'Obamacare' is once again at serious risk

Are you better off than you were 14 years ago? If you are one of the millions of Americans who have a pre-existing condition and don't have a job that offers health benefits, the answer is overwhelmingly yes.

Because? Because before the Affordable Care Act (ACA), also known as

Obamacare

—signed into law on March 23, 2010, though many of its provisions didn't go into effect until 2014—you probably wouldn't have been able to get a medical insurance. Today it does, thanks to provisions in the law that prevent insurers from discriminating based on medical history and that subsidize the insurance policies of many Americans. (These subsidies also give healthy people an incentive to purchase insurance, which improves risk pooling.)

And President Joe Biden has strengthened the program, specifically expanding provisions that eliminated the “gap” that deprived many middle-class Americans of aid. But in the near future, they may lose that hard-earned access. In 2017, Donald Trump and congressional Republicans tried to destroy the ACA and almost succeeded in passing a bill that, according to the Congressional Budget Office, would have left an additional 22 million Americans uninsured by 2026. There are many reasons. to believe that if the Republican Party wins control of Congress and the White House in November, it will once again try to bring back the bad old days of health coverage. And he will probably succeed, having failed in 2017 only thanks to a principled stand by John McCain, something unlikely to happen in today's Republican Party, where slavish obedience to Trump is universal.

Before we get to politics, let's talk about what

Obamacare

has accomplished .

During the Obama era, voices on the right made many dire predictions about its effects. They claimed that the law would not really expand coverage, that it would be a fiscal disaster and a threat to jobs. None of these predictions came true. The percentage of Americans without health insurance has dropped nearly in half since 2010. Federal spending on health programs, far from skyrocketing, has grown much more slowly than expected. In 2010, the budget office projected that outlays on major mandatory health programs would reach 10% of GDP by the mid-2030s and “continue to increase thereafter”; now predicts that figure will be less than 7%. As for jobs, the employment rate among working-age Americans is at its highest level in more than two decades.

And

Obamacare

, initially a political liability for Democrats, is now quite popular. In fact, the Republican attempt to cut the law, which narrowly failed, likely played a major role in the Democratic success in the 2018 midterm elections.

So why is this success story in grave danger? First, it is worth remembering that Trump, in addition to his poisonous attitude toward immigrants and his protectionist instincts, has demonstrated that he neither knows nor cares much about the details of policy. Last week he posted a rant about how an “invasion” of immigrants is “killing Social Security and Medicare,” which is the opposite of the truth, as well as a demonstration that he has little idea how even government programs work. bigger and more important. When he was in office, Trump was a puppet in the hands of right-wing economic ideologues, who really know how to write legislation that furthers their goals; About his only major budget initiatives were a tax cut for the rich and corporations, which passed, and the attempt to gut Obamacare

,

which fell short.

And what we know is that, although Trump likes to present himself as a populist, right-wing economic ideology continues to prevail among congressional Republicans, who are as eager as ever to effectively destroy Obamacare

.

Last week, the Republican Study Committee, which includes most Republican members of the House of Representatives, released a budget proposal that laid out many of the 2017 “reforms” that would have caused millions of Americans to lose health coverage. .

What strikes me about the budget proposal is the way its authors address the fact that none of the dire predictions the right made about

Obamacare

have come true. The answer is that they just pretend that the bad things they predicted that didn't happen did. I am surprised, for example, by the claim that

Obamacare

“dramatically intensified the unsustainable increase in American health spending.” In fact, in 2010, total health spending in the United States was 17.2% of GDP. In 2022, that figure had increased to... 17.3% of GDP. So the reality of

Obamacare

's success will not deter Republicans who want to destroy it. If anything, the success of the law only increases their determination to end it, because it shows that, contrary to their ideology, the Government can really improve the lives of Americans. And Trump will humor them, egg them on, because improving the lives of Americans is not his main objective.

Ultimately, the right would like to destroy America's entire security network. But they will probably start with

Obamacare

; If they sweep this year, I wouldn't be surprised if the program actually disappears between now and 2026.

Paul Krugman

is a Nobel Prize winner in Economics. © The New York Times, 2024. News Clips Translation

Follow all the information on

Economy

and

Business

on

Facebook

and

X

, or in our

weekly newsletter

Subscribe to continue reading

Read without limits

Keep reading

I am already a subscriber

_