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Why Obamacare repeal might be on the 2024 ballot after all

When Democrats tell voters that the future of the Affordable Care Act will be on the ballot in 2024, that’ll be far less hyperbolic than one might think.

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If all you saw was the headline, you’d think that Senate Minority Leader Mitch McConnell delivered good news to health care advocates this week. The Hill, for example, published a report with a headline that read, “ACA is here to stay, McConnell declares.”

But that’s not quite what he said. At a Capitol Hill press conference, a reporter noted that Donald Trump has raised the prospect of “repealing and replacing the Affordable Care Act,” and asked whether Republicans would “make another run at that” if voters put them in power after the 2024 elections. The GOP leader replied:

“We had a fight over that a few years ago, and if [Trump] can develop a base for revisiting that issue, obviously we’d take a look at it, but it seems to me that’s largely over.”

Much of the coverage focused on the “largely over” part of the answer, but it was the rest of the response that stood out for me.

To hear McConnell tell it, it’s “obvious” that Senate Republicans would “take a look at” scrapping the Affordable Care Act if Trump “can develop a base for revisiting that issue.” What the Kentucky senator didn’t mention is that Trump has given every indication that he intends to do exactly that.

As regular readers know, the former president has spent recent months repeatedly targeting Obamacare in increasingly explicit terms, and as recently as December, the Republican posted a video to his social media platform attacking the late Sen. John McCain for not helping him “terminate” the ACA in 2017.

The presumptive GOP nominee soon after vowed to tear down the nation’s existing health care system and replace it with something he said would be “better” — though his assurances didn’t include any details.

What’s more, as we’ve discussed, some congressional Republicans have already added their voices to this debate. Republican Sen. John Cornyn of Texas — who’s running to succeed McConnell as the party’s leader — told Axios in late November, “I think Obamacare has been one of the biggest deceptions on the American people. I mean just look at your health care premiums.” (Premium costs, in reality, have gone down, not up.)

The same report added that Republican Sen. Mike Crapo of Idaho, who’d likely chair the Senate Finance Committee if the GOP retakes control of the chamber, also said he’s open to repeal-and-replace plans.

All of which suggests when Democrats tell voters that the future of the Affordable Care Act will be on the ballot in 2024, that’ll be far less hyperbolic than one might think.

But even if one is skeptical about Republicans making such an effort, let’s also not forget that President Joe Biden and congressional Democrats have vastly expanded ACA subsidies to make premiums more affordable — but those subsidies are set to expire in 2025.

If the GOP runs the table and has control over the levers of power next year, does anyone seriously believe they’ll be prepared to invest billions to extend Democratic benefits?

Health care might not seem like a front-burner issue in the 2024 elections, but that might soon change.

This post updates our related earlier coverage.

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