What Donald Trump Could Do to Obamacare

November 11th 2016

Kyle Jaeger

President-elect Donald Trump made repeated promises on the campaign trail to repeal President Barack Obama's signature health care reform legislation, colloquially referred to as Obamacare. But accomplishing that is easier said than done, according to health care policy experts.


Trump has already signaled that he plans to keep certain provisions of the Affordable Care Act — including a mandate that prevents insurers from denying coverage to patients with preexisting conditions and another that allows young people to remain on their parents' plan until they turn 26, The Wall Street Journal reported. Amending the law will be much simpler than repealing it outright.

That said, there are at least three steps Trump could take immediately on Obamacare.

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Trump could "drop appeals against last May's federal court ruling that said the Obama administration was illegally paying insurance companies to help keep health insurance costs down for low-income clients" and "stop fighting lawsuits against the mandate that employers pay for birth control for women covered under their insurance plans," NBC News reported.

He could also instruct the U.S. Department of Health and Human Services to cease any promotion of the open enrollment period for Obamacare, which ends shortly after the inauguration ceremony in January.

But repealing Obamacare will require congressional action — and Democrats will likely filibuster any such effort, even though Republicans retain a majority in the Senate.


Any attempt to eliminate Obamacare will almost certainly be met with resistance by Senate Democrats, who can filibuster the repeal legislation.

Republicans could anticipate that action and leverage it by blaming Democrats for obstructionism in an effort to gain more Senate seats in 2018. If they gain eight seats, it could enable them to overcome a Democratic filibuster.

Republicans in Congress can work, meanwhile, to amend specific aspects of the law through a "budget reconciliation process," Business Insider reported.

"Republicans can adjust only parts of the law that have to do with the federal government's finances. These parts include the funding for Medicaid expansion given to states, subsidies for people who receive their health insurance through the ACA marketplaces, and money for outreach to get Americans to sign up through the exchanges."

Trump included the repeal of Obamacare in his 100-day plan, but experts agreed that the likelihood of achieving this within the proposed timeline is highly unlikely.

In an outline of his health care plan, Trump did include several reform proposals — such as a drug price transparency requirement for insurers — that could presumably appeal to both parties and pass in Congress — but the prospect of a full repeal during his first term in office would demand bipartisan agreement.