WASHINGTON — Since becoming law in March 2010, the Patient Protection and Affordable Care Act, known more commonly as the ACA or Obamacare, has been a burr under the saddle of Republicans — and President Trump in particular.
While some Americans embraced the ACA as a vehicle for them to get insurance and for its various protections, namely the provision against preexisting conditions, some Americans, including Republicans in Congress, viewed Obamacare as too close to socialized medicine.
As soon as President Obama put his name on the bill, the GOP pledged to “repeal and replace” Obamacare, holding more than 50 votes to at least weaken the ACA or do away with it all together. Despite those efforts, the ACA remained law and then narrowly survived a challenge in the Supreme Court when Chief Justice John Roberts broke ranks with the conservative majority and voted to uphold the legislation.
Now, with Democrats in control of the House of Representatives and Nancy Pelosi speaker again, the prospects of the Republicans erasing Obama’s signature domestic legislation seem more and more unlikely.
In December, in a case brought forward by Republican states, a Texas district court ruled the ACA unconstitutional, an outcome that plays right into the hands of Democrats, who will use the GOP trying to do away with the protections against preexisting conditions — the most popular tenet of the ACA — as an election tactic for 2020. As this case works its way through the appeal process, and potentially to the Supreme Court, it could put Republicans up for reelection in 2020, especially those in less-red states, in the tricky position of defending Obama’s signature legislation or supporting the attacks on established health care legislation that many of their constituents, including those that voted for Trump, have come to rely on.
Pelosi and House Democrats have already seized on this opportunity by launching a legal effort to defend the ACA by asking a federal judge in Texas to allow the House to intervene in the case. If that request is granted, House Democrats could make legal arguments to protect Obamacare, further drawing battle lines for 2020.
Democrats are also running on lowering drug costs, another health care-related issue concerning to Americans and a campaign promise Trump has failed to deliver on thus far.
Earlier this month, in the wake of more price increases by drug firms Sen. Bernie Sanders (I., Vt.) and Rep. Elijah Cummings (D., Md.) have introduced a bill aimed at reining in drug prices.
The bill creates an “international pricing index” that would essentially set benchmarks for drug prices in the U.S. against those in Europe — an idea not dissimilar from what the Trump administration has floated. The Sanders and Cummings bill would also let the secretary of Health and Human Services negotiate prices under Medicare Part D, while allowing Americans to purchase medicines from Canada and other countries.