects of the plan. By contrast, President-elect Donald Trump promised a complete repeal, saying, “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.” Vice President-elect Pence echoed this sentiment, saying, “…Donald Trump and I are going to repeal Obamacare lock, stock and barrel.” Approximately 22 million people would lose insurance coverage following the repeal of the ACA.

While we do not know exactly what lies ahead, we are taking a closer look at the future of health insurance based on current information.

Signed into law by President Obama in 2010, the intent of the ACA was to increase health insurance quality while reducing the cost of health care. The ACA currently:

  • provides no-cost preventive health care services;
  • allows young adults to stay covered under their parents’ plan until they are 26 years old;
  • gives seniors who reach the Medicare Part D coverage gap (the “donut hole”) a 50% discount on brand-name prescription drugs;
  • allows states to cover more low-income people under Medicaid; and
  • makes it illegal for insurance companies to: deny coverage to people with pre-existing conditions, cancel policies when people get sick, or impose annual or lifetime dollar limits on coverage.

Although the ACA has withstood dozens of attempts at repeal, the Republican Party now controls the Executive Branch, the US Senate and the US House of Representatives, which will make it easier for Republican-sponsored legislation to be enacted into law. Additionally, the Senate Majority Leader, the Speaker of the House and the President-elect agree that along with jobs and immigration, repeal of the ACA is a top priority. The President-elect has offered his own plan in its place, which:

  • permits the sale of insurance across state lines;
  • allows individuals to deduct health insurance premiums from their taxes;
  • allows individuals to use Health Savings Accounts (HSAs);
  • requires price transparency from doctors, clinics, hospitals and other health care providers;
  • provides states with block grants to fund Medicaid; and
  • allows consumers to purchase cheaper drugs from overseas pharmaceutical companies.

While some patients would benefit from the provision making insurance premiums tax-deductible, for example, the written plan is silent as to pre-existing conditions, lifetime limits, and the ability for young adults to retain their parents’ coverage. In recent comments, however, Mr. Trump was receptive to keeping some features of Obamacare, saying that he was in favor of protecting individuals with pre-existing conditions and young adults on their parents’ plans.

And, although the election is over, you can still voice your opinion on the importance of health care coverage. Contact your elected federal and state officials (if you need help finding your federal representatives, visit our Policy Advocacy page). If you or a loved one depends on the ACA, your representatives need to hear from you. Together we will continue to press ahead in achieving care coverage for all who need it.

Adapted from “A Post-Election Update: Health Insurance in the U.S.” from Triage Cancer (November 10, 2016).