Now that the Republicans control both the presidency and both houses of Congress, they must put up or shut up on their promise to repeal and replace Obamacare. Here is a flat-footed prediction: the effort will fail for three reasons. First, the Affordable Care Act (aka the ACA or Obamacare) has largely succeeded not failed, as president-elect Trump and other Republicans falsely allege. Second, it is impossible for the stated goals of repeal to be achieved. Finally, the political fallout from the consequences of partial or total repeal would be devastating. When it comes to casting votes, enough Republicans will conclude that repeal is a bad idea and will join Democrats to sustain the basic structure of the health reform law.
First, let's review the facts on Obamacare's success. Tens of millions of people are newly insured. Even so, and whatever the reason, health care spending is better controlled than it has been for decades. Enrollments in the ACA's health marketplaces in 2017 are up. Insurance companies, who raised premiums this year, are expected to make money for the foreseeable future and continue to sell insurance in those market places. These facts contradict the claims of president-elect Trump and other Republicans that the marketplaces will collapse. More and more states, including some with Republican governors, are opting to expand Medicaid eligibility as authorized by the law. Quality indicators are improving.Those facts spell success, not failure.
